4.1 Purpose. This chapter establishes requirements for medical surveillance of Fish and Wildlife Service (Service) personnel.

4.2 Policy. The Service's policy is to monitor workplace exposures for chemical, physical, and biological hazards, and perform follow-up medical surveillance for personnel who are or may be occupationally exposed to identified hazards above established exposure levels.

4.3 Scope. This program applies to Service personnel whose duties may require occupational exposure to toxic chemicals, physical agents, or biological hazards above established Permissible Exposure Limits (PEL) and Threshold Limit Values (TLV). Examples of Service activities that may require medical surveillance include, but are not limited to: pesticide handlers, wildlife inspectors, contaminant specialists, chemical spill clean-up personnel, fire fighters, field personnel and engineering staff working with hazardous wastesite activities. Volunteers under the age of 18 are excluded from activities that require medical surveillance.

4.4 Authority.

A. Departmental Manual - Part 370, Personnel, Chapter 792 (7.1), Medical Surveillance Program.

B. Departmental Manual - Part 485, Safety and Health Program, Chapter 17, Industrial Hygiene and Chapter 18 (18.3D), Occupational Medical Program.

4.5 Responsibilities.

A. Deputy Director - Staff (DD-S) is responsible to the Director for oversight of the medical surveillance program.

B. Chief, Office of Safety and Health, is responsible for assisting Regional Safety Managers in the development and monitoring of Regional medical surveillance programs.

C. Regional Safety Managers (RSM) are responsible for:

(1) Providing technical assistance to project leaders in implementing this policy.

(2) Providing guidance to project leaders, upon request, in finding an Occupational Health Physician (OHP).

(3) Working with project leaders to ensure appropriate sampling data are included in the personnel medical folder (SF 66D). (NOTE: For the purposes of this chapter, appropriate sampling data are information collected for compliance with specific Occupational Safety and Health Administration (OSHA) regulations, e.g., audiograms, asbestos sampling data, etc.).

(4) Working with project leaders in applying or implementing engineering or administrative controls when workers are or may be occupationally exposed to chemical, physical, or biological hazards above established PEL or TLV.

(5) Working with project leaders in the acquisition and proper use of personal protective equipment (PPE) when engineering or administrative controls are in the process of being implemented, are not feasible, or are not effective in protecting workers from occupational exposures to chemical, physical, or biological hazards.

D. Project Leaders are responsible for:

(1) Developing a job hazard analysis (JHA) for operations where chemical, physical, or biological hazards may affect Service personnel. The JHA will be consistent with 240 FW 2.

(2) Identify personnel who require medical surveillance and advise the Regional Office in developing a medical surveillance contract with a health provider; e.g., the U.S. Public Health Service (USPHS).

(3) Utilize OHPs for medical surveillance. If an OHP cannot be found through the USPHS, the project leader will contact the RSM for assistance in locating an OHP.

4.6 Definitions.

A. Personnel is any Service employee who may be exposed to potentially hazardous materials in the workplace.

B. Clinical Laboratory Tests are portions of the overall examination used to detect the absorption of toxic agents, or the physiological or pathological effects caused by their absorption.

C. Medical Surveillance Action Level is the minimum level of personnel exposure that determines the necessity for occupational health medical surveillance examinations.

D. Medical Surveillance is comprised of the following:

(1) Pre-placement or baseline examinations are designed to assess physical capabilities and limitations in relation to job requirements, and to document baseline data for future use in the evaluation of potential exposures of Service personnel.

(2) Special purpose periodic examinations are conducted at pre-determined intervals to evaluate and document the health effects of occupational exposures.

(3) Termination examinations:

(a) Termination of employment examinations are conducted when workers leave employment. It is to assess the relationship of any future medical problems from an exposure in the workplace.

(b) Termination of exposure examinations are applicable when exposure to a specific hazard is removed. Exposures to specific hazards may cease when an worker is reassigned, a process is changed, or the individual leaves employment.

E. Occupational Health Medical Surveillance Examination is an occupationally related medical history, physical examination, and a series of clinical laboratory tests that are performed to assess the health status of individuals.

F. Occupationally Related Medical History is an individual's medical background including occupational exposures, family health, and personal health.

G. OHP is a doctor of medicine or doctor of osteopathy who is licensed to practice medicine. The OHP should be certified by the American College of Occupational Medicine.

H. Physical Examinations are performed to determine fitness of an individual to perform work while evaluating evidence of acute and chronic injury and disease. These examinations should be performed by the OHP; however, other licensed health care professionals such as a registered nurse or a physician's assistant may perform the examinations if supervised by the OHP.

I. Regulated Areas are areas where entry and exit are restricted or controlled because of potential exposures to occupational or environmental hazards.

J. Workplace is a physically definable area where work is performed. Workplaces may be administrative, field, industrial, or laboratory, and are or maybe staffed by personnel.

K. Workplace Sampling is performed to measure personnel exposures to physical, chemical, or biological hazards. This sampling should be performed by an industrial hygienist (IH) or other safety and health professional.

4.7 Procedures.

A. Appropriate medical surveillance will be scheduled for affected personnel and will be conducted by an OHP in accordance with any required OSHA, Department of the Interior, and Service policies, incorporating IH surveys, and safety and health practices.

B. The OHP will:

(1) Provide a schedule of personnel physical examinations to project leaders.

(2) Perform personnel examinations based upon real and/or expected workplace hazards using medical and occupational histories, and clinical and biological screening tests.

(3) Determine personnel condition-of-fitness to wear respiratory protection and other personal protective equipment.

(4) Utilize workplace sampling to determine the appropriate type and frequency of medical surveillance for workers.

C. IH services, as requested by project leaders and provided by Regional or contractual sources will:

(1) Conduct surveys and in-depth studies of workplaces to identify and quantify chemical, physical, and biological exposures to workers.

(2) Coordinate study results and air sampling data as appropriate.

(3) Provide supporting data and recommendations for RSMs consideration on how to eliminate or minimize worker occupational exposures.

4.8 Record keeping.

A. Medical and exposure records are filed by the servicing Personnel Office, in accordance with personnel, medical surveillance, medical records, maintenance rules, and regulations.

B. These records will be placed in the personnel SF 66D, in the servicing Personnel Office apart from other personnel records.