Which employees must be offered medical surveillance?

Employers must make an initial or periodic medical examination available to employees who meet the exposure trigger. The triggers for medical surveillance are:

• Exposures above the PEL for 30 or more days a year from June 23, 2018 through June 22, 2020; and
• Exposures at or above the action level for 30 or more days a year beginning June 23, 2020.

Employers are required to make a medical examination available to those employees:

• Initial exam—within 30 days of initial assignment, unless the employee has had a current examination that meets the requirements of this rule within the last three years; and
• Periodic exam—every three years from the employee’s last examination that met the requirements of the silica standard, or more frequently if recommended by the physician, if the employee will continue to perform tasks that result in exposures at the trigger for 30 or more days per year.

The medical surveillance must be offered at no cost to the employee and at a reasonable time and place. The employee must be paid for the time to travel to, and take, the examination.