A fairly common mistake we see at facilities that have their own emergency response teams is that the responders are NOT receiving a fitness-for-duty evaluation and only receiving the same medical evaluation as those who wear respirators in non-emergency settings. This is a problem, as OSHA has stated that emergency responders need more than the basic respirator medical evaluation. Here is what OSHA says:
emphasis added by me
The medical questionnaire for 1910.134 will NOT satisfy the HAZWOPER requirement for medical surveillance. The intent and the requirements for medical surveillance under HAZWOPER are much different than those required by the Respiratory Protection standard. The intent of the HAZWOPER medical surveillance requirements is two-fold:
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- to determine fitness-for-duty, including the ability to work while wearing PPE (e.g., respirators), and
- to establish baseline data for comparison with future medical data
The Respiratory Protection standard (this should say HAZWOPER standard), however, requires a medical evaluation for the sole purpose of establishing an employee’s ability to use a respirator while performing assigned work tasks with the added psychological and/or physiological burden of wearing the protective equipment.
1910.120(q)(9)(i) requires that members of an organized and designated HAZMAT team and HAZMAT specialists receive a baseline physical examination and medical surveillance in accordance with paragraph (f). A HAZMAT team refers to a group of individuals who are expected to control actual or potential leaks or spills of hazardous substances requiring a close approach to the substance. Examinations must be provided prior to initial assignment, at least yearly thereafter, and at the termination of employment. Medical examinations must also be provided in cases where employees are injured or develop signs or symptoms of overexposure to health hazards.
The actual content of medical examinations (e.g., laboratory tests, chest xrays, spirometry, etc.) is determined by the attending physician. Chapter 5 of the Occupational Safety and Health Guidance Manual for Hazardous Waste Sites (“4 Agency Manual”) provides guidelines for designing a medical program. The medical examination must include a medical and work history (or updated history if one is in the employee’s file) with an emphasis on the following:
- Symptoms related to the handling of hazardous substances and health hazards.
- Fitness for duty and the ability of the employee to wear any required PPE including respiratory protection under the expected conditions at the work site (e.g., temperature extremes).
The employer must also provide medical consultation to any emergency responder (not limited to HAZMAT team members and HAZMAT specialists) who becomes injured or ill or develops signs or symptoms due to exposure to hazardous substances from an emergency response. Consultations must be provided as soon as possible following the incident, and also at additional times if the physician determines it is necessary. Similar to examinations, the content of consultations is determined by the attending physician.
Note: 1910.120(f)(3) provides that the employer must make medical examinations available, at no cost, to employees engaged in hazardous waste operations. The standard does not require an employee to take the medical examination. However, 1910.120(q)(9)(i) provides that members of an organized and designated HAZMAT team and hazardous materials specialists shall receive a baseline examination and be provided with medical surveillance as set forth in 1910.120(f). As a result, in order for an individual to qualify as a member of an organized HAZMAT team, or hazardous materials specialist, the individual must undergo medical examination set forth in paragraph (f). In the event that an employee chooses not to have a medical exam or participate in a medical surveillance program, the employer should so note the refusal in the employees’ personnel file.