Required General Industry OSHA Medical Surveillance Requirements At-A-Glance

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Workers exposed to regulated substances in the workplace (e.g., lead, silica, asbestos) have an elevated risk for occupational diseases. OSHA requires employers to screen these workers for potential exposures with a focus on early detection of illness.

Medical surveillance is a systematic, complex process that looks for problems in the workplace identified by looking at abnormal screening results. Medical screening is one component of medical surveillance that assists with analyzing work group trends.

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['Toxic and Hazardous Substances - OSHA', 'First Aid and Medical', 'Personal Protective Equipment', 'HAZWOPER', 'Industrial Hygiene', 'Bloodborne Pathogens']

['Coke Oven Emissions', 'HAZWOPER', 'Cadmium', 'Acrylonitrile', 'Arsenic', 'Hexavalent Chromium', 'Asbestos', 'First Aid and Medical', 'Formaldehyde', 'Hearing Conservation and Noise', 'Respiratory Protection', 'Bloodborne Pathogens', 'Beryllium', 'Butadiene', 'Lead', 'Benzene', 'Laboratory Safety', 'Cotton Dust', 'Methylene Chloride', 'Ethylene Oxide', 'Carcinogens', 'Crystalline Silica', 'Exposure Sampling']

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1910.95 Occupational noise exposure
Who:	Employees whose occupational noise exposure equals or exceeds 85 decibels over an 8-hour time-weighted average (TWA).
Frequency:	Audiograms. Baseline audiogram must be given within 6 months of an employee’s exposure at or above the action level (85 decibels over an 8-hour time-weighted average (TWA)). Annual audiogram must be offered thereafter. Mobile test van exception. Where mobile test vans are used to meet the audiometric testing obligation, employers must obtain a valid baseline audiogram within 1 year of an employee’s first exposure at or above the action level.
Records:	Audiometric test records. Must be kept for the duration of the affected employee’s employment, and include: Name and job classification of employee, Date of audiogram, Examiner’s name, Date of the last acoustic or exhaustive calibration of the audiometer, and Employee’s most recent noise exposure assessment. Noise exposure measurement records. Must be kept for 2 years.
1910.120 Hazardous Waste Operations and Emergency Response (HAZWOPER)
Who:	All employees who are or may be exposed to hazardous substances or health hazards at or above the permissible exposure limits (PEL) or, if there is no PEL, above the published exposure levels for these substances, without regard to the use of respirators, for 30 days or more a year [1910.120(f)(2)(i)]; All employees who wear a respirator for 30 days or more a year or as required by 1910.134 [1910.120(f)(2)(ii)]; All employees who are injured, become ill, or develop signs or symptoms due to possible overexposure involving hazardous substances or health hazards from an emergency response or hazardous waste operation [1910.120(f)(2)(iii)]; and Members of HAZMAT teams [1910.120(f)(2)(iv)].
Frequency:	For employees covered under paragraphs (f)(2)(i), (f)(2)(ii), and (f)(2)(iv) [see above entry], medical examinations and consultations must be made available: Prior to assignment; At least once every 12 months for each employee covered unless the attending physician believes a longer interval (not greater than biennially) is appropriate; As soon as possible upon notification by an employee that the employee has developed signs or symptoms indicating possible overexposure to hazardous substances or health hazards, or that the employee has been injured or exposed above the permissible exposure limits or published exposure levels in an emergency situation; and At termination of employment or reassignment to an area where the employee would not be covered if the employee has not had an examination within the last 6 months; At more frequent times, if the examining physician determines that an increased frequency of examination is medically necessary. For employees covered under 1910.120(f)(2)(iii) [see above entry] and for all employees including those of employers covered by 1910.120(a)(1)(v) who may have been injured, received a health impairment, developed signs or symptoms which may have resulted from exposure to hazardous substances resulting from an emergency incident, or exposed during an emergency incident to hazardous substances at concentrations above the permissible exposure limits or the published exposure levels without the necessary personal protective equipment being used: As soon as possible following the emergency incident or development of signs or symptoms, and At additional times, if the examining physician determines that follow-up examinations or consultations are medically necessary.
Records:	Medical surveillance records. Must be kept for at least the duration of employment plus 30 years, and include: The name of the employee; Physician’s written opinions, recommended limitations, and results of examinations and tests; Any employee medical complaints related to exposure to hazardous substances; A copy of the information provided to the examining physician by the employer, with the exception of the standard and its appendices.
1910.134 Respiratory protection
Who:	Employees required to use a respirator in the workplace.
Frequency:	Medical evaluation. Must be provided before an employee is fit tested or required to use a respirator in the workplace, to determine employee’s ability to wear a respirator. Additional medical evaluations. Must be provided if: An employee reports medical signs or symptoms that are related to ability to use a respirator; A physician or other licensed health care professional (PLHCP), supervisor, or the respirator program administrator informs the employer that an employee needs to be reevaluated; Information from the respiratory protection program, including observations made during fit testing and program evaluation, indicates a need for employee reevaluation; or A change occurs in workplace conditions (e.g., physical work effort, protective clothing, temperature) that may result in a substantial increase in the physiological burden placed on an employee. Medical evaluations may be discontinued when the employee is no longer required to use a respirator.
