RPM

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, 5^th 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, 5^th 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, 5^th 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

RPM

REQUIREMENTS AND POLICIES MANUAL

Medical Surveillance Program