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DOE-EM-STD-5503-94
7.4. BASELINE (INITIAL) EXAMINATION
The employee should receive a baseline or initial medical examination based on an activity hazard assessment prior to
being assigned to a hazardous or potentially hazardous activity (e.g., exposure to toxic substances or radiological
materials, repetitive motion, heat/cold stress). The examination should include, at a minimum, the items listed below.
7.4.1. Baseline/Periodic Medical Examination Parameters
The baseline medical examination parameters are determined by the Medical Program Administrator or the physician,
after review of the activity hazard assessment. However, at a minimum, the following should be included:
Complete medical and work history,
Physical examination,
Pulmonary function test,
Eye examination,
EKG,
Audiogram,
Urinalysis,
Blood chemistry,
Heavy metal screen (as appropriate),
Radiological bioassay (as appropriate), and
Evaluation of stresses related to repetitive motion.
It may be beneficial to develop a table of hazardous substances expected at the work site, the target organs affected, the
potential health effects, and the medical monitoring to be performed. An example is provided in Table 7-2. (The
information in the table should be consistent with information in the hazard assessment.)
7.5. PERIODIC MEDICAL MONITORING
Employees working on hazardous waste sites, which may include chemical, physical and/or radiological hazards, should
be provided with medical examinations every 12 months, unless the physician believes a shorter or longer duration is
needed or required. The content of the examination is:
Based on applicable laws and regulations,
Determined by the physician,
Designed to detect change from the baseline examination, and
Designed to identify physiological changes.
Employee site-specific exposure data, parameters identified above, official dosimetry records, and a hazard assessment
should be provided to the examining physician.
7-5


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