Employment Exams
Benzene
DEFINITION
Benzene is a regulated hazardous substance covered by OHSA Standard 29 CFR 1910.1028. Benzene can affect the CNS, liver and hematapoetic tissues. The medical surveillance requirements include baseline, annual and termination examinations as well as overexposure examinations. A baseline examination must include enough information for the physician to give a written opinion regarding the safety of the person to work around benzene. Laboratory testing should include complete blood counts with hematocrit, hemoglobin, and erythrocyte indices (MCV, MCH, and MCHC). Additional testing can be done as necessary in the opinion of the examining physician, such as serum benzene levels. Periodic examinations will also include the complete blood count.
The Benzene medical Surveillance requirements state the following:
- If the hemoglobin level, or the hematocrit (red blood cells), falls below the normal limit as determined by the laboratory or these indices show a persistent downward trend from the individuals pre-exposure norms and provided that these cannot be explained by other medical reasons, then additional blood testing will be repeated within two weeks. Similarly, repeat testing is required if the thrombocyte (platelet) count varies more than twenty percent below the employees’ white blood cells, most recent values or falls outside the normal range. If leukocyte count is below 4000 or these is an abnormal differential count testing should be done on a repeat basis within two weeks.
- If the abnormalities above persist, the examining physician shall refer the employee to a hematologist or an internist for further evaluation unless the physician has good reason to believe such referral is unnecessary.
- When a physician makes a referral to a hematologist or internist, as required above, the employee shall be removed from areas where exposures may exceed the action level until such time as the physician makes a determination that is safe for him to return. Any decision on medical removal protection should be discussed with the employee’s supervisor or the director of health and safety.
- If there is an episode of exposure in an emergency situation, then a urinary phenol test will be done. If the result is below 75 mg/L, no further testing is required. If the results of the urinary phenol test is equal to or greater than 75 mg/L, the employer shall provide the employee with a complete blood count including erythrocyte, leukocyte and thrombocyte counts at monthly intervals for duration of three months following the emergency exposure. Another test is the serum benzene level which may be ordered and completed at a reference laboratory. Although this is not part of the Benzene Standard some companies may want to add this to their medical surveillance protocol.
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REQUIRED FORMS:
Listed under Medical Surveillance
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