Elements of Medical Surveillance Program Determination

242 FW 4
Originating Office
Safety Operations

Occupational Exposure Assessment. An occupational exposure assessment includes:

·        Basic Exposure Characterization (qualitative assessment).

·        DOI Medical Handbook Employee Questionnaire. Employees fill out questionnaires on workplace exposure history [found in DOI Medical Handbook, Tab 12, Attachments D2 (b) and (c)].

·        Workplace Exposure Monitoring (quantitative assessment). We perform air sampling to determine airborne levels of various chemical and biological contaminants. Depending on the results, additional periodic exposure monitoring may be warranted.

·        Frequency of Monitoring. If there are already regulatory or consensus standards for the materials we are monitoring, industrial hygienists or other safety professionals use their professional judgment to determine the frequency of monitoring.

·        Assessment Recommendations. The industrial hygienist or other safety professional provides:

     o       Recommendations to the Project Leader/Supervisor/Facility Manager about which employee(s) should be in a medical surveillance program and what type of workplace controls are necessary.

     o       Supporting data and recommendations for the Project Leader/Supervisor/Facility Manager and Regional Safety manager about how to eliminate or minimize worker occupational exposures.

Medical Surveillance. An Occupational Health Physician or a doctor trained in occupational health:

·        Provides a schedule of employee physical examinations to Project Leaders/Supervisors/Facility Managers.

·        Examines employees based on real or expected workplace hazards using medical and occupational histories and clinical and biological screening tests.

·        Determines employees’ ability to wear respiratory protection (242 FW 14) or other personal protective equipment (241 FW 3).

·        Uses workplace sampling results, if available, to determine the appropriate type and frequency of medical surveillance for workers.

Workplace Re-evaluation. When workplace activities warrant implementation of a medical surveillance program, the Project Leader/Supervisor/Facility Manager and occupational safety professionals must consider the changes in the activity and re-evaluate the exposure potential. For example, at Fish Hatchery B, exposures to formaldehyde exceed OSHA’s permissible exposure limit. The Facility Manager initiates medical surveillance and then reviews work practices for changes. The Facility Manager must also establish procedures for the re-evaluation and notify the Regional Safety Office about the need for it.