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Medical Surveillance Program

Title:

Medical Surveillance Examination Program

Publication date:

9/10/2013

Effective date:

12/12/2007

BRIEF

Policy Summary

In accordance with Department of Energy and Occupational Safety and Health Administration regulations, as well as voluntary standards, Berkeley Lab offers medical surveillance examinations to ensure employees are not overexposed to hazards, and to detect early signs of disease, to prevent disease progression, and to protect other members of the workforce.

Who Should Read This Policy

Berkeley Lab employees who work with hazardous chemical or physical agents, and their supervisors.

To Read the Full Policy, Go To:

The POLICY tab on this wiki page

Contact Information

For assistance or information on Berkeley Lab's medical surveillance program, contact:
LBNL Health Services
Site Occupational Medical Director or
Health Services Program Manager

Title:

Medical Surveillance Examination Program

Publication date:

9/10/2013

Effective date:

12/12/2007

POLICY

A. Purpose

This policy describes Lawrence Berkeley National Laboratory's medical surveillance programs.

B. Persons Affected

Berkeley Lab supervisors and employees who work with hazardous chemical and physical agents

C. Exceptions

None

D. Policy Statement

In accordance with Department of Energy (DOE) and Occupational Safety and Health Administration (OSHA) regulations, as well as voluntary standards, Berkeley Lab offers medical surveillance examinations to ensure employees are not overexposed to hazards, and to detect early signs of disease, to prevent disease progression, and to protect other members of the workforce.
Berkeley Lab provides a wide variety of medical surveillance examinations based upon the following:

  • Actual exposure to certain hazardous chemicals
  • Actual or possible exposure to physical agents and radiation
  • The requirement to wear certain types of personal protective equipment
  • Qualification standards to operate certain types of equipment or vehicles
  • Requirements from collaborating institutions (e.g., Antarctic Field Station)

Participation in medical surveillance examinations may be voluntary or mandatory, depending on the regulatory language and Laboratory policy.

E. Roles and Responsibilities

See PUB-3000 for roles and responsibilities related to the execution of this policy's implementation.

Role

Responsibility

Site Occupational Medical Director

  • Oversees medical surveillance efforts offered by Health Services
  • Design exposure-appropriate medical surveillance exams

Supervisors

Make employees available for medical surveillance examinations

Employees

Cooperate and respond to medical surveillance examination offerings

F. Definitions/Acronyms

See PUB-3000 Chapter 3 for technical terms related to the details of this policy and its implementation.

Term

Definition

Medical Surveillance

Medical evaluations designed to detect adverse health effects from workplace exposures, with the intent of halting disease development and progression. Also medical evaluations to determine fitness for certain job duties

G. Recordkeeping Requirements

Role

Recordkeeping Requirement

Health Services

  • Maintains confidential medical records of employees participating in medical surveillance programs
  • Provides work status documentation to Berkeley Lab management as required by regulation
  • Provides documentation of medical findings to Berkeley Lab employees as required by regulation

H. Implementing Documents

Document number

Reference number

Title

Type

07.05.002.001

PUB-3000 Section 3.9

Medical Surveillance Program

Program

02.13.002.001

 

Health Services

Program

07.07.004.001

 

Biosafety

Program

07.07.022.001

 

Noise Hazard Assessment and Control

Program

07.07.018.001

 

Laser Safety Program

Program

07.07.023.001

 

Non-ionizing Radiation

Program

07.07.005.001

 

Chemical Safety Hazards and Controls

Program

07.07.002.001

 

Asbestos Hazards and Controls

Program

07.07.019.001

 

Lead Hazards and Controls

Program

07.07.003.001

 

Beryllium Hazards and Controls

Program

07.07.032.001

 

Respiratory Protection

Program

07.07.013.001

 

Exposure Assessment

Program

07.07.025.001

 

Forklifts and Other Powered Industrial Trucks

Program

07.07.008.001

 

