Medical Surveillance | Asbestos

A medical surveillance program has to be developed for all employees who are exposed to airborne concentrations of asbestos at or above the action level. All examinations must be performed under the supervision of a licensed physician at no cost to the employee and at a reasonable time and place.

Pre-Placement Physical Examination

Before an employee is assigned to a job with airborne concentration exposures of asbestos fibers at or above the TWA and/or excursion limit, a pre-placement medical examination must be provided or made available by the employer. Examinations will include a complete physical examination with emphasis on the:

• Respiratory system,
• Cardiovascular system,
• Digestive tract,
• Chest X-ray; and
• Pulmonary function test.

Each employee also has to complete a respiratory disease questionnaire.

These examinations must be made available annually following the employee's first exposure to asbestos. If the employee is terminated, he or she must be examined within 30 days before or after the date of termination. The employer must give the examining physician a copy of the standard and appendices; a description of the employee's duties relating to the employee's asbestos exposure; the exposure level or anticipated exposure level; a description of any personal protective and respiratory equipment used or to be used; and information from previous medical examinations.

Physician's Opinion

The employer is further responsible to get a written, signed opinion from the physician which contains:

• The results of the medical examination and the physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk from exposure to asbestos;
• Any recommended limitations on the employee or upon the use of personal protective equipment such as clothing or respirators;
• A statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure; and
• A statement that the employee has been informed by the physician of the results of the medical examination.

The physician is not to reveal in the written opinion given to the employer specific findings or diagnoses unrelated to occupational exposure to asbestos. The employer must provide a copy of the physician's written opinion to the affected employee within 30 days after its receipt.