Employment Exams
Hazardous Material Examination
Initial and Termination
DEFINITION
HAZARDOUS MATERIAL (HazMat)
These examinations were developed to help businesses comply with medical surveillance section CFR 1910.120 Hazardous Waste Operations and Emergency Response. The Specific operations covered by this regulation include cleanup operations at uncontrolled hazardous waste sites covered by the Resource Conservation and Recovery Act of 1976; voluntary cleanup operations at sites recognized by federal, state, local or other governmental bodies uncontrolled hazardous waste sites; operations involving hazardous wastes that are conducted at treatment, storage, and disposal (TSD) facilities regulated by 40 CFR Parts 264 and 265 pursuant RCRA; and emergency response operations for releases of, or substantial threats of releases of, hazardous substances without regard to the location of the hazard.
Health risks, which are faced by workers at hazardous waste sites are numerous and complex, running the gamut of potential exposures and unsafe conditions. The major safety and health concerns at hazardous waste sites include chemical and hazardous substance exposure, fire and explosion, oxygen deficiency, confined spaces, ionizing radiation, biological hazards, heat stress from protective equipment, and excessive noise exposure. In addition to the potential chemical exposures, much of the cleanup work and remedial action at a hazardous waste site resembles ordinary construction activities and employs the trades and machinery used in the construction industry. Unlike most workplaces where chemical exposures may be known, workers responding to toxic spills or cleaning up long-buried wastes may encounter complex mixtures of unknown materials. This makes an accurate assessment of potential exposures most difficult.
A site medical program is essential to assess and monitor workers’ health and fitness both prior to employment and during the course of work. Information from a site medical program may be used to conduct future epidemiological studies; to adjudicate claims; to provide evidence in litigation; and to report workers’ medical conditions to federal, state, and local agencies, as required by law. Pre-employment screening has two major functions: (1) fitness for duty determination, including ability to wear protective gear and (2) provision of baseline medical data for future comparison. The components of the pre-employment screening should include a thorough work and health history; a comprehensive physical examination of all body organs, focusing on the pulmonary, cardiovascular, musculosketetal, and neurological systems; and laboratory testing to include vision assessment, audiogram, spirometry, EKG treadmill, urinalysis, blood cell counts, thyroid test, and chemistry panel.
Depending upon the examination findings and/or the result of your pulmonary function test, your examination may also include a one or two view chest x-ray.
The treadmill and chest x-ray need not be performed on an annual basis. Additional biological monitoring can be done for heavy metals including mercury, arsenic, lead cadmium and others PCBs, and pesticide exposure. Consultation with qualified occupational medicine physicians to help plan the testing protocol beyond the basic exam is advisable.
Frequency of examinations is dictated by regulation. The following are required: pre-placement, annual, termination, and when the employee has signs or symptoms indicating possible overexposure to hazardous substances or health hazards. The physician will provide the employer with a written opinion regarding any medical conditions arising from work, any recommended work restrictions and any medical conditions which require further examination or treatment. In order for the physician to provide an accurate assessment of the workers’ ability to perform his job duties, a written job description provided by the employer is mandatory as written in Section (6) of the regulations. “The employer shall provide the following for each employee (1) a description of the employee’s duties as they relate to the employee’s exposures. (2) The employee’s exposure levels or anticipated exposure levels. (3) A description of any personal protective equipment used or to be used. (4) Information from previous medical examination of the employee which is not readily available to the examining physician.
MEDICAL SURVEILLANCE EXAMINATION
Initial/Termination/Periodic
Periodic testing of employees is frequently required to determine whether health problems are work related or to monitor the possible occurrence of work related health problems among employees. These are typically medical surveillance examinations. They require the physician know the type and amount of exposure and what effects that exposure may or may not impart upon the body. Therefore, the purpose of these examinations is to determine potentially harmful effects from exposure to a specific substance or environmental conditions and determine the acuteness or chronicness of that condition. These examinations are often OHSA mandated and cover such exposures as asbestos, lead, formaldehyde and benzene. Any abnormal finding must be followed up appropriately, whether that is further evaluation and/or a referral to a specialist. The frequency of these examinations should be determined by the physician familiar with the type and frequency of exposure.
WHAT TO EXPECT FROM YOUR HAZARDOUS MATERIALS EXAMINATION
Instructions:
Please expect to be at the clinic for 1 1/2 - 2 hours. 3-3 1/2 hours if you are having an initial examination. Please arrive 45 minutes early to complete paperwork (unless previously completed by downloading the forms from our website – see below). Please do not eat or drink anything but water 12-14 hours prior to your exam. If you smoke, please do not smoke 2 hours prior to your exam. Please avoid all seafood (i.e. shellfish, fish of all kinds including canned tuna) 72 hours prior to your exam. Avoid loud noises (loud music, mowing the lawn etc) 16 hours prior to your exam. If you will be having a treadmill test as part of your examination, please bring comfortable clothes and running shoes as well as a snack with you.
During your evaluation, the physician and/or the Medical Assistant will:
- Measure your height and weight
- Check your vision
- Check your hearing in an audiometric booth
- Take a blood pressure reading
- Perform a pulmonary function test to measure lung capacity
- Collect a urine sample to check for sugar, blood and protein
- Draw your blood
- Examine your eyes, ears, nose and throat
- Listen to your chest and heart
Upon completion of your examination your company will be notified if, in the opinion of the examining physician, you are or are not medically certified to wear a respirator or hazardous material certifiable.
You can download our forms prior to your visit from the list below. Please print and fill them out completely to expedite your visit with Cascade Occupational Medicine.
REQUIRED FORMS:
Consent for Contracted Services Form
Initial Medical and Work HIstory
Spiromerty Pre-testing Questionnaire
All forms are presented in PDF format. Adobe Reader or similar software is required to be installed on your computer in order to properly display and print these forms. If you do not have Adobe Reader installed on your computer, please click the icon at the bottom of the page.
