Emergency Response

Chapter 296-824, WAC

Effective Date: 10/01/02

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Medical surveilliance

WAC 296-824-400 

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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


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

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

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

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.

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