Records:	Medical evaluation records. Must be kept for at least the duration of employment plus 30 years.
1910.1001 Asbestos
Who:	Employees who are or will be exposed to airborne concentrations of fibers of asbestos at or above the time-weighted average (TWA) and/or excursion limit. TWA. Airborne concentration of asbestos in excess of 0.1 fiber per cubic centimeter of air as an 8-hour TWA. Excursion limit. Airborne concentration of asbestos in excess of 1.0 fiber per cubic centimeter of air (1 f/cc) as averaged over a sampling period of 30 minutes.
Frequency:	Pre-placement examinations. Must be provided or made available before an employee is assigned to an occupation exposed to airborne concentrations of asbestos fibers at or above the TWA and/or excursion limit. Periodic examinations. Must be made available annually. Termination of employment examinations. Must be provided or made available and given within 30 calendar days before or after the date of termination of employment. Recent examinations. No medical examination is required of any employee, if adequate records show that the employee has been examined in accordance with pre-placement, periodic, or termination examination requirements within the past 1-year period. A pre-employment medical examination which was required as a condition of employment by the employer, may not be used to meet the requirements of a recent examination, unless the cost of that examination is borne by the employer.
Records:	Exposure measurements. Must be kept for at least 30 years and include: The date of measurement; The operation involving exposure to asbestos which is being monitored; Sampling and analytical methods used and evidence of their accuracy; Number, duration, and results of samples taken; Type of respiratory protective devices worn, if any; and Name and exposure of the employees whose exposure are represented. Medical surveillance records. Must be kept for the duration of employment plus 30 years and include: The name of the employee, Physician’s written opinions, Any employee medical complaints related to exposure to asbestos, and A copy of the information provided to the physician.
1910.1003 13 Carcinogens (1910.1003 through 1910.1016)
Who:	Employees considered for assignment to enter regulated areas, and for authorized employees. Regulated area. An area where entry and exit are restricted and controlled. Authorized employees. Employees whose duties require them to be in the regulated area and who have been specifically assigned by the employer.
Frequency:	Pre-assignment physical evaluation. Must be provided before an employee is assigned to enter a regulated area. Periodic physical examination. Must be provided at least annually following the pre-assignment examination.
Records:	Medical examination records. Must be complete and accurate and kept for the duration of the employee’s employment.
1910.1017 Vinyl chloride
Who:	Each employee exposed, without regard to the use of respirators, to vinyl chloride in excess of the action level. Action level. A concentration of vinyl chloride of 0.5 ppm averaged over an 8-hour work day.
Frequency:	Medical examinations. Must be provided: At the time of initial assignment or upon institution of medical surveillance, At least annually thereafter, To employees exposed to an emergency.
Records:	Monitoring and measuring records. Must: State the date of such monitoring and measuring and the concentrations determined and identify the instruments and methods used, and Include any additional information necessary to determine individual employee exposures where such exposures are determined by means other than individual monitoring of employees. Medical records. Must be kept for the duration of the employment of each employee plus 20 years, or 30 years, whichever is longer. All records. Must include the name of each employee where relevant and be kept for not less than 30 years.
1910.1018 Inorganic arsenic
Who:	All employees who are or will be exposed above the action level, without regard to the use of respirators, at least 30 days per year; and All employees who have been exposed above the action level, without regard to respirator use, for 30 days or more per year for a total of 10 years or more of combined employment with the employer or predecessor employers. Action level. A concentration of inorganic arsenic of 5 micrograms per cubic meter of air (5 µg/m³) averaged over any 8-hour period.
Frequency:	Initial examination. At the time of initial assignment to an area where the employee is likely to be exposed over the action level at least 30 days per year. Periodic examination. Must be provided at least annually. Termination examination. Whenever a covered employee has not taken a periodic examination within 6 months preceding the termination of employment, the employer must provide such examination to the employee upon termination of employment. Additional examination. If the employee develops signs or symptoms commonly associated with exposure to inorganic arsenic the employer must provide an appropriate examination and emergency medical treatment.
