This standard applies
to all occupational exposures to cadmium and cadmium compounds,
in all forms, and in all industries covered by the Washington
Industrial Safety and Health Act, except the construction-related
industries, which are covered under WAC
296-155-174.
(1) “Action
level” (AL) is defined as an airborne concentration
of cadmium of 2.5 micrograms per cubic meter of air (2.5 µg/m3),
calculated as an 8-hour time-weighted average (TWA).
(2) “Authorized
person” means any person authorized by the employer
and required by work duties to be present in regulated areas or
any person authorized by the WISH Act or regulations issued under
it to be in regulated areas.
(3) “Director”
means the director of the department of labor and industries,
or authorized representatives.
(4) “Employee
exposure” and similar language referring to the air
cadmium level to which an employee is exposed means the exposure
to airborne cadmium that would occur if the employee were not
using respiratory protective equipment.
(5) “Final
medical determination” is the written medical opinion
of the employee's health status by the examining physician under
WAC
296-62-07423(3) through (12) or, if multiple physician review
under
WAC 296-62-07423(13) or the alternative physician determination
under WAC
296-62-07423(14) is invoked, it is the final, written medical
finding, recommendation or determination that emerges from that
process.
(6) High-efficiency
particulate air (HEPA) filter means a filter capable of trapping
and retaining at least 99.97 percent of mono-dispersed particles
of 0.3 micrometers in diameter.
(7) Regulated area
means an area demarcated by the employer where an employee's exposure
to airborne concentrations of cadmium exceeds, or can reasonably
be expected to exceed the permissible exposure limit (PEL).
WAC
296-62-07405 Permissible exposure limit (PEL).
The employer shall assure that no employee
is exposed to an airborne concentration of cadmium in excess of
five micrograms per cubic meter of air (5 µg/m3), calculated
as an 8-hour time-weighted average exposure (TWA).
(a) Each employer who has a workplace
or work operation covered by this section shall determine if
any employee may be exposed to cadmium at or above the action
level.
(b) Determinations of employee exposure
shall be made from breathing zone air samples that reflect the
monitored employee's regular, daily 8-hour TWA exposure to cadmium.
(c) 8-hour TWA exposures shall be determined
for each employee on the basis of one or more personal breathing
zone air samples reflecting full shift exposure on each shift,
for each job classification, in each work area. Where several
employees perform the same job tasks, in the same job classification,
on the same shift, in the same work area, and the length, duration,
and level of cadmium exposures are similar, an employer may
sample a representative fraction of the employees instead of
all employees in order to meet this requirement. In representative
sampling, the employer shall sample the employee(s) expected
to have the highest cadmium exposures.
(2) Specific.
(a) Initial monitoring. Except as provided
for in (b) and (c) of this subsection, the employer shall monitor
employee exposures and shall base initial determinations on
the monitoring results.
(b) Where the employer has monitored after
September 14, 1991, under conditions that in all important aspects
closely resemble those currently prevailing and where that monitoring
satisfies all other requirements of this section, including
the accuracy and confidence levels of subsection (6) of this
section, the employer may rely on such earlier monitoring results
to satisfy the requirements of WAC
296-62-07427 (2)(a).
(c)
Where the employer has objective data, as defined in WAC
296-62-07427(2), demonstrating that employee exposure to
cadmium will not exceed the action level under the expected
conditions of processing, use, or handling, the employer may
rely upon such data instead of implementing initial monitoring.
(3) Monitoring
frequency (periodic monitoring).
(a) If the initial monitoring or periodic
monitoring reveals employee exposures to be at or above the
action level, the employer shall monitor at a frequency and
pattern needed to represent the levels of exposure of employees
and where exposures are above the PEL to assure the adequacy
of respiratory selection and the effectiveness of engineering
and work-practice controls. However, such exposure monitoring
shall be performed at least every six months. The employer,
at a minimum, shall continue these semiannual measurements unless
and until the conditions set out in (b) of this subsection are
met.
(b) If the initial monitoring or the periodic
monitoring indicates that employee exposures are below the action
level and that result is confirmed by the results of another
monitoring taken at least seven days later, the employer
may discontinue the monitoring for those employees whose exposures
are represented by such monitoring.
(4) Additional monitoring. The employer
also shall institute the exposure monitoring required under (2)(a)
and (3) of this section whenever there has been a change in the
raw materials, equipment, personnel, work-practices, or finished
products that may result in additional employees being exposed
to cadmium at or above the action level or in employees already
exposed to cadmium at or above the action level being exposed
above the PEL, or
whenever the employer has any reason to
suspect that any other change might result in such further exposure.
(5) Employee
notification of monitoring results.
(a) Within fifteen working days after
the receipt of the results of any monitoring performed under
this section, the employer shall notify each affected employee
individually in writing of the results. In addition, within
the same time period the employer shall post the results of
the exposure monitoring in an appropriate location that is accessible
to all affected employees.
(b) Wherever monitoring results indicate
that employee exposure exceeds the PEL, the employer shall include
in the written notice a statement that the PEL has been exceeded
and a description of the corrective action being taken by the
employer to reduce employee exposure to or below the PEL.
(6) Accuracy of measurement. The
employer shall use a method of monitoring and analysis that has
an accuracy of not less than plus or minus twenty-five percent,
with a confidence level of ninety-five percent, for airborne concentrations
of cadmium at or above the action level, the permissible exposure
limit (PEL), and the separate engineering control
(1) Establishment. The employer shall
establish a regulated area wherever an employee's exposure to
airborne concentrations of cadmium is, or can reasonably be expected
to be in excess of the permissible exposure limit (PEL).
(2) Demarcation. Regulated areas
shall be demarcated from the rest of the workplace in any manner
that adequately establishes and alerts employees of the boundaries
of the regulated area.
