Medical surveilliance WAC 296-824-400 Emergency Response

Emergency Response

Chapter 296-824, WAC

Effective Date: 10/01/02

Contents

Helpful Tools

Index

Download

Medical surveilliance

WAC 296-824-400

For printing

Summary

Your responsibility:

To provide and document medical surveillance for your employees

You must

Provide medical surveillance to employees	WAC 296-824-40005
Keep records	WAC 296-824-40010

Rules

WAC 296-824-40005

Provide medical surveillance to employees

You must

(1) Provide medical surveillance for employees to comply with Tables 7 and 8, and the
following:

Make medical surveillance available at:

- Reasonable times and places.
- No cost to employees, including travel associated costs such as mileage, gas or
bus fare if the employee is required to travel off site.
and
- Wages for additional time spent outside of employees' normal work hours.

Make sure a licensed physician performs or supervises exams and procedures.
Give complete information to the examining physician including:

- A copy of this chapter.
- A description of the employee's duties that relate to hazardous substance
exposure.
- The hazardous substance exposure levels anticipated for the employee.
- A description of the personal protective equipment (PPE) the employee could use.
- Information available from previous medical examinations.
- The medical evaluation information required by
chapter 296-842 WAC, Respirators.

Medical exams must include, at a minimum:

- A medical history
- A work history (or updated history if on file)
- A special emphasis on:

Assessment of symptoms related to handling hazardous substances
Health hazards
Evaluation of fitness for duty (including the ability to wear any PPE or other conditions that may be expected at the workplace)

- Other content as determined by the examining physician.

Note:

The physician should consult the Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities and the Medical Management Guidelines for Acute Chemical Exposure (search OSHA website: http://www.osha.gov).

(2) Obtain the physician's written opinion and give a copy to the employee that includes:

A statement of whether or not medical conditions were found which would increase the employee's risk for impairment during emergency response work or respirator use.

- Don't include specific findings or diagnoses unrelated to occupational exposures.

Limitations recommended to the employee's assigned work, if any.
Exam and test results if the employee requests this information.
A statement that affirms the employee has been confidentially informed of medical exam results (including medical conditions requiring follow-up).

Table 7

Medical Surveillance for Employee Categories

If the employee is covered by this chapter and is...	Then you must...
Exposed at least for 30 days a year to health hazards or hazardous substances at or above the permissible exposure limit or published exposure levels (even when respirators are used), OR Required to wear a respirator for at least 30 days a year*	Offer standard medical surveillance as specified in Table 8*
A hazardous materials (HAZMAT) team member. A hazardous materials specialist	Provide standard medical surveillance as specified in Table 8
An emergency responder who shows immediate or delayed signs or symptoms possibly resulting from exposure to hazardous substances during an incident	Provide incident-specific medical surveillance as specified in Table 8
Not an emergency responder and: - May be injured - Show immediate or delayed signs or symptoms possibly resulting from exposure to hazardous substances - May have been exposed to hazardous substances at concentrations above the permissible exposure limits (PELs) or the published exposure levels without appropriate PPE	Offer incident-specific medical surveillance as specified in Table 8

Note:

A medical evaluation for respirator use is required by
chapter 296-842 WAC, Respirators, for those employees who have not been cleared for respirator use during medical surveillance activities.

Table 8
Frequency of Exams and Consultations

If the employee is covered by...	Then medical surveillance must include...
Standard medical surveillance	Exams and consultations: - Before assignment Note: If the employee is a hazardous materials (HAZMAT) team member or a hazardous materials specialist, the employee must receive a baseline physical examination - At least once every 12 months after their initial assignment unless the physician believes a shorter, or longer interval (but no more than 24 months) is appropriate - Whenever employees are reassigned to an area where they will no longer be covered by medical surveillance and they haven't been examined within the past 6 months - As soon as possible after an employee reports: Signs or symptoms of possible overexposure to hazardous substances or health hazards Injury Exposure above the permissible exposure limits or published exposure levels - At the termination of their employment unless they were examined within the past 6 months
Incident-specific medical surveillance	Medical consultations and exams: - As soon as possible following the incident or development of signs or symptoms - At additional times, if the physician determines follow-up is medically necessary

WAC 296-824-40010

Keep Records

You must

Keep a record of:

- Name and Social Security number of the employee receiving medical surveillance
- Physicians' written opinions, recommended limitations, and results of examinations and tests
- Any employee medical complaints regarding hazardous substance exposures
- A copy of all information given to the examining physician (except a copy of this chapter)

Note:

Keep records meeting the criteria specified in Chapter 296-62 WAC, Part B, Access to Records, for the length of time specified in that chapter.

Labor & Industries (L&I), Washington State

Rules & Policies

Emergency Response

Chapter 296-824, WAC

Medical surveilliance

To provide and document medical surveillance for your employees

Provide medical surveillance to employees

Keep Records