Lead - Medical Surveillance

When monitoring shows that employees are exposed above the action level, employers must make available, at no cost to the employee, initial medical surveillance. This initial medical surveillance consists of blood sampling and analysis for lead and zinc protoporyrin (ZPP) levels. In addition, a medical surveillance program with biological monitoring must be made available to any employee exposed at or above the action level for more than 30 days in any consecutive 12 months.

An employer is required to remove an employee from work during the following circumstances:

• Each time periodic and follow-up blood sampling tests indicate that the employee's blood level is at or above 50 micrograms per deciliter of blood (50 µg/dl)
• When a final medical determination indicates that the employee needs reduced lead exposure for medical reasons

An employer may return an employee to former job status when two consecutive blood sampling tests indicate that the employee's blood lead level is below 40 micrograms per deciliter of blood (40 µg/dl).

The employer must provide up to 18 months of medical removal protection benefits each time an employee is removed from lead exposure or medically limited. This means that as long as the employee's position exists, the employer must maintain the earnings, seniority, and other employment rights and benefits as though the employee had not been removed from the job or otherwise medically limited.

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