Records:	Exposure monitoring records. Must be kept for at least 40 years or for the duration of employment plus 20 years, whichever is longer, and include: The date(s), number, duration location, and results of each of the samples taken, including a description of the sampling procedure used to determine representative employee exposure where applicable; A description of the sampling and analytical methods used and evidence of their accuracy; The type of respiratory protective devices worn, if any; The environmental variables that could affect the measurement of the employee’s exposure. Name and job classification of the employees monitored and of all other employees whose exposure the measurement is intended to represent; and Medical surveillance records. Must be kept for at least 40 years or for the duration of employment plus 20 years, whichever is longer, and include: The name and description of duties of the employee; A copy of the physician’s written opinions; Results of any exposure monitoring done for that employee and the representative exposure levels supplied to the physician; and Any employee medical complaints related to exposure to inorganic arsenic. Additional records. The employer must keep (or assure the examining physician keeps) the following medical records for at least 40 years, or for the duration of employment plus 20 years, whichever is longer: A copy of the medical examination results including medical and work history; A description of the laboratory procedures and a copy of any standards or guidelines used to interpret the test results or references to that information; The initial X-ray; Any X-rays with a demonstrated abnormality and all subsequent X-rays. The X-rays for the most recent 5 years; and
1910.1024 Beryllium
Who:	Employees who: Are or are reasonably expected to be exposed at or above the action level for more than 30 days per year, Show signs or symptoms of chronic beryllium disease (CBD) or other beryllium-related health effects, Are exposed to beryllium during an emergency, or Whose most recent written medical opinion required by 1910.1024(k)(6) or (k)(7) recommends periodic medical surveillance. Action level. A concentration of airborne beryllium of 0.1 micrograms per cubic meter of air (μg/m³) calculated as an 8-hour time-weighted average (TWA). Permissible Exposure Limits (PELs): Time-weighted average (TWA) PEL. An airborne concentration of beryllium in excess of 0.2 μg/m³ calculated as an 8-hour TWA. Short-term exposure limit (STEL). An airborne concentration of beryllium in excess of 2.0 μg/m³ as determined over a sampling period of 15 minutes.
Frequency:	Medical examinations. Must be provided within 30 days and at least every 2 years thereafter.
Records:	Air monitoring data. Employers must make and maintain a record of all exposure measurements taken to assess airborne exposure and maintain them for at least 30 years. The records must include at least: The date of measurement for each sample taken; The task that is being monitored; The sampling and analytical methods used and evidence of their accuracy; The number, duration, and results of samples taken; The type of personal protective clothing and equipment, including respirators, worn by monitored employees at the time of monitoring; and The name and job classification of each employee represented by the monitoring, indicating which employees were actually monitored. Medical surveillance records. Must be kept for at least 30 years and include: Name and job classification; A copy of all licensed physicians’ written medical opinions for each employee; and A copy of the information provided to the PLHCP.
1910.1025 Lead
Who:	Employees who are or may be exposed at or above the action level for more than 30 days per year. Action level. Employee exposure, without regard to the use of respirators, to an airborne concentration of lead of 30 micrograms per cubic meter of air (30 µg/m³) averaged over an 8-hour period.
Frequency:	Biological monitoring. Blood lead and zinc protoporphyrin (ZPP) level sampling and analysis must be made available: At least every 6 months to each covered employee. At least monthly during the removal period of each employee removed from exposure to lead due to an elevated blood lead level. At least every 2 months for each employee whose last blood sampling and analysis indicated a blood lead level at or above 40 µg/100 g of whole blood. This frequency must continue until two consecutive blood samples and analyses indicate a blood lead level below 40 µg/100 g of whole blood; and Follow-up blood sampling tests. Whenever the results of a blood lead level test indicate that an employee’s blood lead level is at or above the numerical criterion for medical removal under paragraph (k)(1)(i)(A) of 1910.1025, the employer must provide a second (follow-up) blood sampling test within 2 weeks after the employer receives the results of the first blood sampling test. Medical examinations and consultations. Must be made available: At least annually for each employee for whom a blood sampling test conducted at any time during the preceding 12 months indicated a blood lead level at or above 40 µg/100 g; Prior to assignment for each employee being assigned for the first time to an area in which airborne concentrations of lead are at or above the action level; As soon as possible, upon notification by an employee either that the employee has developed signs or symptoms commonly associated with lead intoxication, that the employee desires medical advice concerning the effects of current or past exposure to lead on the employee’s ability to procreate a healthy child, or that the employee has demonstrated difficulty in breathing during a respirator fitting test or during use; and As medically appropriate for each employee either removed from exposure to lead due to a risk of sustaining material impairment to health, or otherwise limited pursuant to a final medical determination.
Records:	Exposure monitoring records. Must be kept for at least 40 years or for the duration of employment plus 20 years, whichever is longer, and include: The date(s), number, duration, location and results of each of the samples taken, including a description of the sampling procedure used to determine representative employee exposure where applicable; A description of the sampling and analytical methods used and evidence of their accuracy; The type of respiratory protective devices worn, if any; The environmental variables that could affect the measurement of employee exposure. Name and job classification of the employee monitored and of all other employees whose exposure the measurement is intended to represent; and Medical surveillance. Must be kept for the duration of employment plus 30 years and include: The name and description of the duties of the employee; A copy of the physician’s written opinions; Results of any airborne exposure monitoring done for that employee and the representative exposure levels supplied to the physician; and Any employee medical complaints related to exposure to lead. Medical records. Must be kept by the employer or the examining physician for at least 40 years, or for the duration of employment plus 20 years, whichever is longer, and include: A copy of the medical examination results including medical and work history, A description of the laboratory procedures and a copy of any standards or guidelines used to interpret the test results or references to that information, and A copy of the results of biological monitoring. Medical removal records for employees removed from current exposure to lead. Must be kept for at least the duration of an employee’s employment and include: The name of the employee, The date on each occasion that the employee was removed from current exposure to lead as well as the corresponding date on which the employee was returned to his or her former job status, A brief explanation of how each removal was or is being accomplished, and A statement with respect to each removal indicating whether or not the reason for the removal was an elevated blood lead level.
