NASA Procedures and Guidelines |
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This Document is Obsolete and Is No Longer Used.
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| TOC | ChangeHistory | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | Chapter6 | Chapter7 | AppendixA | AppendixB | AppendixC | AppendixD | AppendixE | AppendixF | AppendixG | AppendixH | ALL | |
Exam | Regulation | |
---|---|---|
A. | Arsenic | 29 CFR § 1910.1018 |
B. | Asbestos | 29 CFR § 1910.1001 29 CFR § 1926.1101 |
C. | Benzene | 29 CFR § 1910.1028 |
D. | Beryllium | 29 CFR § 1910.1024 |
E. | Cadmium | 29 CFR § 1910.1027 29 CFR § 1926.1127 |
F. | Chromium | 29 CFR § 1910.1026 29 CFR § 1926.1126 |
G. | Ethylene Oxide | 29 CFR § 1910.1047 |
H. | Formaldehyde | 29 CFR § 1910.1048 |
I. | Hydrazines | NIOSH Occupational Safety and Health Guideline for Hydrazine, 1988 |
J. | Isocyanates | NIOSH |
K. | Lead | 29 CFR § 1910.1025 29 CFR § 1926.62 |
L. | Mercury | OSHA CPL 02-02-006 NIOSH, ATSDR |
M. | Methylene Chloride | 29 CFR § 1910.1052 ATSDR |
N. | 4,4' Methylenebis (2-chloroaniline) (MOCA, MBOCA) | NIOSH, ATSDR, OSHA |
O. | 4,4' Methylenedianiline (MDA) | 29 CFR §§ 1910.19, 1910.1050 and 1926.60 |
P. | Nitrogen Tetroxide (Dioxide) | NIOSH Pocket Guide to Chemical Hazards |
Q. | Polychlorinated Biphenyls (PCB) | ATSDR NIOSH Current Intelligence Bulletin 45, February 24, 1986 NIOSH Pocket Guide to Chemical Hazards |
R. | Silica Dust | 29 CFR § 1910.1053 |
S. | Trichloroethylene | NIOSH |
Exam | Regulation | |
---|---|---|
A. | Bloodborne Pathogens | 20 CFR § 1910.1030 |
B. | Chemistry Laboratory | 29 CFR § 1910.1450 |
C. | Hazardous Waste Operations and Emergency Response | 29 CFR § 1910.120 |
D. | Health Care Provider | 29 CFR § 1910.1030, CDC |
E. | Ionizing Radiation | OSHA 29 CFR §§ 1910.1096, 10 CFR § 20.1502 |
F. | Lasers | ANSI Z 136.1 |
G. | Noise | 29 CFR § 1910.95 NPR 1800.1D Chapter 4.8 |
H. | Pesticides | NIOSH |
I. | Spray Painting | |
J. | Water and Sewage | NIOSH |
K. | Welding | NIOSH Criteria Document No. 88-110 |
Exam | Regulation | |
---|---|---|
A. | Childcare Workers | |
B. | Confined Space/Tank Entry | 29 CFR § 1910.134 |
C. | Crane Operator/Ground Floor/Remote-Operation/High/Cabin/Pulpit | NASA STD 8719.9 ASME B30.5-2011 49 CFR subpt. E |
D. | Diver | 29 CFR § 1910.423 29 CFR § 1910.424 |
E. | DOT/Commercial Driver License/Motor Vehicle Certification/Multiple Passenger Van | 49 CFR subpt. E |
F. | Down Range/Shipboard Duty | 46 CFR subpts. 10 and 12 |
G. | Firefighter | NFPA 1582 |
H. | Food Handler | 46 CFR § 12.25-20 NPR 1800.1 Chapter 4.10 |
I. | Locomotive Engineer | 49 CFR § 240.121 |
J. | Motive (Heavy) Equipment Operator | 49 CFR subpt. E |
K. | Occupational Respirator Use | 29 CFR § 1910.134 29 CFR § 1910.134 Appendix A |
L. | Ordnance Handler | NAVMED P-117, 15-107, AFI132-3001 |
M. | Primary Animal Contact | |
N. | Primary Crew Contact | JSC 22538 |
O. | Security | |
P. | Self-Contained Atmospheric Protective Ensemble | 29 CFR § 1910.134 |
Q. | Soldering | IPC J-STD-001ES |
R. | Voluntary Respirator Use | 29 CFR § 1910.134 29 CFR § 1910.134 Appendix A |
Exam | Regulation | |
---|---|---|
A. | NASA Pilots, Flight Engineers, Other Primary Aircrew, Qualified Non-Crewmember, Unmanned Aircraft System (UAS) Pilots and Observers | OCHMO 110902MED, NPR 7900.3, 14 CFR pt. 67 |
B. | Air Traffic Control Specialist (Not Requiring FAA Certification) | OPM GS-2152 |
C. | Second Class Airman's Medical Certification (Air Traffic Control Tower Operator) | 14 CFR pt. 67 Appendix A |
Exam | Regulation | |
---|---|---|
A. | Fitness for Duty | NPR 1800.1 |
B. | Return to Work | NPD 1840.1 NPR 1800.1 |
C. | International Travel | NPR 1810.1 |
Exam | Regulation | |
---|---|---|
A. | Preventive Health Examination | USPSTF |
B. | Fitness Center Clearance | NPR 1800.1 |
A. Arsenic | |
---|---|
Reference | OSHA 29 CFR § 1910.1018 |
Frequency |
