Medical Surveillance Program

Employers must provide a medical surveillance program for all employees who:

• Engage in Class I, II, or III work or are exposed at or above the permissible exposure limits (PEL) or short-term exposure limit (STEL) for a combined total of 30 or more days per year; or
• Wear negative-pressure respirators.

In addition, a licensed physician must perform or supervise all medical exams and procedures that the employer provides at no cost to their employees and at a reasonable time.

Employers must make medical exams and consultations available to employees as follows:

• Prior to employee assignment to an area where negative pressure respirators are worn;
• Within 10 working days after the 30th day of combined engagement in Class I, II, and III work and exposure at or above a permissible exposure limit, and at least annually thereafter; and
• When an examining physician suggests them more frequently.

If an employee was examined within the past 12 months and that exam meets the criteria of the standard, another medical exam is not required. Medical exams must include the following:

• Medical and work histories;
• Completion of a standardized questionnaire with the initial exam (see 29 CFR Part 1926.1101, Appendix D, Part 1) and an abbreviated standardized questionnaire with annual exams (see 29 CFR Part 1926.1101, Appendix D, Part 2);
• Physical exams focusing on the pulmonary and gastrointestinal systems; and
• Any other exams or tests deemed necessary by the examining physician.

Employers must provide the examining physician with the following:

• A copy of OSHA;s asbestos standard and its appendices D, E, and I;
• Description of the affected employee's duties relating to exposure;
• Employee's representative exposure level or anticipated exposure level;
• Description of any PPE and respiratory equipment used; and
• Information from previous medical exams not otherwise available.

It is the employer's responsibility to obtain the physician's written opinion containing results of the medical exam as well as the following information:

• Any medical conditions of the employee that increase health risks from asbestos exposure
• Any recommended limitations on the employee or protective equipment used
• A statement that the employee has been informed of the results of the medical exam and any medical conditions resulting from asbestos exposure
• A statement that the employee has been informed of the increased risk of lung cancer from the combined effect of smoking and asbestos exposure

Please note that a physician's written opinion must not reveal specific findings or diagnoses unrelated to occupational exposure to asbestos. The employer must provide a copy of the physician's written opinion to the employee involved within 30 days after receipt.

To learn more about Construction Asbestos Safety visit our Construction Asbestos Safety Online Training web page.