1910.1026 Chromium (VI)
Who:	Employees who: Are or may be occupationally exposed to chromium (VI) ‒ commonly referred to as hexavalent chromium ‒ at or above the action level for 30 or more days a year, Experience signs or symptoms of the adverse health effects associated with chromium (VI) exposure, or Are exposed in an emergency. Action level. A concentration of airborne chromium (VI) of 2.5 micrograms per cubic meter of air (2.5 µgm/m³) calculated as an 8-hour time-weighted average (TWA). Permissible exposure limit (PEL). An airborne concentration of chromium (VI) in excess of 5 micrograms per cubic meter of air (5 µgm/m³), calculated as an 8-hour time-weighted average (TWA).
Frequency:	Medical examinations. Must be provided: Within 30 days after initial assignment, unless the employee has received a chromium (VI) related medical examination that meets the requirements of 1910.1026(k) within the last 12 months; Annually; Within 30 days after a physician or other license healthcare professional’s (PLHCP) written medical opinion recommends an additional examination; Whenever an employee shows signs or symptoms of the adverse health effects associated with chromium (VI) exposure; Within 30 days after exposure during an emergency which results in an uncontrolled release of chromium (VI); or At the termination of employment, unless the last examination that satisfied the requirements of 1910.1026(k) was less than 6 months prior to the date of termination.
Records:	Air monitoring data. Must be kept for at least 30 years and include: The date of measurement for each sample taken; The operation involving exposure to chromium (VI) that is being monitored; Sampling and analytical methods used and evidence of their accuracy; Number, duration, and the results of samples taken; Type of personal protective equipment, such as respirators worn; and Name and job classification of all employees represented by the monitoring, indicating which employees were actually monitored. Historical monitoring data. Where the employer has relied on historical monitoring data to determine exposure to chromium (VI), these records must be kept for at least 30 years and include: The data were collected using methods that meet the accuracy requirements of 1910.1026(d)(5); The processes and work practices that were in use when the historical monitoring data were obtained are essentially the same as those to be used during the job for which exposure is being determined; The characteristics of the chromium (VI) containing material being handled when the historical monitoring data were obtained are the same as those on the job for which exposure is being determined; Environmental conditions prevailing when the historical monitoring data were obtained are the same as those on the job for which exposure is being determined; and Other data relevant to the operations, materials, processing, or employee exposures covered by the exception. Objective data. An accurate record of all objective data relied upon to comply with the requirements of 1910.1026 must be kept for 30 years and include: The chromium containing material in question; The source of the objective data; The testing protocol and results of testing, or analysis of the material for the release of chromium (VI); A description of the process, operation, or activity and how the data support the determination; and Other data relevant to the process, operation, activity, material, or employee exposures. Medical surveillance records. Must be kept for 30 years and include: Name; A copy of the PLHCP’s written opinions; and A copy of the information provided to the PLHCP.
1910.1027 Cadmium
Who:	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 30 or more days per year (12 consecutive months); and Employees who prior to the effective date of 1910.1027 (Sept. 14, 1992) 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 Sept. 14, 1992, work for the employer in jobs with exposure to cadmium for an aggregated total of more than 60 months. Action level. 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).
Frequency:	Initial (preplacement) examinations. Must be provided within 30 days after initial assignment to a job with exposure to cadmium. Recent examinations. An initial examination is not required to be provided if adequate records show that the employee was examined in accordance with the requirements of paragraph (l)(2)(ii) of 1910.1027 within the past 12 months. In that case, such records must be maintained as part of the employee’s medical record and the prior exam must be treated as if it were an initial examination for the purposes of paragraphs (l)(3) and (4) of 1910.1027. Periodic medical surveillance. Must be provided within 1 year after the initial examination and thereafter at least biennially. Biological sampling must be provided at least annually, either as part of a periodic medical examination or separately as periodic biological monitoring. Examination for respirator use. Must be provided prior to the employee’s being assigned to a job that requires the use of a respirator, to any employee without a medical examination within the preceding 12 months that satisfies the requirements of 1910.1027(l)(6)(i). Emergency examinations. Must be provided as soon as possible to any employee who may have been acutely exposed to cadmium because of an emergency. Termination of employment examinations. At termination of employment, the employer must provide a medical examination in accordance with paragraph (l)(4)(ii) of 1910.1027, to any employee to whom at any prior time the employer was required to provide medical surveillance. If the last examination satisfied the requirements of paragraph (l)(4)(ii) and was less than 6 months prior to the date of termination, no further examination is required unless otherwise specified in paragraphs (l)(3) or (l)(5). If the employer has discontinued all periodic medical surveillance under paragraph 1910.1027(l)(4)(v), no termination of employment medical examination is required.
