Chapter 16: Medical Surveillance

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Medical Surveillance (Monitoring)

Objectives: By the end of this section, participants will be able to determine the medical surveillance requirements for their operations.

Medical Monitoring is Required for:

Employees who are, or may be, exposed to PELs of hazardous substances or health hazards for 30 or more days/year;

Employees who wear a respirator for 30 or more days/year;

Members of organized HAZMAT teams;

Employees who are injured as a result of overexposure during a site emergency, or who show symptoms of illness that may have resulted from exposure to hazardous substances.

Examination Frequency
Examination Type	Baseline	Periodical	Termination	Unscheduled

History & Physical Exam
Complete Medical History	X	X	X	X
Physical Examination by Physician	X	X	X	X
Visual Acuity	X	X	X	O

Routine Lab Tests / Procedures
Pulmonary Function	X	X	X	O
Hearing Test	X	X	X	O
Electrocardiogram	X	O	X	O
Chest X-ray *	X	O	X	O
Complete Blood Count	X	X	X	O
Routine Urinalysis	X	X	X	O
Blood Chemistry	X	X	X	O

Special Tests
Cholinesterase	X	O	X	O
Methemoglobin	O	O	O	O
Heavy Metal Screen	X	O	O	O
Urine & Sputum Cytology	O	O	O	O
Polychlorinated Biphenyls (PCB)	O	O	O	O

Cardiovascular Stress Test	X	O	O	O

X: Recommended, O: As needed, * Chest x-rays are not repeated more than once per year. Any special test which may be considered on a periodic basis should be included in the baseline test. Source: Occupational Medical Monitoring Program Guidelines for SARA Hazardous Waste Field Activity Personnel (EPA, 1990, Publication 9285.3-04)

Medical Record Maintenance

Must be maintained for at least 30 years after employment is terminated.

Must include the name and Social Security number of the employee.

The physician’s written opinions including recommended occupational limitations and results of examinations and tests.

Any employee medical complaints related to occupational hazardous substance exposure.

Copy of the material that the attending physician was provided before the examination.

The employer is responsible for retaining the records if the employee or physician leaves the area or if the company moves, is acquired,or goes out of business.

Employers who maintain 11 or more employees must keep injury and illness records for each establishment.

Thought Questions:

How does the employee benefit from Medical Surveillance? How does the employer benefit from Medical Surveillance? Can both the employee and the employer benefit from Medical Surveillance?

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