Document V3wG6dVVamBDGwL3nGrQJR2EN

AMERICAN CYANAMID COMPANY CHICAGO PLANT TO DATE Subject: MEDICAL SAMPLING RESULTS EMPLOYEE NO. Results of your blood sample, taken , show a lead level of __ micrograms (ug) lead per 100 grams of blood. Because your blood lead level exceeds ____ ug/lOOg. blood, you are being cautioned that special attention must be given to your exposure levels. You are reminded that your exposure level depends directly on: 1. Engineering controls such as ventilation devices and other mechanical equipment provided in your work area. You are to report immediately to your supervisor any malfunctioning of these controls. 2. Continued adherence to prescribed safe work and personal hygiene practices. 3. Proper use and care of your respirator and other personal protective equipment. These factors are critical to achieving safe breathing zone levels. The results of this sample show that your exposure level has been higher than normal compared to the sampling results of your fellow employees. You should also know the OSHA lead standard requires that you be removed temporarily from working with lead products when your lead blood level exceeds ug/100 g. blood. It is your responsibility to work cooperatively with your supervisor in assuring a safe work environment. By Plant Manager I have received a copy of this letter and reviewed its contents with my supervisor. -- EMPLOYEE DATE I have reviewed the contents of this letter with the above-named employee. SUPERVISOR _______ _______ DATE CYWI 3-000886 AMERICAN CYANAMID COMPANY CHICAGO PLANT TO: _____________________ DATE: ______________________________________________________________________________ Subject: MEDICAL SAMPLING RESULTS EMPLOYEE NO. Results of your blood sample, taken , show a lead level of micrograms (ug) lead per 100 grams of blood. This blood lead level indicates that your exposure level is being controlled by: 1. Engineering controls such as ventilation devices and other mechanical equipment provided in your work area. You are to report immediately to your supervisor any malfunctioning of these controls. 2. Continued adherence to prescribed safe work and personal hygiene practices. 3. Proper use and care of your respirator and other personal protective equipment. These factors are critical to achieving safe breathing zone levels. It is your responsibility to work cooperatively with your supervisor in assuring a safe work environment. By PLANT MANAGER I have received a copy pf this letter and reviewed its contents with my supervisor. Employee Date I have reviewed the contents of this letter with the above-named employee. Supervisor ___________________________________________ Date _______________ CYWI 3-000887