Records:	Medical surveillance records. Must be kept for the duration of employment plus 30 years, and include: Name and description of the duties; A copy of the physician’s written opinions and an explanation sheet for biological monitoring results; A copy of the medical history, and the results of any physical examination and all test results that are required to be provided by 1910.1027, including biological tests, X-rays, pulmonary function tests, etc., or that have been obtained to further evaluate any condition that might be related to cadmium exposure; The employee’s medical symptoms that might be related to exposure to cadmium; and A copy of the information provided to the physician.
1910.1028 Benzene
Who:	Employees who: Are or may be exposed to benzene at or above the action level 30 or more days per year; Are or may be exposed to benzene at or above the permissible exposure limits (PELs) 10 or more days per year; Have been exposed to more than 10 ppm of benzene for 30 or more days in a year prior to the effective date of the standard when employed by their current employer; and Are involved in the tire building operations called tire building machine operators, who use solvents containing greater than 0.1 percent benzene. Action level. An airborne concentration of benzene of 0.5 ppm calculated as an 8-hour time-weighted average (TWA). PELs: Time-weighted average limit (TWA). An airborne concentration of benzene in excess of one part of benzene per million parts of air (1 ppm) as an 8-hour TWA. Short-term exposure limit (STEL). An airborne concentration of benzene in excess of 5 ppm as averaged over any 15-minute period.
Frequency:	Initial examinations. Before the time of initial assignment. Periodic examinations. At least annually following the initial examination. Emergency examinations. If an employee is exposed to benzene in an emergency situation, the employer must have the employee provide a urine sample at the end of the employee’s shift and have a urinary phenol test performed on the sample within 72 hours.
Records:	Exposure measurements. Must be kept for at least 30 years and include: The dates, number, duration, and results of each of the samples taken, including a description of the procedure used to determine representative employee exposures; A description of the sampling and analytical methods used; A description of the type of respiratory protective devices worn, if any; and The name, job classification, and exposure levels of the employee monitored and all other employees whose exposure the measurement is intended to represent. Medical surveillance records. Must be kept for the duration of employment plus 30 years, and include: The name of the employee; The employer’s copy of the physician’s written opinion on the initial, periodic and special examinations, including results of medical examinations and all tests, opinions and recommendations; Any employee medical complaints related to exposure to benzene; A copy of the information provided to the physician; and A copy of the employee’s medical and work history related to exposure to benzene or any other hematologic toxins.
1910.1029 Coke oven emissions
Who:	Employees who are employed in a regulated area at least 30 days per year. Regulated area. An area defined at 1910.1029(d) with access limited to authorized persons. Permissible exposure limit. Employees in the regulated area must not be exposed to coke oven emissions at concentrations greater than 150 micrograms per cubic meter of air (150 µg/m³), averaged over any 8-hour period.
Frequency:	Initial examinations. Must be provided at the time of initial assignment to a regulated area or upon the institution of the medical surveillance program. Periodic examinations. Must be provided at least annually.
Records:	Medical surveillance records. Must include: Name and description of duties of the employee, A copy of the physician’s written opinion, The signed statement of any refusal to take a medical examination, and Any employee medical complaints related to exposure to coke oven emissions. Medical records. The employer must keep, or assure that the examining physician keeps: A copy of the medical examination results including medical and work history, The initial x-ray, A description of the laboratory procedures used and a copy of any standards or guidelines used to interpret the test results, The x-rays for the most recent 5 years, Any x-ray with a demonstrated abnormality and all subsequent x-rays, The initial cytologic examination slide and written description, The cytologic examination slide and written description for the most recent 10 years, and Any cytologic examination slides with demonstrated atypia, if such atypia persists for 3 years, and all subsequent slides and written descriptions. All medical records and medical surveillance records. Must be kept for at least 40 years, or for the duration of employment plus 20 years, whichever is longer.
1910.1030 Bloodborne pathogens
Who:	Employees with occupational exposure to bloodborne pathogens, as defined at 1910.1030(b).
Frequency:	Hepatitis B vaccine and vaccination series. Must be offered to all employees with occupational exposure. Post-exposure evaluation and follow-up. Must be made immediately available to all employees who have had an exposure incident.
Records:	Medical records. Must be kept for the duration of employment plus 30 years and include: The name of the employee; A copy of the employee’s hepatitis B vaccination status including the dates of all the hepatitis B vaccinations and any medical records relative to the employee’s ability to receive vaccination; The employer’s copy of the healthcare professional’s written opinion; and A copy of all results of examinations, medical testing, and follow-up procedures; A copy of the information provided to the healthcare professional.