(3) Access. Access to regulated areas
shall be limited to authorized persons.
(4) Provision of respirators. Each
person entering a regulated area shall be supplied with and required
to use a respirator, selected in accordance with WAC
296-62-07413(2).
(5) Prohibited activities. The employer
shall assure that employees do not eat, drink, smoke, chew tobacco
or gum, or apply cosmetics in regulated areas, carry the products
associated with these activities into regulated areas, or store
such products in those areas.
(a) Except as specified in (b), (c), and
(d) of this subsection, the employer shall implement engineering
and work-practice controls to reduce and maintain employee exposure
to cadmium at or below the PEL, except to the extent that the
employer can demonstrate that such controls are not feasible.
(b) Except as specified in (c) and (d)
of this subsection, in industries where a separate engineering
control air limit (SECAL) has been specified for particular
processes (Table 1 of this subsection), the employer shall implement
engineering and work-practice controls to reduce and maintain
employee exposure at or below the SECAL, except to the extent
that the employer can demonstrate that such controls are not
feasible.
Table 1. --Separate Engineering
Control Airborne Limits (SECALs) for Processes in Selected Industries
(SECALs)
Process
SECAL
(µg/m3)
Nickel Cadmium battery
Plate making, plate preparation
All other processes
* Processes in these industries that are
not specified in this table must achieve the PEL using engineering
controls and work-practices as required in (a) of this subsection.
(c) The requirement to implement engineering
and work-practice controls to achieve the PEL or, where applicable,
the SECAL does not apply where the employer demonstrates the
following:
(i) The employee is only intermittently
exposed; and
(ii) The employee is not exposed above
the PEL on thirty or more days per year (twelve consecutive
months).
(d) Wherever engineering and work-practice
controls are required and are not sufficient to reduce employee
exposure to or below the PEL or, where applicable, the SECAL,
the employer nonetheless shall implement such controls to reduce
exposures to the lowest levels achievable.
The employer shall supplement such controls
with respiratory protection that complies with the requirements
of WAC
296-62-07413 and the PEL.
(e) The employer shall not use employee
rotation as a method of compliance.
(2) Compliance
program.
(a) Where the PEL is exceeded, the employer
shall establish and implement a written compliance program to
reduce employee exposure to or below the PEL by means of engineering
and work-practice controls, as required by subsection (1) of
this section. To the extent that engineering and work-practice
controls
cannot reduce exposures to or below the
PEL, the employer shall include in the written compliance program
the use of appropriate respiratory protection to achieve compliance
with the PEL.
(b) Written compliance programs shall
include at least the following:
(i) A description of each operation
in which cadmium is emitted; e.g., machinery used, material
processed, controls in place, crew size, employee job responsibilities,
operating procedures, and maintenance practices;
(ii) A description of the specific means
that will be employed to achieve compliance, including engineering
plans and studies
used to determine methods selected for
controlling exposure to cadmium, as well as, where necessary,
the use of appropriate respiratory protection to achieve the
PEL;
(iii) A report of the technology considered
in meeting the PEL;
(iv) Air monitoring data that document
the sources of cadmium emissions;
(v) A detailed schedule for implementation
of the program, including documentation such as copies of
purchase orders for equipment, construction contracts, etc.;
(vii) A written plan for emergency situations,
as specified in WAC
296-62-07415; and
(viii) Other relevant information.
(c) The written compliance programs shall
be reviewed and updated at least annually, or more often if
necessary, to reflect significant changes in the employer's
compliance status.
(d) Written compliance programs shall
be provided upon request for examination and copying to affected
employees, designated employee representatives, and the director.
(3) Mechanical
ventilation.
(a) When ventilation is used to control
exposure, measurements that demonstrate the effectiveness of
the system in controlling exposure, such as capture velocity,
duct velocity, or static pressure shall be made as necessary
to maintain its effectiveness.
(b) Measurements of the system's effectiveness
in controlling exposure shall be made as necessary within five
working days of any change in production, process, or control
that might result in a significant increase in employee exposure
to cadmium.
(c) Recirculation of air. If air from
exhaust ventilation is recirculated into the workplace, the
system shall have a high efficiency filter and be monitored
to assure effectiveness.
(d) Procedures shall be developed and
implemented to minimize employee exposure to cadmium when maintenance
of ventilation systems and changing of filters is being conducted.
(1) General. For employees who use
respirators required by this section, the employer must provide
respirators that comply with the requirements of this subsection.
Respirators must be used during:
(a) Periods necessary to install or implement
feasible engineering and work-practice controls when employee
exposure levels exceed the PEL;
(b) Maintenance and repair activities,
and brief or intermittent operations, where employee exposures
exceed the PEL and engineering and work-practice controls are
not feasible or are not required;
(c) Activities in regulated areas as specified
in WAC
296-62-07409;
(d) Work operations for which the employer
has implemented all feasible engineering and work-practice controls
and such controls are not sufficient to reduce employee exposures
to or below the PEL;
(e) Work operations for which an employee
who is exposed to cadmium at or above the action level, and
the employee requests a respirator;
(f) Work operations for which an employee
is exposed above the PEL and engineering controls are not required
by WAC
296-62-07411(1)(b); and
(g) Emergencies.
(2) Respirator
program.
(a) The employer must develop, implement
and maintain a respiratory protection program as required by
chapter 296-842
WAC, Respirators.
(b) No employees must use a respirator
if, based on their recent medical examination, the examining
physician determines that they will be unable to continue to
function normally while using a respirator. If the physician
determines that the employee must be limited in, or removed
from, their current job because of their inability to use a
respirator, the limitation or removal must be in accordance
with WAC
296-62-07423(11) and (12).
(c) If an employee has breathing difficulty
during fit testing or respirator use, the employer must provide
the employee with a medical examination as required by WAC
296-62-07423(6)(b) to determine if the employee can use
a respirator while performing the required duties.
