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DOE-EM-STD-5503-94
7.0.
MEDICAL SURVEILLANCE
7.1. BACKGROUND
The Medical Surveillance Program is a regulatory requirement designed to ensure that the health
of employees working on hazardous waste sites is, at a minimum, monitored and documented
before, during, and at termination of work on the site.
The medical surveillance requirements have been derived from numerous sources, including the
Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (also
referred to as the Four-Agency Document NIOSH/OSHA/USCG/EPA, 1985), DOE Order
5480.8A, Contractor Occupational Medical Program, and generally accepted work practices.
For sites that contain mixed wastes, DOE orders and standards should be consulted for
radiological requirements. These requirements should be incorporated into the medical
surveillance program. The medical surveillance program requirements include:
Baseline or pre-assignment examination,
Periodic monitoring,
Examination after illness or injury,
Termination examination, and
Maintenance of medical records.
Medical surveillance programs are designed to:
Establish the baseline medical condition of employees and fitness for duty,
Determine the ability to work while wearing protective equipment,
Track the physiological conditions of employees on an established schedule and at
termination of the project or employment, and
Ensure documentation of employee exposure and medical conditions is provided and
maintained as a part of the employee's medical record.
The overall objectives of the Medical Surveillance chapter are to identify:
All personnel covered by the medical surveillance program;
The decision-making needs of the personnel involved in the medical surveillance program;
Pertinent details regarding the baseline, periodic, after-illness/injury, and termination
examinations;
Which medical records are to be maintained;
The confidentiality of medical records.
The sequence of events associated with the medical surveillance process is shown in Figure 7-1.
7-1


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