HAZWOPER Medical Surveillance FAQs—Part 1
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Q: Which employees must employers include in a medical surveillance program?
A: According to 29 CFR 1910.120(f)(2)(i)–(iv), employees who meet the following requirements must be included in a medical surveillance program:
- All employees who are or may be exposed to hazardous substances or health hazards at or above the permissible exposure limits (PELs) or, if there is no permissible exposure limit, above the published exposure levels for these substances, without regard to the use of respirators, for 30 days or more a year (1910.120(f)(2)(i));
- All employees who wear a respirator for 30 days or more a year or as required by the personal protective equipment (PPE) regulations defined in 1910.134 (1910.120(f)(2)(ii));
- All employees who are injured, become ill, or develop signs or symptoms due to possible overexposure involving hazardous substances or health hazards from an emergency response or hazardous waste operation (1910.120(f)(2)(iii)); and
- Members of HAZMAT teams (1910.120(f)(2)(iv)).
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Q: Are volunteer members of an organized and designated HAZMAT team required to participate in medical surveillance or can they choose to opt out?
A: According to OSHA, under 29 CFR 1910.120(q)(9)(i), which covers emergency response to hazardous substance releases, HAZMAT team members and hazardous materials specialists “shall receive a baseline physical examination and be provided with medical surveillance as required in paragraph 1910.120(f) of this section.” This means that all HAZMAT team members taking part in emergency response operations covered by 1910.120(q)(9)(i) must receive a baseline physical exam and those that do not have the baseline exam may not perform emergency response duties as part of a HAZMAT team or as a hazardous materials expert. This applies whether the individual volunteers or is required by his or her employer to be a HAZMAT team member.
However, OSHA also clarified that while the baseline medical examination is mandatory for operations under 1910.120(q)(9)(i), continued medical surveillance is not, and HAZMAT team members and hazardous materials specialists may decline this additional participation. In this case, “OSHA recommends that the employer note the refusal in the employee’s work file.”
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Q: What, if any, information must employers provide to the physician providing medical examinations and consultations to covered employees?
A: Employers are required by 1910.120(f)(6) to provide a copy of 1910.120 and its appendices, as well as the following employee-specific information:
- A description of the employee’s duties as they relate to the employee’s exposures,
- The employee’s exposure levels or anticipated exposure levels,
- A description of any PPE used or intended for use,
- Information from previous medical examinations of the employee that is not readily available to the examining physician, and
- Information required by 1910.134, which covers medical requirements for employees that are required to use respirators.
Q: What records must be kept and should they be kept by the employer or the attending physician?
A: According to 112.120(f)(8), records of required medical surveillance must meet the requirements of 1910.1020 (covering access to employee exposure and medical records), be retained, and include, at a minimum, the following:
- The name and Social Security number of the employee,
- Physician’s written opinions, recommended limitations, and results of examinations and tests,
- Any employee medical complaints related to exposure to hazardous substances, and
- A copy of the information provided to the examining physician by the employer, with the exception of the standard and its appendices.
While the employer is responsible for establishing and maintaining a record for each employee covered by the medical surveillance requirements, OSHA notes: “In actual practice, the physician’s office maintains physical custody of the records under agreement with the employer. Procedures need to be established to allow access, storage, transfer, and disposal of these records in accordance with 29 CFR 1910.1020, while keeping personal medical information confidential.”