Safety Tidbit #2.9 – Medical Surveillance
Source: OSHA’s Clinicians Webpage
As an industrial hygienist, I routinely get questions from clients asking what medical surveillance should their employees be enrolled in. The more frustrating question comes from physicians asking a slightly different question “What is required for this employee’s medical surveillance?” Well, medical surveillance should happen before, during, and after employment. As for the clinicians’ question about what is required, well that depends on the hazard.
First, Pre-employment: I recommend to all of my clients that they should conduct medical examination prior to hiring any new employees. Yes, you can ask if the employee has any disabilities or they may even request special accommodations due to their physical disability as per ADA requirements. However, a pre-employment physical identifies any underlying health conditions that the particular job may exacerbate. Also, the pre-employment physical ensures the worker can perform the necessary physical demands of the position. And lastly, the physical gives the status of the employee’s health upon hire. This can be very helpful down the road to establishing causality of an occupational disease or injury.
The second are the periodical examinations. This is what the clinicians are really curious about. OSHA as put together a nice website specifically for Clinicians and also a publication Screening and Surveillance: A Guide to OSHA Standards. These are very helpful for the clinicians to ensure they are doing the minimum medical surveillance requirements of the individual OSHA Standards. Most clinicians, like us consultants, know there are many more hazards out there than what OSHA has regulations for and wish to have more information. So, using the Clinicians web page is a good start, however, I further recommend they look to the American Conference of Governmental Industrial Hygienists to their Threshold Limit Values (TLVs) and Biological Exposure Indices (BEIs). Specifically, the BEIs are medical testing that can be performed routinely to evaluate if an employee has suffered occupational exposure to a hazardous agent or check the effectiveness of personal protective equipment. The testing could be the amount of a chemical in the expired breath or it could be as complicated as a particular threshold of a metabolite in the urine or blood directly after the completion of the work shift.
And lastly, to complete the employee’s career a termination physical should be accomplished. Similar to the pre-employment physical, the termination physical gives a snapshot of the employee’s physical condition at the end of service.
Ultimately, each employee is being paid to perform a service for their employer. They are not paid to degrade their health nor to give up a limb or eye. We all age, so let nature’s course degrade our health and not artificially inflate the process with poor working conditions.
Hope this was helpful and thanks for reading my Safety Tidbits ~ Bryan
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