(3) Respirator selection. The
employer must:
(a) Select and provide the appropriate
respirator as specified in this section and WAC 296-842-13005,
found in the respirator rule.
(i) Provide employees with full-facepiece
respirators when they experience eye irritation.
(ii) Make sure high-efficiency particulate
air (HEPA) filters or N-, R-, or P-100 series filters are
provided for powered air-purifying respirators (PAPRs) and
negative-pressure air-purifying respirators.
(b) Provide an employee with a powered,
air-purifying respirator (PAPR) instead of a negative-pressure
respirator when an employee who is entitled to a respirator
chooses to use this type of respirator, and such a respirator
provides adequate protection to the employee.
WAC
296-62-07415 Emergency situations.
The employer shall develop and implement a written plan
for dealing with emergency situations involving substantial releases
of airborne cadmium. The plan shall include provisions for the
use of appropriate respirators and personal protective equipment.
In addition, employees not essential to
correcting the emergency situation shall be restricted from
the area and normal operations halted in that area until the
emergency is abated.
(1) Provision and use. If an employee
is exposed to airborne cadmium above the PEL or where skin or
eye irritation is associated with cadmium exposure at any level,
the employer shall provide at no cost to the employee, and assure
that the employee uses, appropriate protective work clothing
and equipment that prevents contamination of the employee and
the employee's garments.
Protective work clothing and equipment
includes, but is not limited to:
(a) Coveralls or similar full-body work
clothing;
(b) Gloves, head coverings, and boots
or foot coverings; and
(c) Face shields, vented goggles, or
other appropriate protective equipment that complies with
WAC
296-800-160.
(2) Removal
and storage.
(a) The employer shall assure that employees
remove all protective clothing and equipment contaminated
with cadmium at the completion of the work shift and do so
only in change rooms provided in accordance with WAC
296-62-07419(1).
(b) The employer shall assure that no
employee takes cadmium-contaminated protective clothing or
equipment from the workplace, except for employees authorized
to do so for purposes of laundering, cleaning, maintaining,
or disposing of cadmium contaminated protective clothing and
equipment
at an appropriate location or facility
away from the workplace.
(c) The employer shall assure that contaminated
protective clothing and equipment, when removed for laundering,
cleaning, maintenance, or disposal, is placed and stored in
sealed, impermeable bags or other closed, impermeable containers
that are designed to prevent dispersion of cadmium dust.
(d) The employer shall assure that bags
or containers of contaminated protective clothing and equipment
that are to be taken out of the change rooms or the workplace
for laundering, cleaning, maintenance, or disposal shall bear
labels in accordance with WAC
296-62-07425(3).
(3) Cleaning,
replacement, and disposal.
(a) The employer shall provide the protective
clothing and equipment required by subsection (1) of this
section in a clean and dry condition as often as necessary
to maintain its effectiveness, but in any event at least weekly.
The employer is responsible for cleaning and laundering the
protective clothing and equipment required by this paragraph
to maintain its effectiveness and is also responsible for
disposing of such clothing and equipment.
(b) The employer also is responsible
for repairing or replacing required protective clothing and
equipment as needed to maintain its effectiveness. When rips
or tears are detected while an employee is working they shall
be immediately mended, or the worksuit shall be immediately
replaced.
(c) The employer shall prohibit the
removal of cadmium from protective clothing and equipment
by blowing, shaking, or any other means that disperses cadmium
into the air.
(d) The employer shall assure that any
laundering of contaminated clothing or cleaning of contaminated
equipment in the workplace is done in a manner that prevents
the release of airborne cadmium in excess of the permissible
exposure limit prescribed in WAC
296-62-07405.
(e) The employer shall inform any person
who launders or cleans protective clothing or equipment contaminated
with cadmium of the potentially harmful effects of exposure
to cadmium and that the clothing and equipment should be laundered
or cleaned in a manner to effectively prevent the release
of airborne cadmium in excess of the PEL.
(1) General. For employees whose
airborne exposure to cadmium is above the PEL, the employer
shall provide clean change rooms, handwashing facilities, showers,
and lunchroom facilities that comply with WAC
296-800-230.
(2) Change rooms. The employer
shall assure that change rooms are equipped with separate storage
facilities for street clothes and for protective clothing and
equipment, which are designed to prevent dispersion of cadmium
and contamination of the employee's street clothes.
(3) Showers
and handwashing facilities.
(a) The employer shall assure that employees
who are exposed to cadmium above the PEL shower during the
end of the work shift.
(b) The employer shall assure that employees
whose airborne exposure to cadmium is above the PEL wash their
hands and faces prior to eating, drinking, smoking, chewing
tobacco or gum, or applying cosmetics.
(4) Lunchroom
facilities.
(a) The employer shall assure that the
lunchroom facilities are readily accessible to employees,
that tables for eating are maintained free of cadmium, and
that no employee in a lunchroom facility is exposed at any
time to cadmium at or above a concentration of 2.5 µg/m3.
(b) The employer shall assure that employees
do not enter lunchroom facilities with protective work clothing
or equipment unless surface cadmium has been removed from
the clothing and equipment by HEPA vacuuming or some other
method that removes cadmium dust without dispersing it.
(1) All surfaces shall be maintained as
free as practicable of accumulations of cadmium.
(2) All spills and sudden releases of
material containing cadmium shall be cleaned up as soon as possible.
(3) Surfaces contaminated with cadmium
shall, wherever possible, be cleaned by vacuuming or other methods
that minimize the likelihood of cadmium becoming airborne.
(4) HEPA-filtered vacuuming equipment
or equally effective filtration methods shall be used for vacuuming.
The equipment shall be used and emptied in a manner that minimizes
the reentry of cadmium into the workplace.