1910.1043 Cotton dust
Who:	Employees exposed to cotton dust. Action levels: Yarn manufacturing and cotton washing operations: Airborne concentration of lint-free respirable cotton dust of 100 µg/m³ mean concentration, averaged over an 8-hour period, as measured by a vertical elutriator or an equivalent instrument. Waste houses for textile operations: Airborne concentration of lint-free respirable cotton dust of 250 µg/m³ mean concentration, averaged over an 8-hour period, as measured by a vertical elutriator or an equivalent instrument. Textile processes known as slashing and weaving: Airborne concentration of lint-free respirable cotton dust of 375 µg/m³ mean concentration, averaged over an 8-hour period, as measured by a vertical elutriator or an equivalent instrument.
Frequency:	Initial examinations. Must be provided to each employee who is or may be exposed to cotton dust. New employees must be provided an examination prior to initial assignment. Periodic examinations. Must be provided: At least annually for all employees exposed to cotton dust above the action level in yarn manufacturing, slashing and weaving, cotton washing and waste house operations. At least every 2 years for all employees exposed to cotton dust at or below the action level, for all employees exposed to cotton dust from washed cotton (except from washed cotton defined in 1910.1043(n)(3)), and for all employees exposed to cotton dust in cottonseed processing and waste processing operations.
Records:	Medical records. Must be kept for at least 20 years and include: The name and description of the duties of the employee; A copy of the medical examination results including the medical history, questionnaire response, results of all tests, and the physician’s recommendation; A copy of the physician’s written opinion; Any employee medical complaints related to exposure to cotton dust; A copy of 1910.1043 and its appendices, except that employers may keep one copy of the standard and the appendices for all employees, provided that they reference 1910.1043 and appendices in the medical surveillance record of each employee; and A copy of the information provided to the physician.
1910.1044 – 1,2-dibromo-3-chloropropane
Who:	Employees who work in regulated areas and those who are subjected to DBCP exposures in an emergency situation. Regulated areas are those where DBCP concentrations are in excess of the permissible exposure limit (PEL). PEL: Inhalation. Airborne concentration of DBCP in excess of 1 part DBCP per billion parts of air (ppb) as an 8-hour time-weighted average (TWA). Dermal and eye exposure. No employee must be exposed to skin or eye contact with DBCP.
Frequency:	Medical examinations. Must be provided at the time of initial assignment and annually thereafter.
Records:	Medical records. Must be kept for at least 40 years or the duration of employment plus 20 years, whichever is longer, and include: The name of the employee, A copy of the physician’s written opinion, Any employee medical complaints related to exposure to DBCP, A copy of the information provided the physician, and A copy of the employee’s medical and work history.
1910.1045 Acrylonitrile
Who:	Employees who are or will be exposed to AN at or above the action level, without regard to the use of respirators. Action level. A concentration of AN of 1 ppm as an 8-hour time-weighted average (TWA).
Frequency:	Initial examinations. Must be provided at the time of initial assignment or upon institution of the medical surveillance program. Periodic examinations. Must be provided at least annually. If an employee has not had the initial examination within 6 months preceding termination of employment, the employer must make such examination available to the employee prior to termination. Additional examinations. Must be provided to employees who develop signs or symptoms which may be associated with exposure to AN.
Records:	Medical records. Must be kept for at least 40 years, or for the duration of employment plus 20 years, whichever is longer, and include: A copy of the physician’s written opinions, Any employee medical complaints related to exposure to AN, A copy of the information provided to the physician, and A copy of the employee’s medical and work history.
1910.1047 Ethylene oxide
Who:	All employees who are or may be exposed to EtO at or above the action level, without regard to the use of respirators, for at least 30 days a year, and all employees who have been exposed to EtO in an emergency situation. Action level. A concentration of airborne EtO of 0.5 ppm calculated as an 8-hour time-weighted average (TWA).
Frequency:	Medical examinations. Must be provided: Prior to assignment of the employee to an area where exposure may be at or above the action level for at least 30 days a year. At least annually for each employee exposed at or above the action level for at least 30 days in the past year. At termination of employment or reassignment to an area where exposure to EtO is not at or above the action level for at least 30 days a year. As medically appropriate for any employee exposed during an emergency. As soon as possible, upon notification by an employee either (1) that the employee has developed signs or symptoms indicating possible overexposure to EtO, or (2) that the employee desires medical advice concerning the effects of current or past exposure to EtO on the employee’s ability to produce a healthy child. If the examining physician determines that any of the examinations should be provided more frequently than specified, the employer must provide such examinations to affected employees at the frequencies recommended by the physician.
Records:	Medical records. Must be kept for the duration of employment plus 30 years and include: The name of the employee, Physicians’ written opinions, Any employee medical complaints related to exposure to EtO, and A copy of the information provided to the physician.
1910.1048 Formaldehyde
Who:	Employees who are exposed to formaldehyde at concentrations at or exceeding the action level or exceeding the short-term exposure limit (STEL), or in emergencies. Employees who develop signs and symptoms of overexposure to formaldehyde. Action level. A concentration of 0.5 part formaldehyde per million parts of air (0.5 ppm) calculated as an 8-hour time-weighted average (TWA) concentration. Short-term exposure limit (STEL). An airborne concentration of formaldehyde which exceeds two parts formaldehyde per million parts of air (2 ppm) as a 15-minute STEL.
