9.0 MEDICAL SURVEILLANCE
The Project will utilize the services of a Board-Certified Occupational Medicine Physician for the medical surveillance requirements of this project. Dr. Elayne F. Theriault (below) will review all medical examinations and will be available for medical consultation on an "as-needed" basis.
Dr. Elayne F. Theriault
4360 Chamblee Dunwoody Road, Suite 207
Atlanta, Georgia 30341
(404) 455-0818 or (800) 229-3674
9.1 Medical Examination
All personnel on-site with the potential for exposure to contamination will have successfully completed a pre-placement or periodic/updated physical examination. The contents of this examination have been determined by Dr. Elayne F. Theriault.
9.1.1 Pre-Placement Exam
This examination has been designed to meet 29 CFR 1926.65 and 29 CFR 1910.120 requirements for hazardous waste site operations.
The medical surveillance program examination, at a minimum, consists of:
· Medical and occupational history questionnaire which includes information on past gastrointestinal, hematologic, renal cardiovascular, reproductive, immunological, and neurologic problems
· Physical examination
· Chest X-ray (no more frequently than every four years)
· Blood pressure
· Complete Blood Count (CBC) and differential to include hemoglobin and hematocrit determinations, red cell indices, and smear of peripheral morphology
· Blood urea nitrogen and serum creatinine
· Sequential Multiple Analyzer Computer Profile (SMAC 24)
· Pulmonary function test
· Audiogram
· EKG for employees over 35 years old or when other complications indicate the necessity
· Stress test (as directed by the occupational Physician based on EKG/pulmonary function testing)
· Visual acuity
· Urinalysis, as necessary, for baseline bioassay for radionuclides and heavy metals (arsenic, cadmium, chromium), serum lead, and zinc protoporphyrin.
The following information is, or has been, provided to the occupational physician:
· Copy of 29 CFR 1926.65 and 29 CFR 1910.120
· Description of employee's duties
· Site contaminant information
· Description of the PPE to be used and employee anticipated or measured exposure
· Information from previous medical exams
· Copy of Section 5.0 of NIOSH Publication 85-115
· Information required by 29 CFR 1910.134.
The medical surveillance provided to the employee includes a judgment by the medical examiner of the ability of the employee to use either positive- or negative-pressure respiratory protection equipment. Any employee found to have a medical condition which could directly or indirectly be aggravated by exposure to these chemical substances or by the use of respiratory equipment will not be employed for the project. A copy of the medical examination is provided at the employee's request.
The employee will be informed of any medical conditions that would result in work restriction or that would prevent them from working at hazardous waste sites.
9.1.2 Annual Exam
Employees receive an annual update exam meeting the requirements of 29 CFR 1926.65/29 CFR 1910.120. The results of these exams are compared to previous results and the baseline physical to determine if any effects due to exposure have occurred. Appropriate actions are taken as recommended by the physician should the results indicate an exposure; otherwise, employees are cleared for continued work. For workers not required to wear respiratory protection, a physical examination is required every two years.
9.1.3 Exit Exam
Exit physical exams will be afforded for all employees involved in the medical surveillance program upon completion of the project.
9.1.4 Other Exams
Periodically, the need arises to conduct medical examinations at times other than those previously discussed. These times include: upon reassignment in accordance with 29 CFR 1910.120 (e)(3)(i)(C) and 29 CFR 1926.65 (e)(3)(i)(C), if an employee develops signs or symptoms of illness relating to work place exposure, if the physician determines examinations need to be conducted more often than once a year, and whenever an employee develops a lost time injury or illness.
9.2 Subcontractor Requirements
Subcontractors will certify that their employees have successfully completed a physical examination by a qualified physician on the Training Acknowledgment Form. The physical examinations will meet the requirements of 29 CFR 1926.65 and 29 CFR 1926.103.
9.3 Medical Records
Medical and personal exposure monitoring records will be maintained according to the requirements of 29 CFR 1926.65/29 CFR 1910.120 and will be kept for a minimum of 30 years. The confidentiality of employee medical records are maintained. The written medical opinion from the occupational physician are kept in project files.
9.4 Medical Restrictions
When a medical care provider identifies a need to restrict work activity, the employee's home office will communicate the restriction to the employee, the PM, the CM, and the CHP. The terms of the restriction will be discussed with the employee and the CHP. Every attempt will be made to keep the employee working, while not violating the terms of the medical restriction.
9.5 Drug and Alcohol Testing
The Project is firmly committed to providing employees a safe and healthful workplace, and to providing clients and the public safe and efficient services. Employee involvement with the use, possession, or sale of alcohol, illegal drugs, "look a likes," or any substance represented as a controlled substance creates an impediment toward meeting these commitments and is prohibited.
All employees, including subcontractors will be subject to drug and alcohol testing.
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