(5) Shoveling, dry or wet sweeping, and
brushing may be used only where vacuuming or other methods that
minimize the likelihood of cadmium becoming airborne have been
tried and found not to be effective.
(6) Compressed air shall not be used to
remove cadmium from any surface unless the compressed air is
used in conjunction with a ventilation system designed to capture
the dust cloud created by the compressed air.
(7) Waste, scrap, debris, bags, containers,
personal protective equipment, and clothing contaminated with
cadmium and consigned for disposal must be collected and disposed
of in sealed impermeable bags or other closed, impermeable containers.
These bags and containers must be labeled in accordance with
WAC
296-62-07425(3).
(i) Currently exposed. The employer
shall institute a medical surveillance program for all employees
who are or may be exposed to cadmium at or above the action
level unless the employer demonstrates that the employee
is not, and will not be, exposed at or above the action
level on thirty or more days per year (twelve consecutive
months); and
(ii) Previously exposed. The employer
shall also institute a medical surveillance program for
all employees who prior to the effective date of this section
might previously have been exposed to cadmium at or above
the action level by the employer, unless the employer demonstrates
that the employee did not prior to the effective date of
this section work for the employer in jobs with exposure
to cadmium for an aggregated total of more than sixty months.
(b) To determine an employee's fitness
for using a respirator, the employer shall provide the limited
medical examination specified in subsection (6) of this section.
(c) The employer shall assure that all
medical examinations and procedures required by this standard
are performed by or under the supervision of a licensed physician,
who has read and is familiar with the health effects WAC
296-62-07441, Appendix A, the regulatory text of this
section, the protocol for sample handling and laboratory selection
in WAC
296-62-07451, Appendix F and the questionnaire of WAC
296-62-07447, Appendix D. These examinations and procedures
shall be provided without cost to the employee and at a time
and place that is reasonable and convenient to employees.
(d) The employer shall assure that the
collecting and handling of biological samples of cadmium in
urine (CdU), cadmium in blood (CdB), and beta-2 microglobulin
in urine (ß2-M) taken from employees under this section is
done in a manner that assures their reliability and that analysis
of biological samples of cadmium in urine (CdU), cadmium in
blood (CdB), and beta-2 microglobulin in urine (ß2-M) taken
from employees under this section is performed in laboratories
with demonstrated proficiency for that particular analyte.
(See WAC
296-62-07451, Appendix F.)
(2) Initial
examination.
(a) The employer shall provide an initial
(preplacement) examination to all employees covered by the
medical surveillance program required in subsection (1)(a)
of this section. The examination shall be provided to those
employees within thirty days after initial assignment to a
job with exposure to cadmium or no later than ninety days
after the effective date of this section, whichever
date is later.
(b) The initial (preplacement) medical
examination shall include:
(i) A detailed medical and work history,
with emphasis on:
Past, present, and anticipated future
exposure to cadmium; any history of renal, cardiovascular,
respiratory, hematopoietic, reproductive, and/or musculo-skeletal
system dysfunction; current usage of medication with potential
nephrotoxic side-effects; and smoking history and current
status; and
(ii) Biological monitoring that includes
the following tests:
(A) Cadmium in urine (CdU), standardized
to grams of creatinine (g/Cr);
(B) Beta-2 microglobulin in urine
(ß2-M), standardized to grams of creatinine (g/Cr), with
pH specified, as described in WAC
296-62-07451, Appendix F; and
(C) Cadmium in blood (CdB), standardized
to liters of
whole blood (lwb).
(c) Recent examination: An initial examination
is not required to be provided if adequate records show that
the employee has been examined in accordance with the requirements
of (b) of this subsection within the past twelve months. In
that case, such records shall be maintained as part of the
employee's medical record and the prior exam shall be treated
as if it were an initial examination for the purposes of subsections
(3) and (4) of this section.
(3) Actions
triggered by initial biological monitoring:
(a) If the results of the initial biological
monitoring tests show the employee's CdU level to be at or
below 3 µg/g Cr, ß2-M level to be at or below 300 µg/g Cr
and CdB level to be at or below 5 µg/lwb, then:
(i) For currently exposed employees,
who are subject to medical surveillance under subsection
(1)(a)(i) of this section, the employer shall provide the
minimum level of periodic medical surveillance in accordance
with the requirements in subsection (4)(a) of this section;
and
(ii) For previously exposed employees,
who are subject to medical surveillance under subsection
(1)(a)(ii) of this section, the employer shall provide biological
monitoring for CdU, ß2-M, and CdB one year after the initial
biological monitoring and then the employer shall comply
with the requirements of subsection (4)(e) of this section.
(b) For all employees who are subject
to medical surveillance under subsection (1)(a) of this section,
if the results of the initial biological monitoring tests
show the level of CdU to exceed 3 µg/g Cr, the level of ß2-M
to exceed 300 µg/g Cr, or the level of CdB to exceed 5 µg/lwb,
the employer shall:
(i) Within two weeks after receipt
of biological monitoring results, reassess the employee's
occupational exposure to
cadmium as follows:
(A) Reassess the employee's work-practices
and personal hygiene;
(B) Reevaluate the employee's respirator
use, if any, and the respirator program;
(C) Review the hygiene facilities;
(D) Reevaluate the maintenance and
effectiveness
of the relevant engineering controls;
(E) Assess the employee's smoking
history and status;
(ii) Within thirty days after the
exposure reassessment, specified in (b)(i) of this subsection,
take reasonable steps to correct any deficiencies found
in the reassessment that may be responsible for the employee's
excess exposure to cadmium; and,
(iii) Within ninety days after receipt
of biological monitoring results, provide a full medical
examination to the employee in accordance with the requirements
of WAC
296-62-07423 (4)(b). After completing the medical examination,
the examining physician shall determine in a written medical
opinion whether to medically remove the employee.
