Document zQkMRMq43JENKnj1Np380rMyR

22728 Federal Register / Vol. 51. No. 119 / Friday, June 20. 1986 / Rules and Regulations (The medical surveillance program|... is not a practical requirement to be implemented (in construction). . . [and]. . . is very difficult to enforce because of the highly transitory nature of the employers as well as the employees ... The AIA/NA continued. ". . . medical surveillance [is also| time consuming, burdensome, (and) expensive" (Tr. 7/6). In a similar vein. Shcrrel Mercer of the Mercer Construction Company maintained that ". . . medical surveillance requirements would serve no purpose and would impose great cost. It would be extremely difficult to arrange examinations at remote worksites" (Tr. 7/20X). OSHA recognizes that the high turnover among construction employees and the non-fixed nature of construction workplaces complicates implementation of a medical surveillance program difficult in this sector, and the Agency has consequently retained some provisions and made changes to other requirements of the existing standard to accommodate this industry's characteristics. For example, the revised rule has maintained the provision from the existing standard permitting employers to use documentation showing that their employees have had a medical examination within the last 12 months that is equivalent to the one specified in the standard. This provision is particularly adapted to conditions in the construction industry, where, as - , CACOSH (Ex. 84-233) pointed out, employees may work for as many as 10 employers in a single year. OSHA is also aware that there are numerous organizations that provide' onsite chest x ray and spirometry testing through the use of mobile van units, and the Agency has, in past rulemakings, required that medical testing be performed even if these examinations must take place outside of a clinic or doctor's office. For example, the final rule for Occupational Noise Exposure (48 FR 4078; January 18,1981) requires that audiometric testing be conducted and it is not uncommon for commercial specialists who evaluate employees' hearing to transport an audiometric test booth in a mobile van directly to the ' organization that has contracted for the testing. A respondent from Oregon's occupational safety and health regulatory agency, the Workers Compensation Department, Accident Prevention-Division (APD), submitted an Oregon program directive issued to construction firms, that requires medical, examinations whenever employees are "engaged in the removal or demolition of pipes, structures; or equipment covered with asbestos.insuiation or - building materials. . . ." According to . Oil, Chemical and Atomic Workers Kathryn T. Ellis, Supervisor of the Union (OCAWU) indicated that. . . Technical Section of APD, inspection of "[OCAWU| fully support(s) the AFL- all asbestos demolition projects has CIO in their position that the . . . action indicated that "the demolition firms are level of. . . medical surveillance be set complying with the current Oregon at one half the PEL" (Tr. 6/26). Setting asbestos standard" (Ex. 92-013). the trigger for medical surveillance at 0.1 North Carolina also has a successful f/cc is consistent with the OSHA state program for asbestos removal Program Directive issued on October 11, operations; this program issued 1978, which instructed OSHA guidelines entitled Specifications for compliance officers to "provide uniform Asbestos Removal in 1981 (Ex. 90-254). inspection and compliance procedures These specifications require contractors for the medical examination to provide medical examinations for all requirement in the asbestos employees. According to John C. Brooks. standard". . . . specified that "(mjedical Commissioner of Labor of North Carolina, ". . . contractors (are] generally cooperative and [foltow| established guidelines. Only 15 of 106 [asbestosj removal sites had received a notice of violation as of April 27,1984." In addition to questioning the feasibility of requiring a medical surveillance program for a construction standard for asbestos, the following issues were raised by comments regarding medical surveillance programs: (1) The level at which the medical surveillance requirements should be triggered; (2) Which employees should be covered by these provisions; (3) How frequently chest roentgenograms and/or medical examinations should be administered, and the content of these examinations; (4) The need for mandatory vs recommendatory medical tests; (5) The necessity of administering a respiratory disease questionnaire; (6) Whether non-physicians Who administer pulmonary function testing should be required to complete a NIOSH-approved course in spirometry. One issue raised in the November notice was at what level the medical examinations . . . (are) required for any 7- to 8-hour time weighted average concentration of 0.1 f/cc or for a greater concentration." The scope of the medical surveillance requirements was also an issue of concern to commenters. Several respondents agreed with certain elements of the provision regarding employee coverage (Exs. 84-457,123.A, 263, 277); The Associated General Contractors of America (AGC), in a statement endorsed by the National Constructors Association (NCA) and the National Erectors Association (NEA), indicated that "the standard should require construction employers to provide an employee with a medical examination whenever that employee, though fully protected, has encountered airborne asbestos, at any level, for 30 days or more . . ." (Ex. 84-457). The Organization Resources Counselors, Inc. (ORC) recommended that employers institute a medical surveillance program for all employees exposed to asbestos in excess "of the action level" for more than a total of 30 days per year (Ex. 123.A). The Building and Construction Trades Department, AFL-CIO (BCTD) advocated a separate respirator surveillance program should be examination for all persons required to triggered. A'few respondents supported wear negative-pressure or pressure triggering the medical surveillance . demand respirators and recommended provisions at 0.2 f/cc (Exs. 90-180; 90- that all employees exposed to asbestos 186, and 90-173). Atlantic Richfield, be provided an initial medical commenting on the standard as it examination, except those workers who applies to both construction and general had received medical examinations industry, noted that ", . . with the within the past one year period. It also . proposed standards of 0.2 or 0.5 f/cc, the advocated the medical screening of action level of 0.2 f/cc is reasonable for almost all workers involved in the [triggering] medical surveillance...." building trades for 10 years or more, (Ex. 90-160). under the assumption that all Some commenters, however, construction workers, including those advocated a 0.1 f/cc trigger for medical not working directly with asbestos surveillance (Exs. 90-49, 90-185, 92-015, containing materials, have incurred and Tr. 8/28). For example, the some exposure to asbestos in the course Departmentof the Army suggested that of a decade of work in construction "[fjor a PEL of 0.2 fiber/cc it is (Exs. 277, 330). The International recommended that an.action level of 0.-1 Brotherhood of Boiler Makers supported fiber/cc be established for medical BCTD's recommended medical surveillance... . ." (Ex; 90-49). Similarly. examination protocol "as to both the Dr. Kenneth Miller, a physician with the detection of asbestos-related disease -: GLEASON-000976