(1) General.
(a) The employer shall determine that dive
team members who are, or are likely to be, exposed to hyperbaric conditions are
medically fit to perform assigned tasks in a safe and healthful
manner.
(b) The employer shall
provide each dive team member who is, or is likely to be, exposed to hyperbaric
conditions with all medical examinations required by this standard.
(c) All medical examinations required by this
standard shall be performed by, or under the direction of, a physician at no
cost to the employee.
(2) Frequency of medical examinations.
Medical examinations shall be provided:
(a)
Prior to initial hyperbaric exposure with the employer, unless an equivalent
medical examination has been given within the preceding 12 months and the
employer has obtained the results of the examination and an opinion from the
examining physician of the employee's medical fitness to dive or to be
otherwise exposed to hyperbaric conditions;
(b) At one year intervals from the date of
initial examination or last equivalent examination; and
(c) After an injury or illness requiring
in-patient hospitalization.
(3) Information provided to examining
physician. The employer shall provide the following information to the
examining physician:
(a) A copy of the medical
requirements of this standard; and
(b) A summary of the nature and extent of
hyperbaric conditions to which the dive team member will be exposed, including
diving modes and types of work to be assigned.
(4) Content of medical examinations.
(a) Medical examinations conducted initially
and annually shall consist of the following:
(i) Medical history;
(ii) Diving-related work history;
(iii) Basic physical examination;
(iv) The tests required by Table I;
and
(v) Any additional tests the
physician considers necessary.
(b) Medical examinations conducted after an
injury or illness requiring in-patient hospitalization shall be appropriate to
the nature and extent of the injury or illness as determined by the examining
physician.
TABLE I
TESTS FOR DIVING MEDICAL EXAMINATION
|
Test
|
Initial
Examination
|
Annual
Reexamination
|
|
Chest X ray . . . . . . . . . . . .
|
x
|
|
|
Visual acuity . . . . . . . . . . . .
|
x
|
x
|
|
Color blindness . . . . . . . . . . . .
|
x
|
|
|
EKG: Standard 12L1 . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . .
|
|
Hearing test . . . . . . . . . . . .
|
x
|
x
|
|
Hematocrit or . . . . . . . . . . . .
|
x
|
x
|
|
hemoglobin.
|
|
|
|
Sickle cell index . . . . . . . . . . . .
|
x
|
|
|
White blood count . . . . . . . . . . . .
|
x
|
x
|
|
Urinalysis . . . . . . . . . . . .
|
x
|
x
|
|
1To be given to the
employee once, at age 35 or over.
|
(5) Physician's
written report.
(a) After any medical
examination required by this standard, the employer shall obtain a written
report prepared by the examining physician containing:
(i) The results of the medical examination;
and
(ii) The examining physician's
opinion of the employee's fitness to be exposed to hyperbaric conditions,
including any recommended restrictions or limitations to such exposure (see WAC
296-37-585) .
(b) The employer shall provide the
employee with a copy of the physician's written report.
(6) Determination of employee fitness.
(a) The employer shall determine the extent
and nature of the dive team member's fitness to engage in diving or be
otherwise exposed to hyperbaric conditions consistent with the recommendations
in the examining physician's report.
(b) If the examining physician has
recommended a restriction or limitation on the dive team member's exposure to
hyperbaric conditions, and the affected employee does not concur, a second
physician selected by the employee shall render a medical opinion on the nature
and extent of the restriction or limitation, if any.
(c) If the recommendation of the second
opinion differs from that of the examining (first) physician, and if the
employer and employee are unable to agree on the nature and extent of the
restriction or limitation, an opinion from a third physician selected by the
first two physicians shall be obtained. The employer's determination of the
dive team member's fitness shall be consistent with the medical opinion of the
third physician, unless the employer and employee reach an agreement which is
otherwise consistent with the recommendation or opinion of at least two of the
physicians involved.
(d) Nothing in
this procedure shall be construed to prohibit either a dive team member from
accepting, or an employer from offering, an assignment which is otherwise
consistent with at least one medical opinion while a final determination on the
employee's fitness is pending.