If the physician determines that medical removal is not
necessary, then until the employee's CdU level falls to
or below 3 µg/g Cr, ß2-M level falls to or below 300 µg/g
Cr and CdB level falls to or below 5 µg/lwb, the employer
shall:
(A) Provide biological monitoring
in accordance with subsection (2)(b)(ii) of this section
on a semiannual basis; and
(B) Provide annual medical examinations
in accordance
with subsection (4)(b) of this section.
(c) For all employees who are subject
to medical surveillance under subsection (1)(a) of this section,
if the results of the initial biological monitoring tests
show the level of CdU to be in excess of 15 µg/g Cr, or the
level of CdB to be in excess of 15 µg/lwb, or the level f
ß2-M to be in excess of 1,500 µg/g Cr, the employer shall
comply with the requirements of (b)(i) and (ii) of this subsection.
Within ninety days after receipt of biological monitoring
results, the employer shall provide a full medical examination
to the employee in accordance with the requirements of subsection
(4)(b) of this section.
After completing the medical examination,
the examining physician shall determine in a written medical
opinion whether to medically remove the employee. However,
if the initial biological monitoring results and the biological
monitoring results obtained during the medical examination
both show that: CdU exceeds 15 µg/g Cr; or CdB exceeds 15
µg/lwb; or ß2-M exceeds 1500 µg/g Cr, and in addition CdU
exceeds 3 µg/g Cr or CdB exceeds 5 µg/liter of whole blood,
then the physician shall medically remove the employee from
exposure to cadmium at or above the action level. If the second
set of biological monitoring results obtained during the medical
examination does not show that a mandatory removal trigger
level has been exceeded, then the employee is not required
to be removed by the mandatory provisions of this section.
If the employee is not required to be removed by the mandatory
provisions of this section or by the physician's determination,
then until the employee's CdU level falls to or below 3 µg/g
Cr, ß2-M level falls to or below 300 µg/g Cr and CdB level
falls to or below 5 µg/lwb, the employer shall:
(i) Periodically reassess the employee's
occupational exposure to cadmium;
(ii) Provide biological monitoring
in accordance with subsection (2)(b)(ii) of this section
on a quarterly basis; and
(iii) Provide semiannual medical examinations
in accordance
with subsection (4)(b) of this section.
(d) For all employees to whom medical
surveillance is provided, beginning on January 1, 1999, and
in lieu of (a) through (c) of this subsection:
(i) If the results of the initial
biological monitoring tests show the employee's CdU level
to be at or below 3 µg/g Cr, ß2-M level to be at or below
300 µg/g Cr and CdB level to be at or below 5 µg/lwb, then
for currently exposed employees, the employer shall comply
with the requirements of (a)(i) of this subsection and for
previously exposed employees, the employer shall comply
with the requirements of (a)(ii) of this subsection;
(ii) If the results of the initial
biological monitoring tests show the level of CdU to exceed
3 µg/g Cr, the level of ß2-M to exceed 300 µg/g Cr, or the
level of CdB to exceed 5 µg/lwb, the employer shall comply
with the requirements of (b)(i) through (iii) of this subsection;
and
(iii) If the results of the initial
biological monitoring tests show the level of CdU to be
in excess of 7 µg/g Cr, or the level of CdB to be in excess
of 10 µg/lwb, or the level of ß2-M to be in excess of 750
µg/g Cr, the employer shall: Comply with the requirements
of (b)(i) through (ii) of this subsection; and, within ninety
days after receipt of biological monitoring results, provide
a full medical examination to the employee in accordance
with the requirements of subsection (4)(b) of this section.
After completing the medical examination, the examining
physician shall determine in a written medical opinion whether
to medically remove the employee. However, if the initial
biological monitoring results and the biological monitoring
results obtained during the medical examination both show
that: CdU exceeds 7 µg/g Cr; or CdB exceeds 10 µg/lwb; or
ß2-M exceeds 750 µg/g Cr, and in addition CdU exceeds 3
µg/g Cr or CdB exceeds 5 µg/liter of whole blood, then the
physician shall medically remove the employee from exposure
to cadmium at or above the action level. If the second
set of biological monitoring results obtained during the
medical examination does not show that a mandatory removal
trigger level has been exceeded, then the employee is not
required to be removed by the mandatory provisions of this
section. If the employee is not required to be removed by
the mandatory provisions of this section or by the physician's
determination, then until the employee's CdU level falls
to or below 3 µg/g Cr, ß2-M level falls to or below 300
µg/g Cr and CdB level falls to or below 5 µg/lwb, the employer
shall: periodically reassess the employee's occupational
exposure to cadmium; provide biological monitoring in accordance
with subsection (2)(b)(ii) of this section on a quarterly
basis; and provide semiannual medical examinations in accordance
with subsection (4)(b) of this section.
(4) Periodic
medical surveillance.
(a) For each employee who is covered
under subsection (1)(a)(i) of this section, the employer shall
provide at least the minimum level of periodic medical surveillance,
which consists of periodic medical examinations and periodic
biological monitoring. A periodic medical examination shall
be provided within one year after the initial examination
required by subsection (2) of this section and thereafter
at least biennially. Biological sampling shall be provided
at least annually, either as part of a periodic medical examination
or separately as periodic biological monitoring.