Cranes, Hoisting, and Rigging Safety

Program

I. Contact Information

LBNL Health Services
Site Occupational Medical Director or
Health Services Program Manager

 h3. J. Revision History

Date

Revision

By whom

Revision Description

Section(s) affected

Change Type

9/10/2013

1.1

P. Lichty

Reviewed 8/29/13

Brief,Policy D,definitions, Roles, Next Review date

Minor

1/2/2012

1

P. Lichty

Rewrite for RPM

all

Minor

DOCUMENT INFORMATION

Title:

Medical Surveillance Examination Program

Document number

07.05.002.000

Revision number

1.1

Publication date:

9/10/2013

Effective date:

12/12/2007

Next review date:

9/10/2016

Policy Area:

Health Services

RPM Section (home)

Human Services

RPM Section (cross-reference)

none

Functional Division

EH&S

Prior reference information (optional)

PUB-3000 Section 3.9, RPM Section 1.12(A)(1)

Source Requirements Documents

  • 10 CFR 851 Appendix A, Section 8, (k)(3), Worker Health and Safety Program; Occupational Medicine Section; Employee Counseling and Health Promotional Programs

The following are in the Laboratory's DOE Contract 31, or are good references.

Topic

Subtopic

Regulation#

Animal Care Worker

Initial Exam

Berkeley Lab Environmental Safety and Health Manual (PUB-3000)
National Research Council Guide for the Care and Use of Laboratory Animals (reference only, not in Contract 31)

Antarctica

Exam

Driven by organization servicing the south pole groups (requirements are driven by form brought in by employee)

Asbestos

Comment

There are no personnel who qualify for mandatory general industry asbestos and the number of individualsqualifying for mandatory construction surveillance is fairly small.

Asbestos

Voluntary

N/A – Past exposure history

Asbestos (construction)

Annual Exam

8 CCR 1529(m)(2)(A)(3)

Asbestos (construction)

Exit Exam

8 CCR 1529(m)(2)(A)(6)

Asbestos (construction)

Initial Exam

8 CCR 1529(m)(2)(A)(1)-(2)

Beryllium

Emergency

10 CFR 850

Beryllium

Initial

10 CFR 850.34

Beryllium

Periodic

10 CFR 850

Biological Agents andWorkers withCompromised Heath

Immune competence

Biosafety In Microbiological and Biomedical Laboratories, 5th ed. Section IV Laboratory Biosafety Level 2(A.11.) Criteria and VII Occupational Health and Immunoprophylaxis. Also Biosafety Manual Section 5.3 andC.3.1.11.

Biological ExposureIncidents

Exposure

Biosafety In Microbiological and Biomedical Laboratories, 5th ed. Section IV Laboratory Biosafety Level 2(B.8) Criteria and Section VII Occupational Health and Immunoprophylaxis. Also Biosafety Manual Section5.3, 5.10.2, and C.3.2.8.

Biosafety HumanPathogens

Potential exposureidentified in BiosafetyWork Authorization

Biosafety In Microbiological and Biomedical Laboratories, 5th ed. Section IV Laboratory Biosafety Level 2(B.2.) Criteria and Section VII Occupational Health and Immunoprophylaxis. Also Biosafety Manual Section5.3, and C.3.2.2

Bloodborne Pathogen

Exposure Incident related to a job duty or not related to a job duty

29 CFR 1910.1030
Biosafety Manual Sections 3.3.4 , 5.3, and 5.10.2

Bloodborne Pathogen

Vaccination

29 CFR 1910.1030

CERN

Exam

Driven by organization (requirements and form brought in by employee)

Chemical Hygiene

Event

29 CFR 1910.1450(g)(1)

Crane Operator

Chapter 27.5 >2 tons

No Regulation
Currently have PUB-3000 Chapter 27
Clinic follows NCCCO Handbooks, which matches ASME B30 (NCCCO not found in Contract 31)
10 CFR 851, Appendix A 8(g)(2)(ii), requires a fitness-for-duty exam

Crane Operator

Chapter 27.5
>2 tons and mobile crane driver

8 CCR 5006.1

Crane Operator

Chapter 27.5 <2 tons

No regulation
Currently have PUB-3000 Chapter 27
Clinic follows NCCCO Handbooks, which matches ASME B30 (NCCCO not found in Contract 31)
10 CFR 851, Appendix A 8(g)(2)(ii) requires a fitness-for-duty exam

