Document zob8jmQEragwYMO31Y3BvkyZR

22?02 Federal Register / Vol. 51, No. 119 ./ Friday, June 20, .1986 / Rules and Regulations employee, (2) to determine the of any personal protective and. comment and testimony. First, the . suitability'of the prospective employee respiratory equipment use or to be used; frequency of x-rays for younger for the.job under consideration, and (3) and information from the employee's employees and employees who have io establish a baseline health condition previous medical examinations which is only recently been exposed has been against which changes in an employee's not readily available to the examining reduced. Given the potential radiation health may be compared. OSHA physician. Making this information hazards posed by x-rays and given the believes that any problems associated available to the physician will aid in the tong latency periods for most asbestos- with.this revised rule will be minimal evaluation of the employee's health in related diseases, the requirement for since some type of medical surveillance relation to assigned duties and fitness to annual x-rays has been changed to one program is commonplace in most wear personal protective equipment, that establishes frequencies based.on a industries where asbestos is handled, when required. worker's age, duration of exposure and even in the smallest firms. The employer is required to obtain a latency considerations. OSHA received many comments written signed opinion from the Many commenters expressed the view regarding the frequency of periodic examining physician containing the that annual x-rays do not provide useful medical examinations. A number of results of the medical examinations; the information in young persons and during commenters were in favor of the annual physician's opinion as to whether the the first few years of potential exposure. examination [Exs. 90-140. 90-158, 241-A, employee has any.detected medical It was felf that annual x-rays in early 248-B, 296] while other commenters conditions which would place the exposure years is of minimal value, were in favor of basing the frequency of employee.at increased risk of material while exposing persons unnecessarily to the medical examination on the age of impairment from exposure to asbestos; the worker with consideration given to any recommended restrictions upon the the years that have elapsed since first employee's exposure to asbestos or exposure to asbestos (Exs. 123-A, 158- upon the use of protective clothing or D, 182, 328J. equipment such as respirators; and a After thorough review and analysis of statement that the employee has been the comments and testimony received in informed by the physician of the results connection with this issue, OSHA of the medical examination and of any reaffirms its position on the medical conditions resulting from appropriateness of the annual medical asbestos exposure that require further examination. The annual medical explanation or treatment. This written examination and evaluation is an opinion must not reveal specific findings important tool in protecting the worker or diagnoses unrelated to occupational exposed to asbestos by, (1) establishing exposure to asbestos and a copy of the andmaintaining rapport between the opinion must be provided.to the affected medical staff and asbestos exposed employee. workers; (2) detecting changes in a The purpose in requiring the worker's physical condition; (3) examining physician to supply the delecting biological effects of inhalation employer with a written opinion is to of.asbestos as early as possible; (4) provide the employer with a medical providing a way to re-evaluate the basis to aid in the determination of workplace conditions; and (5) evaluating initial placement of employees and to the worker's suitability to continue assess the employee's ability to use doing the same job. For these reasons. protective clothing and equipment. The OSHA has retained the provision of an . requirement that a physician's opinion annual medical examination in the final be.in written form will ensure that standard.. . . employers have had the benefit of this The final standard provides that all information. The requirement that an examinations and procedures be employee be provided with a copy of the performed by or'under the supervision physician's written opinion will ensure of a licensed physician and be provided that the employee is informed of the without cost to the employee, Clearly, a results of the medical examination. The licensed physician is the appropriate purpose in requiring that specific person to be supervising and evaluating findings or diagnoses unrelated to the medical examination. However, occupational exposure to asbestos not potential harmful radiation. Comments received from Monsanto [Ex. 90-138], CAL/OSHA [Ex. 182], Atlantic Richfield [Ex. 90-160], 3M Co [Ex 90-163], Chemical Manufacturers Association. [Ex. 90-166], U.S. Navy [Ex. 90-178] and. N10SH [Ex. 91-40] all suggested that the medical surveillance requirements be changed to allow for less frequent x- rays. Consequently, the final standard requires that x-rays be offered at 5 year intervals during the 10 years following any employee's first exposure to asbestos. After 10 years from the employee's first exposure, the age category of an employee will determine. the frequency of x-ray testing: up until age 35, x-rays will be required at 5. year intervals; between the ages of 35-45 medical exams will be required every 2 years; and above age 45, x-ray will be required on an annual basis. Such a program is currently in place in a number of asbestos surveillance programs (for example, see Lewinsohn, Ex. 258A). A number of commenters stated that x-ray films should be interpreted and " classified by qualified and/or certified individuals using standardized radiological procedures [Exs. 86-4,131, 158-D]. For example, the AFL-CIO stated:. certain parts of the required be included in the written opinion is to X-rays are one. of- the most important examination do not necessarily require the physician'sexpertise and may be conducted by a health care professional designated by the physician and under . the supervision of the physician. The final standard requires the employer to provide the physician with the following information; a copy of this standard and its appendices; a encourage employees to take the , medical examination'by removing the concern that the employer will obtain information about their physical condition that has no relation tq present occupational exposures. The requirement that the physician sign the opinion is to ensure that what he gives to the employer has been seen and read diagnostic tools for asbestos-related lung diseases. The prevalence and seriousness of these diseases warrants the establishment of standardized procedure for theevajuation of . x-rays by certified! qualified individuals [Ex. 131. p. 19].. OSHA shares the view of the above ' referred commenters, and in the final standard requires that. (1) chest x-rays description of the affected employees' by the physician. be interpreted and classified in duties as they relate to the.employee's A few substantive changes In the. accordance with a professionally exposure level; the employee's current medical surveillance accepted classification system by either .representative exposure level or requirements were made as the result of a B-reader, a board eligible/certified anticipated exposure level; a description OSHA's review of extensive public radiologist, or.an experienced physician GLEASON-000950