1. Baseline Examination 2. Annual Exam, if less than 45 years old 3. Semiannually, if 45 years old or older, or with 10 or more years of exposure 4. Variable or Exposure-Determined Examination 5. Exit/Reassignment Examination |
Laboratory |
1. Chest X-ray (PA), annual 2. Discretionary Tests a. Pulmonary Function b. Complete Blood Count |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on peripheral and CNS, GI system, skin including nasal mucosa, respiratory tract, and thyroid 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Liver, kidneys, skin, lungs, lymphatic system, CNS, PNS |
Written Opinion | Standard Written Medical Opinion |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
B. Asbestos | |
---|---|
Reference |
OSHA 29 CFR § 1910.1001 OSHA 29 CFR § 1926.1101 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory (TX) 1. |
1. Chest X-ray (PA) (Must be read by "B reader", a board eligible/certified radiologist, or an experienced physician with known expertise in pneumoconiosis.):
a. Baseline
2. Pulmonary Function b. Periodic: i. 1-10 years since first exposure: 1. every 5 years ii. 10+ years since first exposure, and:
1. below age 35, every 5 years
2. age 35-45, every 2 years 3. age 45+, annually 3. Discretionary Tests
a. Hemoccult
b. Annual TB Screening c. Urinalysis (dipstick) |
Physical Exam |
1. Required Asbestos Questionnaire (Standardized on initial exam, Abbreviated Standardized on annual exam) 2. Physical Examination with focus on respiratory, CV, and GI systems 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory/lungs, pleural (Mesothelioma), gastrointestinal |
Written Opinion | Standard Written Medical Opinion for Asbestos within 30 days, including statement that employee was informed of the increased risk of lung cancer attributable to combined effect of smoking and asbestos. |
Employee Counseling | Exam results and conditions of increased risk including increased risk of lung cancer from combined effects of smoking and asbestos exposure |
Medical Removal | No requirement in standard |
C. Benzene | |
---|---|
Reference | OSHA 29 CFR § 1910.1028 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination |
Laboratory |
1. Complete Blood Count (CBC) including a leukocyte count with differential, a quantitative thrombocyte count, hematocrit, hemoglobin, erythrocyte count, and erythrocyte indices (MCV, MCH, MCHC). (Repeat within 2 weeks if abnormal, refer to standard for action level) 2. Pulmonary Function (if employee wears respirator, initial exam and then every 3 years) 3. For Emergency Exposures Only:
a. Urine sample provided at the end of employee's shift for urinary phenol test within 72 hours and urine specific gravity corrected to 1.024.
4. Discretionary Tests:b. If urinary phenol test is equal to or greater than 75 mg phenol/L of urine, repeat Complete Blood Count monthly for 3 months.
a. Refer to Appendix C of standard for guidance
|
Physical Exam |
1. Detailed Medical and Occupational History initially, brief update annually 2. Complete Physical Examination with focus on the blood, skin, CNS, and liver and kidney function 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Eyes, respiratory, CNS, skin, blood/bone marrow |
Written Opinion | Standard Written Medical Opinion within 15 days |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | Required when referred to hematologist/internist |
D. Beryllium | |
---|---|
Reference | 29 CFR § 1910.1024 |
Frequency | 1. Baseline Examination |
Laboratory | 1. Be-LPT or equivalent |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on skin, eyes, and respiratory tract 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory, skin |
Written Opinion | Written opinion to employee within 45 days to include explanation of examination results and detection of medical conditions such as chronic beryllium disease (CBD), beryllium sensitization and medical conditions related to airborne exposures that require further evaluation.
