• Under HAZWOPER, employers are required to provide medical surveillance, but employees can opt out of it.

For hazardous waste cleanup operations, medical surveillance must be made available to employees if:

• They are or may be exposed for 30 or more days a year to hazardous substances or health hazards at or above the permissible exposure limits (or PELs), or, if no PEL is available, then over the published exposure levels for these substances.
• They wear a respirator for 30 days or more a year.
• They are injured, become ill, or develop signs or symptoms due to possible overexposure involving hazardous substances or health hazards.
• They belong to a HAZMAT team, whose members are expected to control actual or potential leaks or spills of hazardous substances requiring possible close approach to the substance.

Employees who fit any of the criteria listed above are considered “covered employees.”

Under the Hazardous Waste Operations and Emergency Response (HAZWOPER) Standard, employers are obligated to make medical surveillance available without cost to employees, but the Occupational Safety and Health Administration (OSHA) does not require employees to participate. If an employee chooses not to take part in the medical surveillance program, this should be documented with a signed record in the employee’s personnel file.

HAZWOPER training should incorporate the purpose and content of the medical surveillance program required by the standard so employees understand that it is for their protection.

OSHA does not require employees to take a medical exam. However, employees who refuse to be medically evaluated cannot be assigned to work in areas where they are required to wear a respirator.