Document Rp5n1VEVZnR23o9qD35d214EE

Federal Register'/ Vol.. 51, No. 119 / Friday, June 20. 1966 / Rules and Regulations 22701 Over (he past decade, since Ihe asbestos including tests for occult blood in the upon post administrative interpretation, standard was first issued, other work practices end controls hove evolved and developed which have been demonstrated to be effective means of limiting exposures. . . . The prohibition of certain practices, including blowing asbestos dust with compressed air, dry-sweeping and dry clean-up of asbestos, feces; and further specifications for the interpretation and reading of chest Xrays.' The final standard requires each employer to institute a medical surveillance program for all employees comments submitted.to the record, and OSHA's traditional policy of using the same action level to trigger other specific compliance activities (as discussed elsewhere in the preamble). Furthermore, in the case of asbestos, and prohibition against accumulation of who are or will be exposed to asbestos significant health risks are likely to be ' asbestos waste on surfaces have all been at or above the action level. Providing present at an airborne concentration of shown to be effective means for preventing medical surveillance for employees 0.1 f/cc and consequently supplemental the resuspension of asbestos fibers, and exposed at or above the action level is protective measures are clearly 'k reducing airborne concentrations (Exs. 84009.2641. The record shows that these work consistent with other health standards warranted. which incorporate an action level and is In Ihe final rule for asbestos, OSHA practices, prohibitions and controls are considered by OSHA to be appropriate has revised the time within which the widely accepted standard procedures in for monitoring the adequacy of the employer must conduct preplacement many asbestos industries and operations (Ex. exposure limit specified. examinations after hiring employees. 84-457.12GA, 222-F 225) and feasible for the asbestos industries as a whole (Ex 84-009). The revised permanent standard should therefore be updated and expanded to include the work practices prohibitions and controls to reduce airborne concentrations of asbestos in the work place (Ex. 335. p. 47). The final standard requires that the medical surveillance program provide each affected employee with an opportunity for a comprehensive annual medical examination. In this regard the final standard does not change The Final slandardrequires that preplacement medical examinations be given prior to the assignment of an individual to a job exposed to concentrations of airborne asbestos. In the general questions contained in the i*4 * % OSHA agrees with this assessment and consequently has included Ihe specific provisions for housekeeping to Ihe final rule. OSHA believes, however, that Ihe obligation incurred under these provisions should be measured by a standard of practicability. Therefore. OSHA anticipates that compliance wilh this provision will entail a regular provisions of the existing standard requiring medical examinations on an annual basis. A comprehensive medical examination as defined by OSHA would encompass a medical history, a complete physical examination of all systems with emphasis on the respiratory system, the cardiovascular system and digestive tract, a chest roentgenogram (posterior-anterior 14 x preamble to the proposed rule, OSHA asked for clarification of the time issue, as the current standard permits Ihe employer lo conduct medical examinations within the first 30 days of the hire date. In response to this issue, a number of commenters strongly favored a preplacement medical examination, housekeeping schedule based on 17 inches), pulmonary function tests.to assessing each worker's state of health exposure conditions at a particular plant include forced vital capacity (FVC) and and the capability, for emergency forced expiratory volume at 1 second prior to the beginning of exposure toasbestos fibers jExs. 84-397,90-140; 91- cleanup of spills or other unexpected (FEVi), and any additional tests deemed 40.128,158E, 258, 328j. The American source of exposure. appropriate by the examining physician. Association of Occupational Health 12. Paragraph (I).Medical One major change in the final-standard Nurses, commented: surveillance. reduces the frequency of x-rays for Baseline data regarding the health status of In the April notice (49.FR 14116-: younger workers who have been workers is essential at the time of -; 14145), OSHA solicited commepts.on exposed for a short period of time. employment in determining whether changes whether the existing medical In the final standard, OSHA believes occur over Ihe period of employment. surveillance provision for asbestos- it appropriate to trigger the medical Delaying the gathering of this essential exposed employees should.be modified. ' Specifically, comments were invited regarding the appropriateness of triggering the medical surveillance requirements of a revised standard at 0.2 f/cc; decreasing the frequency of surveillance requirements at the action level of 0.1 f/cc as an eight-hour TWA. This level is consistent with current enforcement policy based on a past - judicial ruling that upheld OSHA's medical surveillance at any level, but baseline information could be detrimental to both employee and employer because knowledge of a pre-existing condition could influence initial job placement. AAOHN therefore recommends that preplacement physical examinations be administered to employees before placing them into positions chest X-rays for young employees or for recommended that OSHA establish with asbestos exposure (Ex 128). .1 those with short duralions of exposure; clarifying the time permitted for employers to conduct the pre-placement examination after initial hiring; and the' administratively a level that would trigger the medical surveillance requirement. [GAF Corp. v. OSHRC, No. 7&-1028, U.S. Court of Appeals for. the. . A few commenters supported the current OSHA standard, that is, requiring the medical examination to be necessity of specifying additional tests District of Columbia Circuit).Jdowever, given within 30 days of job assignment or procedures fpr the early diagnosis of in the proposal, OSHA raised the jExs. 123A, 182). Oh the other hand, a any asbestos-related disease, including possibility of triggering medical . number of commenters supported the Ihe administration of a respiratory surveillance at 0.2 f/cc. . proposed latitude in the timing of . disease questionnaire. Comments were Many commenters supported 0.1 f/cc preplacementexaminations jExs. 90- also requested on the need for as a. trigger for medical surveillance 168, 90-1811. additional specifications regarding the |Exs. .86-4, 328, 90-166, 90-174, 90-180). After thorough review of all the facts, performance of pulmonary function While others favored an action level of and evidence in the record, OSHA testing, including completion of a course 0.2 f/cc [Exs. 90-160, 90-175). A number concurs with the majority of in spirometry for nonphysicians who of the concerns expressed about the commenters supporting Ihe position that administer these, tests, calculation of the medical surveillance trigger.centered the preplaccment medical examination percentage difference from predicted around general objections lo a 0.1 f/cc be given prior to job assignment. The values and use- of standard predicted action level, as discussed earlier. purpose of the preplacement values; the appropriateness of requiring In sum. OSHA's decision to trigger examination is (1) to make an initial screening for colo-fectal cancer, medical surveillance at 0.1 f/cc is based assessment of the health of each GLEASON-000949