Occupational Medicine (CAQ-OccMed)
Occupational Medicine is the single domain of the CAQ-OccMed exam. Items are scenario-based: you act as plant physician or consultant and must pick the answer that is both clinically sound and legally required - linking an exposure to a diagnosis, then applying OSHA, ADA, DOT and workers' compensation rules.
Core rules to have at hand
- OSHA recordkeeping: a case is recordable when work-related and it causes death, days away, restricted work or transfer, medical treatment beyond first aid, loss of consciousness, or a significant diagnosis. Enter it on the 300 log within 7 calendar days; report a fatality within 8 hours and an amputation, loss of an eye or in-patient hospitalization within 24 hours.
- Hearing conservation: the action level is an 85 dBA 8-hour TWA with a 5 dB exchange rate. A standard threshold shift (STS) is a 10 dB average shift at 2000, 3000 and 4000 Hz in either ear.
- Respirators: OSHA 1910.134 requires a medical evaluation by questionnaire before fit testing. Spirometry and chest radiographs are not routine requirements for every user.
- ADA: medical inquiries and exams must be job-related and consistent with business necessity. Post-offer exams are conditional, applied to all entrants into the same job category, and clearance turns on essential functions with or without accommodation.
Worked example
A 51-year-old press operator's annual audiogram moves the right 4000 Hz threshold from 25 to 45 dB; 2000 and 3000 Hz are unchanged. Reason it through: the STS is the average of 2000, 3000 and 4000 Hz, so (0 + 0 + 20) / 3 = 6.7 dB - not a recordable STS, even though it is a real change. Confirm with a retest, refit hearing protection, counsel on off-duty noise, and recheck in a year rather than filing a 300 entry.
Traps that cost marks
Equating OSHA recordability with workers' compensation compensability (different tests); confusing a PEL with an action level (90 vs 85 dBA; 50 vs 30 µg/m³ for lead); ordering imaging before taking an exposure history and temporal pattern; treating a single-frequency shift as an STS; collecting a DOT specimen without the split-specimen, MRO and SAP return-to-duty chain.