Medical Surveillance and Recordkeeping
You are the supervisor for an asbestos abatement company. A new employee, age 35, has been hired and will be working on asbestos abatement projects. He has no prior asbestos experience. He provides a medical questionnaire but no physical exam. He is assigned to a project that requires respirator use. After six months, he begins to experience shortness of breath and a persistent cough. He reports this to you. You review his records and find that he has not been given a medical exam since hiring, and his respirator fit test was done but no medical clearance was documented. The company has a written respiratory protection program but it is not consistently followed.
1. What are the medical surveillance requirements for this employee under OSHA?
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Under OSHA's asbestos standard (29 CFR 1926.1101), the employer must provide medical examinations to employees who are exposed to asbestos above the permissible exposure limit (PEL) or who wear respirators. The examination must be provided within 30 days of assignment and annually thereafter. The exam must include a medical and work history, a physical exam, and may include a chest X-ray and pulmonary function test. The employee must be medically cleared for respirator use before fit testing and use. In this case, the employee did not receive a medical exam at hiring, so the employer is in violation. The employee's symptoms may be work-related and require immediate medical evaluation. The employer must provide the exam now and ensure future compliance.
2. What recordkeeping requirements apply, and what should be done with the employee's medical records?
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The employer must maintain accurate records of employee exposure monitoring, medical exams, and fit testing. Medical records must be kept for the duration of employment plus 30 years. Exposure records must be kept for 30 years. The employee must be provided access to his records. The employee's medical records must be kept confidential. In this case, the employer must ensure that the medical exam is conducted and the results are recorded. The employee's symptoms should be documented and reported to the physician. The employer should also review the respiratory protection program to ensure compliance.