Written opinion to the employer within 45 days that examination has met the requirement of the standards,recommendations on limitations for use of protective equipment, including respirators, and that results have been explained to the employee. If employee gives written authorization opinion may include recommendation for medical removal due to confirmed CBD or referral to CBD diagnostic center. |
Employee Counseling | Counseling on exam results and conditions, risks related to beryllium exposure that requires further evaluation, treatment or lifestyle modification. |
Medical Removal | Required based upon medical recommendation |
Multiple Physician Review Process | Referral to CBD if recommended by provider. |
E. Cadmium | |
---|---|
Reference |
OSHA 29 CFR § 1910.1027 OSHA 29 CFR § 1926.1127 |
Frequency |
1. Baseline Examination 2. Annual Examination 1 year following Baseline Examination 3. Biennially Examination (see standard for guidance on frequency with abnormal laboratory findings) 4. Variable or Exposure-Determined Examination 5. Exit/Reassignment Examination |
Laboratory |
Annual Laboratory: 1. Cadmium in urine (CdU) (See Appendix F for protocol for sample handling and laboratory selection) 2. Beta-2 microglobulin in urine (B(2)-M) 3. Cadmium in blood (CdB) 4. BUN and Serum Creatinine 5. Complete Blood Count (CBC) 6. Chest X-ray (PA)
a. Baseline
7. Pulmonary Functionb. Exit/Reassignment 8. Discretionary Tests:
a. Annual Chest X-ray
b. PSA (for males 50 years and older) c. Urinalysis |
Physical Exam |
1. Cadmium Exposure Questionnaire required (Appendix D in CFR) 2. Complete Physical Examination with focus on blood pressure, respiratory, and urinary systems (refer to health effects Appendix A) 3. Prostate palpation, males 40 years and older 4. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Written Opinion | Standard Written Medical Opinion for Cadmium |
Employee Counseling | Counseling on exam results and medical conditions related to cadmium exposure requiring further evaluation or treatment or removal. |
Medical Removal | Required |
Multiple Physician Review Process | Required if requested by examinee (see CFR) |
F. Chromium | |
---|---|
Reference | OSHA 29 CFR §1910.1026, 29 CFR § 1926.1126 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory | Discretionary |
Physical Exam |
1. Medical and Occupational History 2. Physical Exam with focus on skin and respiratory tract |
Target Organs | Respiratory, liver, kidney, eye, skin |
Written Opinion | Standard Written Medical Opinion within 30 days | Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
G. Ethylene Oxide | |
---|---|
Reference | OSHA 29 CFR § 1910.1047 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Complete Blood Count (CBC) with differential 2. Discretionary Tests:
a. Pregnancy test, if requested by employee
b. Laboratory evaluation of fertility if requested by examinee and considered appropriate by provider c. Blood Chemistry Panel d. Urinalysis |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on pulmonary, hematologic, neurologic, and reproductive system, and eyes and skin. 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory, blood, CNS, reproductive, eye, skin, liver, kidney |
Written Opinion | Standard Written Medical Opinion within 15 days |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
H. Formaldehyde | |
---|---|
Reference | OSHA 29 CFR § 1910.1048 |
Frequency |
1. Baseline Examination 2. Annual Examination (for employees required to wear respirator, others discretionary) 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Pulmonary Function (for required respirator use)
a. Baseline
b. Annual |
Physical Exam | 1. Medical and Occupational History (nonmandatory medical disease questionnaire
- Appendix D in CFR is recommended) 2. Physical Examination with focus on eyes, skin, mucous membranes, and allergies and allergic reactions 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory, eyes, skin |
Written Opinion | Standard Written Medical Opinion for Formaldehyde within 15 days of results |
Employee Counseling | Counseling on exam results and conditions of increased risk including whether medical conditions were caused by past or emergency exposures. |
Medical Removal | Required |
Multiple Physician Review Process | Required if requested by examinee (see CFR) |
I. Hydrazines | |
---|---|
Reference | NIOSH Occupational Safety and Health Guideline for Hydrazine, 1988 |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Baseline Chest X-ray 2. Complete Blood Count 3. Liver Profile 4. Urinalysis with microscopic 5. Discretionary:
a. Pulmonary Function
|
Physical Exam |
1. Medical and Occupational History 2. Physical Examination 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Eyes, respiratory, skin, CNS, liver, kidneys |
Written Opinion | No requirement in standard |
Employee counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
(e.g., Methylene Diisocyanate (MDI), Toluene Diisocyanate (TDI).)