(b) The periodic medical examination
shall include:
(i) A detailed medical and work history,
or update thereof, with emphasis on: Past, present and anticipated
future exposure to cadmium; smoking history and current
status; reproductive history; current use of medications
with potential nephrotoxic side-effects; any history of
renal, cardiovascular, respiratory, hematopoietic, and/or
musculo-skeletal system dysfunction; and as part of the
medical and work history, for employees who wear respirators,
questions 3-11 and 25-32 in WAC
296-62-07447, Appendix D;
(ii) A complete physical examination
with emphasis on: Blood pressure, the respiratory system,
and the urinary system;
(iii) A 14 inch by 17 inch, or a reasonably
standard sized posterior-anterior chest X-ray (after the
initial X-ray, the
frequency of chest X-rays is to be
determined by the examining physician);
(iv) Pulmonary function tests, including
forced vital capacity (FVC) and forced expiratory volume
at 1 second (FEV1);
(v) Biological monitoring, as required
in subsection (2)(b)(ii) of this section;
(vi) Blood analysis, in addition to
the analysis required under this section, including blood
urea nitrogen, complete blood count, and serum creatinine;
(vii) Urinalysis, in addition to the
analysis required under subsection (2)(b)(ii) of this section,
including the determination of albumin, glucose, and total
and low molecular weight proteins;
(viii) For males over forty years
old, prostate palpation, or other at least as effective
diagnostic test(s); and
(ix) Any additional tests deemed appropriate
by the examining physician.
(c) Periodic biological monitoring shall
be provided in accordance with subsection (2)(b)(ii) of this
section.
(d) If the results of periodic biological
monitoring or the results of biological monitoring performed
as part of the periodic medical examination show the level
of the employee's CdU, ß2-M, or CdB to be in excess of the
levels specified in subsection (3)(b) or (c) of this section;
or, beginning on January 1 1999, in excess of the levels specified
in subsection (3)(b) or (d) of this section, the employer
shall take the appropriate actions specified in subsection
(3)(b) through (d) of this section.
(e) For previously exposed employees
under subsection (1)(a)(ii) of this section:
(i) If the employee's levels of CdU
did not exceed 3 µg/g Cr, CdB did not exceed 5 µg/lwb, and
ß2-M did not exceed 300 µg/g Cr in the initial biological
monitoring tests, and if the results of the follow-up biological
monitoring required by subsection (3)(a)(ii) of this section
one year after the initial examination confirm the previous
results, the employer may discontinue all periodic medical
surveillance for that employee.
(ii) If the initial biological monitoring
results for CdU, CdB, or ß2-M were in excess of the levels
specified in subsection (3)(a) of this section, but subsequent
biological monitoring results required by subsection (3)(b)
through (e) of this section show that the employee's CdU
levels no longer exceed 3 µg/g Cr, CdB levels no longer
exceed 5 µg/lwb, and 2-M levels no longer exceed 300 µg/g
Cr, the employer shall provide biological monitoring for
CdU, CdB, and ß2-M one year after these most recent biological
monitoring results. If the results of the follow-up biological
monitoring, specified in this section, confirm the previous
results, the employer may discontinue all periodic medical
surveillance for that employee.
(iii) However, if the results of the
follow-up tests specified in (e)(i) or (ii) of this subsection
indicate that the level of the employee's CdU, ß2-M, or
CdB exceeds these same levels, the employer is required
to provide annual medical examinations in accordance with
the provisions of (b) of this subsection until the results
of biological monitoring are consistently below these levels
or the examining physician determines in a written medical
opinion that further medical surveillance is not required
to protect the employee's health.
(f) A routine, biennial medical examination
is not required to be provided in accordance with subsections
(3)(a) and (4) of this section if adequate medical records
show that the employee has been examined in accordance with
the requirements of (b) of this subsection within the past
twelve months. In that case, such records shall be maintained
by the employer as part of the employee's medical record,
and the next routine, periodic medical examination shall be
made available to the employee within two years of the previous
examination.
(5) Actions triggered by medical examinations.
If the results of a medical examination carried out in accordance
with this section indicate any laboratory or clinical finding
consistent with cadmium toxicity that does not require employer
action under subsections (2), (3), or (4) of this section, the
employer, within thirty days, shall reassess the employee's
occupational exposure to cadmium and take the following corrective
action until the physician determines they are no longer necessary:
(a) Periodically reassess: The employee's
work-practices and personal hygiene; the employee's respirator
use, if any; the employee's smoking history and status; the
respiratory protection program; the hygiene facilities; and
the maintenance and effectiveness of the relevant engineering
controls;
(b) Within thirty days after the reassessment,
take all reasonable steps to correct the deficiencies found
in the reassessment that may be responsible for the employee's
excess exposure to cadmium;
(c) Provide semiannual medical reexaminations
to evaluate the abnormal clinical sign(s) of cadmium toxicity
until the results are normal or the employee is medically
removed; and
(d) Where the results of tests for total
proteins in urine are abnormal, provide a more detailed medical
evaluation of the toxic effects of cadmium on the employee's
renal system.
(6) Examination
for respirator use.
(a) To determine an employee's fitness
for respirator use, the employer shall provide a medical examination
that includes the elements specified in (a)(i) through (iv)
of this subsection. This examination shall be provided prior
to the employee's being assigned to a job that requires the
use of a respirator or no later than ninety days after this
section goes into effect, whichever date is later, to any
employee without a medical examination within the preceding
twelve months that satisfies the requirements of this paragraph.
(i) A detailed medical and work history,
or update thereof, with emphasis on: Past exposure to cadmium;
smoking history and current status; any history of renal,
cardiovascular, respiratory, hematopoietic, and/or musculoskeletal
system dysfunction; a description of the job for which the
respirator is required; and questions 3 through 11 and 25
through 32 in WAC
296-62-07447, Appendix D;
(ii) A blood pressure test;
(iii) Biological monitoring of the
employee's levels of CdU, CdB and ß2-M in accordance with
the requirements of subsection (2)(b)(ii) of this section,
unless such results already have been obtained within the
previous twelve months; and
(iv) Any other test or procedure that
the examining physician deems appropriate.
(b) After reviewing all the information
obtained from the medical examination required in (a) of this
subsection, the physician shall determine whether the employee
is fit to wear a respirator.
