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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
    Laboratory 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

    Laboratory 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
    Laboratory Medical Director or
    Health Services Program Manager

    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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