|
|
---|---|
Reference | NIOSH 78-215 |
Frequency |
1. Baseline Examination 2. Variable or Exposure Determined Examination 3. Annual Examination |
Laboratory |
1. Pulmonary Function 2. Chest X-ray (PA) at 5-year intervals |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on respiratory system, skin, and mucous membranes (Isocyanates are potent sensitizers. Acute exposures may cause severe airway obstruction.) 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Eyes, respiratory, kidney, liver, skin, CNS |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk and delayed effects such as coughing or difficulty breathing at night. |
Medical Removal | No requirement in standard |
K. Lead | |
---|---|
Reference |
OSHA 29 CFR § 1910.1025 OSHA 29 CFR § 1926.62 |
Frequency |
1. Baseline Examination 2. Annual Examination for employee's with blood lead over 40ug/100g in the preceding 12 months 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Blood Lead and ZPP (Baseline and every 6 months) 2. If Blood Lead is at or above 40ug/100g, repeat every 2 months 3. Repeat blood lead 2 weeks after any test is at or above 60ug/100g (requires medical removal) 4. During Medical Removal, Blood Lead and ZPP monthly 5. Hemoglobin and Hematocrit, red cell indices, and examination of peripheral smear morphology 6. BUN and Serum Creatinine 7. Urinalysis with microscopic 8. Discretionary Tests:
a. Pregnancy/fertility testing, if employee requests
|
Physical Exam |
1. Medical and Occupational History 2. Complete Physical Examination with focus on teeth, gums, hematological, GI, CV, renal, and neurological system. 3. Blood Pressure 4. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Pulmonary, kidney, blood, reproductive, CNS, gastrointestinal, CV, gums, teeth, eyes |
Written Opinion | Standard Written Medical Opinion for all evaluations and employee written notification of blood level results over 40ug/100g within 5 business days | Employee Counseling | Counseling on exam results and conditions of increased risk including advising of occupational and non-occupational conditions requiring further examination or treatment. |
Medical Removal | Required (see CFR for criteria) |
Multiple Physician Review Process | Required if requested by examinee (see CFR) |
L. Inorganic Mercury | |
---|---|
Reference | OSHA CPL 02-02-06 |
Frequency |
1. Baseline Examination 2. Annual Interim History 3. Variable or Exposure-Determined Examination |
Laboratory |
1. Complete Blood Count (CBC) 2. Urinalysis 3. Voluntary pregnancy test, where appropriate 4. Urine mercury level (for history of exposure, recommend all employees in given work area be tested at the same time). If exposed above PEL test every 3 months, if below PEL test every 6 months. |
Physical Exam |
1. Medical and Occupational History (annual interim history) 2. Physical Examination with focus on central nervous and respiratory systems, kidneys, and skin. 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Liver, kidney, CNS, PNS, lung, eye, mucous membranes |
Written Opinion | Standard Written Medical Opinion |
Employee Counseling | Counseling on exam results and conditions of increased risk and any medical conditions which require further examination or treatment. |
Medical Removal | No requirement in standard |
M. Methylene Chloride | |
---|---|
Reference | OSHA 29 CFR § 1910.1052 |
Frequency |
1. Baseline Examination 2. Annual Medical and Occupational History Update 3. Examination Frequency Age Determined: a. Annual, if age 45 or older b. Every 36 months under age 45 4. Variable or Exposure-Determined Examination 5. Exit/Reassignment Examination |
Laboratory |
1. Discretionary:
a. Pulmonary Function
b. Hemoglobin and Hematocrit c. ALT, SGPT d. Post-shift Carboxyhemoglobin e. ECG |
Physical Exam |
1. Methylene Chloride Questionnaire required (annual interim history-CFR Appendix B) 2. Physical Examination focus on employee health status and analysis of questionnaire responses 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory, CV, liver, CNS, skin, blood |
Written Opinion |
Standard Written Medical Opinion for Methylene Chloride with the following within 15 days of completion of medical and laboratory findings but not more than 30 days past examination including:
a. Statement that the physician has informed the employee Methylene Chloride (MC) is a potential carcinogen risk
b. The risk factors for heart disease, and the potential exacerbation of underlying heart disease from MC exposure and its metabolism to carbon monoxide |
Employee Counseling | Counseling on exam results and that MC is a potential occupational carcinogen, risk factors for heart disease and potential exacerbation of underlying heard disease by exposure to MC through metabolism of carbon monoxide. |
Medical Removal | Required |
Multiple Physician Review Process | Required if requested by examinee (see CFR) |
N. 4,4' Methylenebis (2-chloroaniline) (MOCA, MBOCA) | |
---|---|