Frequency:	Medical examinations. Must be given: To any employee who the physician feels, based on information in the medical disease questionnaire, may be at increased risk from exposure to formaldehyde. At the time of initial assignment. At least annually thereafter to all employees required to wear a respirator to reduce exposure to formaldehyde. Emergency medical examinations. Must be made available as soon as possible to all employees who have been exposed to formaldehyde in an emergency.
Records:	Medical records. Must be kept for the duration of employment plus 30 years and include: The name of the employee; The physician’s written opinion; A list of any employee health complaints that may be related to exposure to formaldehyde; and A copy of the medical examination results, including medical disease questionnaires and results of any medical tests required by the standard or mandated by the examining physician.
1910.1050 Methylenedianiline
Who:	Employees exposed to MDA at or above the action level for 30 or more days per year; Employees subject to dermal exposure to MDA for 15 or more days per year; Employees exposed in an emergency situation; Employees whom the employer, based on results from compliance with paragraph 1910.1050(e)(8), has reason to believe are being dermally exposed; and Employees who show signs or symptoms of MDA exposure. Action level. A concentration of airborne MDA of 5 ppb as an 8-hour time-weighted average (TWA). Dermal exposure to MDA. Occurs where employees are engaged in the handling, application, or use of mixtures or materials containing MDA, with any of the following non-airborne forms of MDA: Liquid, powdered, granular, or flaked mixtures containing MDA in concentrations greater than 0.1% by weight or volume; and Materials other than “finished articles” containing MDA in concentrations greater than 0.1% by weight or volume.
Frequency:	Initial examinations. Before the time of initial assignment. Periodic examinations. At least annually following the initial examination. Emergency examinations. If the employer determines that the employee has been exposed to a potentially hazardous amount of MDA in an emergency situation. Additional examinations. Where the employee develops signs and symptoms associated with exposure to MDA.
Records:	Medical surveillance records. Must be kept for at least the duration of employment plus 30 years and include: The name and description of the duties of the employee; The employer’s copy of the physician’s written opinion on the initial, periodic, and any special examinations, including results of medical examination and all tests, opinions, and recommendations; Results of any airborne exposure monitoring done for that employee and the representative exposure levels supplied to the physician; and Any employee medical complaints related to exposure to MDA. Medical records. The employer must keep, or assure that the examining physician keeps, for at least the duration of employment plus 30 years, the following medical records: A copy of 1910.1050 and its appendices, except that the employer may keep one copy of the standard and its appendices for all employees provided the employer references the standard and its appendices in the medical surveillance record of each employee; A copy of the information provided to the physician as required by any paragraphs in the regulatory text; A description of the laboratory procedures and a copy of any standards or guidelines used to interpret the test results or references to the information; and A copy of the employee’s medical and work history related to exposure to MDA. Medical removal records. Records for employees removed from current exposure to MDA must be kept for at least the duration of an employee’s employment plus 30 years, and include: The name of the employee, The date of each occasion that the employee was removed from current exposure to MDA as well as the corresponding date on which the employee was returned to his or her former job status, A brief explanation of how each removal was or is being accomplished, and A statement with respect to each removal indicating the reason for the removal.
1910.1051 1,3-Butadiene
Who	Employees with exposure to BD at concentrations at or above the action level on 30 or more days or for employees who have or may have exposure to BD at or above the permissible exposure limits (PELs) on 10 or more days a year. Employers (including successor owners) must continue to provide medical screening and surveillance for employees, even after transfer to a non-BD exposed job and regardless of when the employee is transferred, whose work histories suggest exposure to BD: At or above the PELs on 30 or more days a year for 10 or more years; At or above the action level on 60 or more days a year for 10 or more years; or Above 10 ppm on 30 or more days in any past year; and Each employee exposed to BD following an emergency situation. Action level. A concentration of airborne BD of 0.5 ppm calculated as an 8-hour time-weighted average (TWA). Permissible exposure limits (PELs): Time-weighted average (TWA) limit. No employee must be exposed to an airborne concentration of BD in excess of 1 part BD per million parts of air (ppm) measured as an 8-hour time-weighted average. Short-term exposure limit (STEL). No employee must be exposed to an airborne concentration of BD in excess of 5 parts of BD per million parts of air (5 ppm) as determined over a sampling period of 15 minutes.
Frequency:	Health questionnaire and complete blood count with differential and platelet count (CBC). Annually. Initial physical examination. Must be given: If 12 months or more have elapsed since the last physical examination conducted as part of a medical screening program for BD exposure, Before assumption of duties by the employee in a job with BD exposure, Every 3 years after the initial physical examination, At the discretion of the physician or other licensed care professional reviewing the annual health questionnaire and CBD, At termination of employment if 12 months or more have elapsed since the last physical examination. Emergency medical screening. Must be conducted as quickly as possible but not later than 48 hours after the exposure. Respirator fit test. For each employee who must wear a respirator, physical ability to perform the work and use the respirator must be determined as required by 1910.134.
