Wash. Admin. Code § 296-62-07371 - Medical surveillance
(1)
General.
(a) Employees covered.
(i) The employer must institute a medical
surveillance program for all employees who are or may be exposed to EtO at or
above the action level, without regard to the use of respirators, for at least
thirty days a year.
(ii) The
employer must make available medical examinations and consultations to all
employees who have been exposed to EtO in an emergency situation.
(b) Examination by a physician.
The employer must ensure that all medical examinations and procedures are
performed by or under the supervision of a licensed physician, and are provided
without cost to the employee, without loss of pay, and at a reasonable time and
place.
(2) Medical
examinations and consultations.
(a)
Frequency. The employer must make available medical examinations and
consultations to each employee covered under subsection (1)(a) of this section
on the following schedules:
(i) Prior to
assignment of the employee to an area where exposure may be at or above the
action level for at least thirty days a year.
(ii) At least annually each employee exposed
at or above the action level for at least thirty days in the past
year.
(iii) At termination of
employment or reassignment to an area where exposure to EtO is not at or above
the action level for at least thirty days a year.
(iv) As medically appropriate for any
employee exposed during an emergency.
(v)
As soon as possible, upon notification by an employee either (A)
that the employee has developed signs or symptoms indicating possible
overexposure to EtO, or (B) that the employee desires medical advice concerning
the effects of current or past exposure to EtO on the employee's ability to
produce a healthy child.
(vi) If
the examining physician determines that any of the examinations should be
provided more frequently than specified, the employer must provide such
examinations to affected employees at the frequencies recommended by the
physician.
(b) Content.
(i) Medical examinations made available
pursuant to (a)(i) through (iv) of this subsection must include:
(A) A medical and work history with special
emphasis directed to symptoms related to the pulmonary, hematologic,
neurologic, and reproductive systems and to the eyes and skin.
(B) A physical examination with particular
emphasis given to the pulmonary, hematologic, neurologic, and reproductive
systems and to the eyes and skin.
(C)
A complete blood count to include at least a white cell count
(including differential cell count), red cell count, hematocrit, and
hemoglobin.
(D) Any laboratory or
other test which the examining physician deems necessary by sound medical
practice.
(ii) The
content of medical examinations or consultation made available pursuant to
(a)(i)(v) of this subsection shall be determined by the examining physician,
and shall include pregnancy testing or laboratory evaluation of fertility, if
requested by the employee and deemed appropriate by the physician.
(3) Information
provided to the physician. The employer must provide the following information
to the examining physician:
(b) A description of the affected employee's
duties as they relate to the employee's exposure.
(c) The employee's representative exposure
level or anticipated exposure level.
(d)
A description of any personal protective and respiratory
equipment used or to be used.
(e)
Information from previous medical examinations of the affected employee that is
not otherwise available to the examining physician.
(4) Physician's written opinion.
(a) The employer must obtain a written
opinion from the examining physician. This written opinion must contain the
results of the medical examination and must include:
(i)
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 EtO;
(ii) Any recommended limitations on the
employee or upon the use of personal protective equipment such as clothing or
respirators; and
(iii) A statement
that the employee has been informed by the physician of the results of the
medical examination and of any medical conditions resulting from EtO exposure
that require further explanation or treatment.
(b) The employer must instruct the physician
not to reveal in the written opinion given to the employer specific findings or
diagnoses unrelated to occupational exposure to EtO.
(c) The employer must provide a copy of the
physician's written opinion to the affected employee within fifteen days from
its receipt.
Notes
Statutory Authority: Chapter 49.17 RCW. 87-24-051 (Order 87-24), § 296-62-07371, filed 11/30/87.
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