Baseline (Initial) Examination

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.

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