Posted by Luis Pieretti, PhD, CIH, CSP
Our prior posts covered the new exposure limits, exposure assessments, regulated areas, methods of compliance, and housekeeping requirements of the new standard. Now we will cover the medical surveillance and training requirements and the effective dates of the standard.
Another requirement that will be triggered by the employee’s exposure to respirable crystalline silica is the medical surveillance requirement. This section of the standard applies to those employees whose exposures are above the action level of 25 µg/m3 for 30 days or more during a year. This surveillance should be administered within 30 days of the initial assignment (considered to be the baseline) and be repeated within 3 years of the initial medical surveillance assessment.
The assessment includes:
- A medical and work history with emphasis on silica, dust, and other agents affecting the respiratory system.
- A physical examination with emphasis on the respiratory system, chest X-rays, pulmonary function tests, tuberculosis testing, and other tests deemed appropriate by the physician or other licensed health care professional (PLHCP).
- The standard includes what information should be included in the written medical report for the employee and the written medical opinion to the employer.
The medical report to the employee should contain a statement with the examination results, including “any medical condition(s) that would place the employee at increased risk of material impairment to health from exposure to respirable crystalline silica and any medical conditions that require further evaluation or treatment; any recommended limitations of the employee’s use of respirators; any recommended limitations on the employee’s exposure to respirable silica and a statement if the employee should be examined by a specialist depending on the results of the x-ray[i]”.
This information is available to the employee, not the employer. The written medical opinion for the employer will only contain:
- Date of the exam.
- A statement that indicates that the examination met the requirements of the standard.
- Any recommended limitations on the employee’s use of respirators.
However, the employee could provide written authorization to share this information regarding the employer such as the recommended limitations on the employee’s exposure to respirable crystalline silica and the exam results statement if the employee should be examined by a specialist. If the PLHCP recommends that the employee be examined by a specialist, the employer should make available a medical examination by a specialist within 30 days after receiving the written opinion of the PLHCP. The requirements of the medical surveillance should be available at no cost to the employee.
Training for the affected employees should include the health hazards associated with respirable crystalline silica, the specific tasks that could result in exposure, specific measures the employer has implemented to protect the employees, and the purpose and description of the medical surveillance.
The employer should maintain information about all exposure assessments:
- The measurement dates for each sample.
- Task monitored.
- Sampling and analytical method used, number of samples, duration of sampling and results.
- Identity of the laboratory that performed the analysis.
- Personal protective equipment used by the monitored employees.
- Name (and social security number) and job classification of all employees represented by the monitoring and indicating which employees were actually monitored.
If objective data was used the employer should document the material containing crystalline silica, the source of the objective data, the testing protocol and results of the testing, description of tasks which the objective data were based on, and any other relevant data. The employer should maintain all the information generated by the medical surveillance requirement as well.
The standard is effective June 23, 2016. The requirements regarding medical surveillance are effective on June 23, 2018 for those employees exposed to levels above OSHA’s PEL for more than 30 days. The medical surveillance requirements for employees exposed to levels above OSHA’s action level for more than 30 days take effect on June 23, 2020. Some provisions for hydraulic fracturing operations will take place on June 23, 2021.
The information provided about the regulatory requirements is just a summary. It should not be interpreted/assumed as the complete text of the OSHA standard.
[i] OSHA’s Final Rule to Protect Workers from Exposure to Respirable Crystalline Silica: https://www.osha.gov/silica/