(c) Whenever an employee has exhibited
difficulty in breathing during a respirator fit test or during
use of a respirator, the employer, as soon as possible, shall
provide the employee with a periodic medical examination in
accordance with subsection (4)(b) of this section to determine
the employee's fitness to wear a respirator.
(d) Where the results of the examination
required under (a), (b), or (c) of this subsection are abnormal,
medical limitation or prohibition of respirator use shall
be considered. If the employee is allowed to wear a respirator,
the employee's ability to continue to do so shall be periodically
evaluated by a physician.
(7) Emergency
examinations.
(a) In addition to the medical surveillance
required in subsections (2) through (6) of this section, the
employer shall provide a medical examination as soon as possible
to any employee who may have been acutely exposed to cadmium
because of an emergency.
(b) The examination shall include the
requirements of subsection (4)(b) of this section, with emphasis
on the respiratory system, other organ systems considered
appropriate by the examining physician, and symptoms of acute
overexposure, as identified in WAC
296-62-07441 (2)(b)(i) through (ii) and (4), Appendix
A.
(8) Termination
of employment examination.
(a) At termination of employment, the
employer shall provide a medical examination in accordance
with subsection (4)(b) of this section, including a chest
x-ray, to any employee to whom at any prior time the employer
was required to provide medical surveillance under subsection
(1)(a) or (7) of this section. However, if the last examination
satisfied the requirements of subsection (4)(b) of this section
and was less than six months prior to the date of termination,
no further examination is required unless otherwise specified
in subsection (3) or (5) of this section;
(b) However, for employees covered by
subsection (1)(a)(ii) of this section, if the employer has
discontinued all periodic medical surveillance under subsection
(4)(e) of this section, no termination of employment medical
examination is required.
(9) Information provided to the physician.
The employer shall provide the following information to the
examining physician:
(a) A copy of this standard and appendices;
(b) A description of the affected employee's
former, current, and anticipated duties as they relate to
the employee's occupational exposure to cadmium;
(c) The employee's former, current,
and anticipated future levels of occupational exposure to
cadmium;
(d) A description of any personal protective
equipment, including respirators, used or to be used by the
employee, including when and for how long the employee has
used that equipment; and
(e) Relevant results of previous biological
monitoring and medical examinations.
(10) Physician's
written medical opinion.
(a) The employer shall promptly obtain
a written, signed medical opinion from the examining physician
for each medical examination performed on each employee. This
written opinion shall contain:
(i) The physician's diagnosis for
the employee;
(ii) The physician's opinion as to
whether the employee has any detected medical condition(s)
that would place the employee at increased risk of material
impairment to health from further exposure to cadmium, including
any indications of potential cadmium toxicity;
(iii) The results of any biological
or other testing or related evaluations that directly assess
the employee's absorption of cadmium;
(iv) Any recommended removal from,
or limitation on the activities or duties of the employee
or on the employee's use of personal protective equipment,
such as respirators;
(v) A statement that the physician
has clearly and carefully explained to the employee the
results of the medical examination, including all biological
monitoring results and any medical conditions related to
cadmium exposure that require further evaluation or treatment,
and any limitation on the employee's diet or use of medications.
(b) The employer promptly shall obtain
a copy of the results of any biological monitoring provided
by an employer to an employee independently of a medical examination
under subsections (2) and (4) of this section, and, in lieu
of a written medical opinion, an explanation sheet explaining
those results.
(c) The employer shall instruct the
physician not to reveal orally or in the written medical opinion
given to the employer specific findings or diagnoses unrelated
to occupational exposure to cadmium.
(11) Medical removal protection (MRP).
(a) General.
(i) The employer shall temporarily
remove an employee from work where there is excess exposure
to cadmium on each occasion that medical removal is required
under subsection (3), (4), or (6) of this section and on
each occasion that a physician determines in a written medical
opinion that the employee should be removed from such exposure.
The physician's determination may be based on biological
monitoring results, inability to wear a respirator, evidence
of illness, other signs or symptoms of cadmium-related dysfunction
or disease, or any other reason deemed medically sufficient
by the physician.
(ii) The employer shall medically
remove an employee in accordance with this subsection regardless
of whether at the time of removal a job is available into
which the removed employee may be transferred.
(iii) Whenever an employee is medically
removed under this subsection, the employer shall transfer
the removed employee to a job where the exposure to cadmium
is within the permissible levels specified in that subsection
as soon as one becomes available.
(iv) For any employee who is medically
removed under the provisions of (a) of this subsection,
the employer shall provide follow-up biological monitoring
in accordance with subsection (2)(b)(ii) of this section
at least every three months and follow-up medical examinations
semiannually at least every six months until in a written
medical opinion the examining physician determines that
either the employee may be returned to his/her former job
status as specified under (d) through (e) of this subsection
or the employee must be permanently removed from excess
cadmium exposure.
(v) The employer may not return an
employee who has been medically removed for any reason to
his/her former job status
until a physician determines in a
written medical opinion that continued medical removal is
no longer necessary to protect the employee's health.
(b) Where an employee is found unfit
to wear a respirator under subsection (6)(b) of this section,
the employer shall remove the employee from work where exposure
to cadmium is above the PEL.
(c) Where removal is based on any reason
other than the employee's inability to wear a respirator,
the employer shall remove the employee from work where exposure
to cadmium is at or above the action level.
(d) Except as specified in (e) of this
subsection, no employee who was removed because his/her level
of CdU, CdB and/or ß2-M exceeded the medical removal trigger
levels in subsection (3) or (4) of this section may be returned
to work with exposure to cadmium at or above the action level
until the employee's levels of CdU fall to or below 3 µg/g
Cr, CdB falls to or below 5 µg/lwb, and ß2-M falls to or below
300 µg/g Cr.