Records:	Exposure measurements. Records must be kept for at least 30 years and include: The date of measurement; The operation involving exposure to BD which is being monitored; Sampling and analytical methods used and evidence of their accuracy; Number, duration, and results of samples taken; Type of protective devices worn, if any; and Name and exposure of the employees whose exposures are represented. The written corrective action and the schedule for completion of this action required by 1910.1051(d)(7)(ii). Medical screening and surveillance records. Must kept for the duration of employment plus 30 years and include: The name of the employee; Physician’s or other licensed healthcare professional’s written opinions as described in 1910.1051(k)(7); A copy of the information provided to the physician or other licensed healthcare professional as required by 1910.1051(k)(7)(ii)-(iv).
1910.1052 Methylene chloride
Who:	Employees who are or may be exposed to MC: At or above the action level on 30 or more days per year, or above the 8-hour TWA permissible exposure limit (PEL) or the short-term exposure limit (STEL) on 10 or more days per year; Above the 8-TWA PEL or STEL for any time period where an employee has been identified by a physician or other licensed health care professional as being at risk from cardiac disease or from some other serious MC-related health condition and such employee requests inclusion in the medical surveillance program; and During an emergency. Action level. A concentration of airborne MC of 12.5 parts per million (ppm) calculated as an 8-hour time-weighted average (TWA). Eight-hour time-weighted average (TWA) PEL. Airborne concentration of MC in excess of 25 parts of MC per million parts of air (25 ppm) as an 8-hour TWA. Short-term exposure limit (STEL). An airborne concentration of MC in excess of 125 parts of MC per million parts of air (125 ppm) as determined over a sampling period of 15 minutes.
Frequency:	Medical evaluation. Before having an employee use a supplied-air respirator in the negative-pressure mode, or a gas mask with an organic-vapor canister for emergency escape, the employer must: Have a physician or other licensed healthcare professional (PLHCP) evaluate the employee’s ability to use such respiratory protection. Ensure that the PLHCP provides their findings in a written opinion to the employee and the employer. Medical surveillance. Must be made available: Initially, before the time of an employee’s initial assignment; Annually thereafter; When recommended in the written medical opinion; and When an employee leaves the employer’s workplace or is reassigned to an area where exposure to MC is consistently at or below the action level and STEL, medical surveillance must be made available if 6 months or more have elapsed since the last medical surveillance.
Records:	Medical surveillance records. Must be kept for the duration of employment plus 30 years, and include: The name and description of the duties of the employee, Written medical opinions, and Any employee medical conditions related to exposure to MC.
1910.1053 Respirable crystalline silica
Who:	Employees who will be occupationally exposed to respirable crystalline silica at or above the action level for 30 or more days per year. Action level. A concentration of airborne respirable crystalline silica of 25 μg/m³, calculated as an 8-hour time-weighted average (TWA).
Frequency:	Initial examinations. An initial (baseline) examination must be made available within 30 days after initial assignment, unless the employee has received a medical examination that meets the requirements of 1910.1053 within the last 3 years. Periodic examinations. At least every 3 years, or more frequently if recommended by the physician or other licensed healthcare professional (PLHCP). Additional examinations. If the PLHCP’s written medical opinion indicates that an employee should be examined by a specialist, the employer must make available a medical examination by a specialist within 30 days after receiving the PLHCP’s written opinion.
Records:	Medical surveillance records. Must be kept for the duration of employment plus 30 years, and include: Employee name, A copy of the PLHCPs’ and specialists’ written medical opinions, and A copy of the information provided to the PLHCPs and specialists.
1910.1450 Occupational exposure to hazardous chemicals in laboratories
Who:	Employees exposed above the action level or the permissible exposure limit (PEL) for an OSHA-regulated substance for which there are exposure monitoring and medical surveillance requirements.
Frequency:	Medical examinations. Whenever employees develop signs or symptoms associated with a hazardous chemical to which they may have been exposed in the laboratory, they must be provided an opportunity to receive an appropriate medical examination. Medical surveillance. Where exposure monitoring reveals an exposure level routinely above the action level (or in the absence of an action level, the permissible exposure limit (PEL)) for an OSHA-regulated substance for which there are exposure monitoring and medical surveillance requirements, medical surveillance must be established for the affected employee as prescribed by the particular standard. Medical consultations. Whenever an event takes place in the work area such as a spill, leak, explosion, or other occurrence resulting in the likelihood of a hazardous exposure, the affected employee must be provided an opportunity for a medical consultation. The consultation must be for the purpose of determining the need for a medical examination.
Records:	Medical and monitoring records. The following records must be kept for at least the duration of employment plus 30 years: Any measurements taken to monitor employee exposures, Any medical consultation, and Examinations including tests or written opinions required by 1910.1450.