DOT Driver

Driver Medical Exam

49 CFR 391.41 et seq. (Reference only - not in Contract 31)

General Health Exam

Age Based

10 CFR 851, Appendix A 8(g)(2)(i)

General Health Exam

Termination

10 CFR 851, Appendix A 8(g)(2)(v)

Hazwoper

Annual or Periodic Exam

29 CFR 1910.120(a)(1) (i)-(iv); f(2)(ii)

Hazwoper

Exposure Exam

29 CFR 1910.120(a)(1) (i)-(iv); (f)(2)(iii)

Hazwoper

Pre-placement

29 CFR 1910.120(a)(1) (i)-(iv); f(2)(ii)

Hazwoper

Termination Exam

29 CFR 1910.120(a)(1) (i)-(iv); f(2)(ii)

Hearing Conservation

Annual Exam

29 CFR 1910.95(g)

Hearing Conservation

Baseline

29 CFR 1910.95(g)

Laser

Exposure Exam

ANSI Z136.1

Laser

Pre-use

ANSI Z136.1
PUB-3000 Section 16.4.3.2

Laser

Termination Exam

Legal considerations, courtesy to user

Lead

Comment

There are no personnel who qualify for mandatory annual surveillance for construction.

Lead

Voluntary

29 CFR 1910.1025(j); 8 CCR 1532.1(j) (as guides)

Lead (construction)

Initial

8 CCR 1532.1(j)(1)

Nanoparticle

Initial

DOE Notice/Order 456.1 (proposed)

Nanoparticle

Termination

DOE Notice/Order 456.1

PIT Operator

Medical Clearance

ASME B56.1, Powered Industrial Trucks
PUB-3000 Section 28.5
Berkeley Lab Health Services Clinic follows NCCCO Handbooks, which matches ASME B30 (NCCCO not found in Contract 31)
10 CFR 851, Appendix A, 8(g)(2)(ii) requires a fitness-for-duty exam

Pre-placement Exam

None

10 CFR 851, Appendix A 8(g)(2)

Respiratory Protection

Annual Exam (SCBA users)

29 CFR 1910.134
Z88.6 9.1.2

Respiratory Protection

Fit Test

29 CFR 1910.134(f)

Respiratory Protection

Initial Non-voluntary Use

29 CFR 1910.134

Respiratory Protection

Voluntary Users (non-dust mask)

29 CFR 1910.134(c)(2)

Return to Work Exam

Suitability

10 CFR 851, Appendix A, 8(g)(2)(iv)

Transfer Exam

None

10 CFR 851, Appendix A, 8(g)(2)(i)

Related Berkeley Lab Policies

  • EHS Core Policy, 07.01.001.000
  • Health Services Overview, 02.13.002.000
  • Family and Medical Leave Policy, 02.07.003.000
  • Workers' Compensation Policy, 02.06.008.000

Implementing Documents

Document number

Reference number

Title

Type

07.05.002.001

PUB-3000 Section 3.9

Medical Surveillance Program

Program

02.13.002.001

 

Health Services

Program

07.07.004.001

 

Biosafety

Program

07.07.022.001

 

Noise Hazard Assessment and Control

Program

07.07.018.001

 

Laser Safety Program

Program

07.07.023.001

 

Non-ionizing Radiation

Program

07.07.005.001

 

Chemical Safety Hazards and Controls

Program

07.07.002.001

 

Asbestos Hazards and Controls

Program

07.07.019.001

 

Lead Hazards and Controls

Program

07.07.003.001

 

Beryllium Hazards and Controls

Program

07.07.032.001

 

Respiratory Protection

Program

07.07.013.001

 

Exposure Assessment

Program

07.07.025.001

 

Forklifts and Other Powered Industrial Trucks

Program

07.07.008.001

 

Cranes, Hoisting, and Rigging Safety

Program

Other References

  • DOE G 440.1-8, Implementation Guide for Use with 10 CFR Part 851, Worker Safety and Health Programs, Section 3.6.8.9 Assistance and Wellness

 

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