(e) However, when in the examining physician's
opinion continued exposure to cadmium will not pose an increased
risk to the employee's health and there are special circumstances
that make continued medical removal an inappropriate remedy,
the physician shall fully discuss these matters with the employee,
and then in a written determination
may return a worker to his/her former job status despite what
would otherwise be unacceptably high biological monitoring
results. Thereafter, the returned employee shall continue
to be provided with medical surveillance as if he/she were
still on medical removal until the employee's levels of CdU
fall to or below 3 µg/g Cr, CdB falls to or below 5 µg/lwb,
and ß2-M falls to or below 300 µg/g Cr.
(f) Where an employer, although not
required by (a) through (c) of this subsection to do so, removes
an employee from exposure to cadmium or otherwise places limitations
on an employee due to the effects of cadmium exposure on the
employee's medical condition, the employer shall provide the
same medical removal protection benefits to that employee
under subsection (12) of this section as would have been provided
had the removal been required under (a) through (c) of this
subsection.
(12) Medical
removal protection benefits (MRPB).
(a) The employer shall provide MRPB
for up to a maximum of eighteen months to an employee each
time and while the employee is temporarily medically removed
under subsection (11) of this section.
(b) For purposes of this section, the
requirement that the employer provide MRPB means that the
employer shall maintain the total normal earnings, seniority,
and all other employee rights and benefits of the removed
employee, including the employee's right to his/her former
job status, as if the employee had not been removed from the
employee's job or otherwise medically limited.
(c) Where, after eighteen months on
medical removal because of elevated biological monitoring
results, the employee's monitoring results have not declined
to a low enough level to permit the employee to be returned
to his/her former job status:
(i) The employer shall make available
to the employee a medical examination pursuant in order
to obtain a final medical determination as to whether the
employee may be returned to his/her former job status or
must be permanently removed from excess cadmium exposure;
and
(ii) The employer shall assure that
the final medical determination indicates whether the employee
may be returned to his/her former job status and what steps,
if any, should be taken to protect the employee's health.
(d) The employer may condition the provision
of MRPB upon the employee's participation in medical surveillance
provided in accordance with this section.
(13) Multiple physician review.
(a) If the employer selects the initial
physician to conduct any medical examination or consultation
provided to an employee under this section, the employee may
designate a second physician to:
(i) Review any findings, determinations,
or recommendations of the initial physician; and
(ii) Conduct such examinations, consultations,
and laboratory tests as the second physician deems necessary
to facilitate this review.
(b) The employer shall promptly notify
an employee of the right to seek a second medical opinion
after each occasion that an initial physician provided by
the employer conducts a medical examination or consultation
pursuant to this section. The employer may condition its participation
in, and payment for,
multiple physician review upon the employee
doing the following within fifteen days after receipt of this
notice, or receipt of the initial physician's written opinion,
whichever is later:
(i) Informing the employer that he
or she intends to seek a medical opinion; and
(ii) Initiating steps to make an appointment
with a second physician.
(c) If the findings, determinations,
or recommendations of the second physician differ from those
of the initial physician, then the employer and the employee
shall assure that efforts are made for the two physicians
to resolve any disagreement.
(d) If the two physicians have been
unable to quickly resolve their disagreement, then the employer
and the employee, through their respective physicians, shall
designate a third physician to:
(i) Review any findings, determinations,
or recommendations of the other two physicians; and
(ii) Conduct such examinations, consultations,
laboratory tests, and discussions with the other two physicians
as the third physician deems necessary to resolve the disagreement
among them.
(e) The employer shall act consistently
with the findings, determinations, and recommendations of
the third physician, unless the employer and the employee
reach an agreement that is consistent with the recommendations
of at least one of the other two physicians.
(14) Alternate physician determination.
The employer and an employee or designated employee representative
may agree upon the use of any alternate form of physician determination
in lieu of the multiple physician review provided by subsection
(13) of this section, so long as the alternative is expeditious
and at least as protective of the employee.
(15) Information the employer must
provide the employee.
(a) The employer shall provide a copy
of the physician's written medical opinion to the examined
employee within two weeks after receipt thereof.
(b) The employer shall provide the employee
with a copy of the employee's biological monitoring results
and an explanation sheet explaining the results within two
weeks after receipt thereof.
(c) Within thirty days after a request
by an employee, the employer shall provide the employee with
the information the employer is required to provide the examining
physician under subsection (9) of this section.
(16) Reporting. In addition to
other medical events that are required to be reported on the
OSHA Form No. 200, the employer shall report any abnormal condition
or disorder caused by occupational exposure to cadmium associated
with employment as specified in WAC 296-27-060.
(1) General. In communications
concerning cadmium hazards, employers shall comply with
the requirements of WISHA's chemical hazard communication standard,
WAC 296-800-170,
including but not limited to the requirements concerning warning
signs and labels, material safety data sheets (MSDS), and employee
information and training. In addition, employers shall comply
with the following requirements:
(2) Warning signs.
(a) Warning signs shall be provided
and displayed in regulated areas. In addition, warning signs
shall be posted at all approaches to regulated areas so that
an employee may read the signs and take necessary protective
steps before entering the area.
(b) Warning signs required by (a) of
this subsection shall bear the following information:
DANGER CADMIUM CANCER
HAZARD CAN CAUSE LUNG AND KIDNEY DISEASE AUTHORIZED PERSONNEL
ONLY RESPIRATORS REQUIRED IN THIS AREA
(c) The employer shall assure that signs
required by this subsection are illuminated, cleaned, and
maintained as necessary so that the legend is readily visible.
(3) Warning
labels.
(a) Shipping and storage containers
containing cadmium, cadmium compounds, or cadmium contaminated
clothing, equipment, waste, scrap, or debris shall bear appropriate
warning label
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