Content
(ii) Content. Medical examinations made available pursuant to paragraphs (m)(2)(i)(A) through (m)(2)(i)(C) of this section shall include: (A) A medical and work history with special emphasis directed to the pulmonary, cardiovascular, and gastrointestinal systems. (B) On initial examination, the standardized questionnaire contained in part 1 of appendix D to this section, and, on annual examination, the abbreviated standardized questionnaire contained in part 2 of appendix D to this section. (C) A physical examination directed to the pulmonary and gastrointestinal systems, including a 14- by 17-inch or other reasonably-sized standard film or digital posterior-anterior chest X-ray to be administered at the discretion of the physician, and pulmonary function tests of forced vital capacity (FVC) and forced expiratory volume at one second (FEV1). Classification of all chest X-rays shall be conducted in accordance with appendix E to this section. (D) Any other examinations or tests deemed necessary by the examining physician. (3) Information provided to the physician. The employer shall provide the following information to the examining physician: (i) A copy of this standard and Appendices D, E, and I to this section; (ii) A description of the affected employee's duties as they relate to the employee's exposure; (iii) The employee's representative exposure level or anticipated exposure level; (iv) A description of any personal protective and respiratory equipment used or to be used; and (v) Information from previous medical examinations of the affected employee that is not otherwise available to the examining physician. (4) Physician's written opinion. (i) The employer shall obtain a written opinion from the examining physician. This written opinion shall contain the results of the medical examination and shall include: (A) The physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos; (B) Any recommended limitations on the employee or on the use of personal protective equipment such as respirators; and (C) A statement that the employee has been informed by the physician of the results of the medical examination and of any medical conditions that may result from asbestos exposure. (D) A statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure. (ii) The employer shall instruct the physician not to reveal in the written opinion given to the employer specific findings or diagnoses unrelated to occupational exposure to asbestos. (iii) The employer shall provide a copy of the physician's written opinion to the affected employee within 30 days from its receipt.