A description of the duties expected to be performed by the employee,
Available information from previous medical surveillance examinations, and
Updated medical and occupational history.
For hazardous waste work, the following site employees should be included in the Medical
All employees who are exposed to hazardous substances or health hazards above
published exposure limits (e.g., OSHA PELs, ACGIH TLVs, NIOSH RELs) without
regard to the use of respirators, for 30 days or more a year;
All employees who wear a respirator for 30 days (or fractions of days) or more a year or
as required by 29 CFR 1910.134;
All employees who are injured, become ill, or develop signs or symptoms due to possible
overexposure involving hazardous substances or health hazards from an emergency
response or hazardous waste operation; and
Members of HAZMAT teams.
Each contractor should implement DOE Quality Assurance and Records Management
requirements with respect to medical records and medical surveillance records. In addition, the
physician(s) should document that they have a copy of the Occupational Safety and Health
Administration regulations, 29 CFR 1910.120, Hazardous Waste Operations and Emergency
Response, and 29 CFR 1910.20, Access to Employee Exposure and Medical Records.
7.3. EXAMINATION CONTENT
Medical examinations should include a medical and work history with special emphasis on
symptoms related to exposure to hazardous substances or radiological materials and their health
effects, and on fitness for duty when conducting project tasks. The content of the medical
examinations should be based on applicable laws, regulations, and known or potential exposure
to contaminants. Where possible, the content should be determined by a licensed physician
certified in Occupational Medicine by the American Board of Preventive Medicine. However, at
a minimum, the physician making the determination should be knowledgeable and experienced
in occupational medicine screening and surveillance. If no physician is on the staff of the
employer, the content of the examination is determined by the Medical Program Administrator in
concert with a contract physician.
An example of a matrix of medical examination by job task is shown in Table 7-1.