Reference | NIOSH Publication No. 78-188 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Laboratory only every 6 months (employees working directly in production or handling for 10 years or longer) |
Laboratory |
1. Complete Blood Count (CBC) 2. Blood Chemistry Profile (to include LFTs) 3. Urinalysis with microscopic 4. Chest X-ray (discretionary) |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination |
Target Organs | Liver, blood, kidneys |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
O. 4,4' Methylenenedianiline (MDA) | |
---|---|
Reference | OSHA 29 CFR § 1910.1050 |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Blood Chemistry Profile (to include LFTs) 2. Urinalysis with microscopic |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on skin disease and liver dysfunction 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Skin, eyes, liver, CV, spleen | Written Opinion | Standard Written Medical Opinion required |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | Required |
Multiple Physician Review Process | Required if requested by examinee (see CFR) |
P. Nitrogen Tetroxide (Dioxide) | |
---|---|
Reference | NIOSH Pocket Guide to Chemical Hazards-Nitrogen Dioxide |
Frequency | Baseline Examination |
Laboratory |
1. Discretionary
a. CBC with diff
b. PFT c. EKG d. CXR |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on pulmonary system, skin, and eyes |
Target Organs | Eyes, respiratory, CV |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
Q. Polychlorinated Biphenyls (PCB) | |
---|---|
Reference | NIOSH Current Intelligence Bulletin 45, February 24, 1986, NIOSH Pocket Guide to Chemical Hazards-Polychlorinated Biphenyls |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Blood Chemistry 2. Complete Blood Count 3. Urinalysis 4. Chest x-ray (baseline) 5. Discretionary Tests:
a. ECG
b. Pulmonary Function c. Fecal Occult |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on the skin, liver, and nervous system. 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Skin, eyes, liver, reproductive system |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
R. Silica Dusts | |
---|---|
Reference | 29 CFR § 1910.1053 |
Frequency | 1. Baseline Examination |
Laboratory | 1. Chest X-ray (Must be read by NIOSH-certified B Reader) |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on respiratory system 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Lungs/respiratory |
Written Opinion | Written opinion to employee within 30 days including: the results of the examination, conditions that place employee at increased risk due to exposure to silica, conditions that require further evaluation, recommended limitations on respirator use, limitations on exposure to silica and recommendations for referral to a specialist. Written opinion to employer including statement that examination met the requirements of the standard, recommended limitations of respirator use. If employee gives written authorization opinion may include recommended limitations to exposure to silica and recommended referral to a specialist. |
Employee Counseling | Counseling on exam results and conditions of increased risk and any medical conditions which require further examination or treatment. |
Medical Removal | No requirement in standard |
S. Trichloroethylene | |
---|---|
Reference | NIOSH Pocket Guide to Chemical Hazards-Trichloroethylene |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
Discretionary
a. LFTs
b. PFTs c. Urinalysis d. Blood Chemistry e. Complete Blood Count f. Visual acuity |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on cardiac, pulmonary, liver, and kidneys 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Respiratory, CV, kidney, liver, skin, CNS, eyes |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
A. Bloodborne Pathogens | |
---|---|
Reference | OSHA 20 CFR § 1910.1030 |
Frequency |
1. Baseline Examination (for occupational groups covered under the standard) 2. Variable or Exposure-Determined Examination |
Laboratory |
1. Hepatitis B Vaccine 2. Hepatitis B Surface antibody (HepBSAb)Titer (required one time only after 3rd dose completed) 3. Declination statement must be signed if Hepatitis B Vaccine declined by employee (Appendix A of OSHA Standard) 4. Discretionary: Post-exposure
a. Victim: HIV test, HepBSAb if not already documented, and HepCAb (other tests per provider)
b. Source (after consent given): HIV test (rapid screen if available), HepB Surface Antigen (HepBSAg), and HepCAb (other tests per provider) c. If any HIV test is performed because of a specific occupational exposure, then a confidential ID system and a secure method to receive the test results shall be insured for both victim and source. |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination (discretionary) |
Target Organs | Multiple organs |
Written Opinion | Standard Written Medical Opinion required within 15 days of completion of evaluation including whether Hepatitis B immunization is indicated and if the employee has received such vaccine |
Employee Counseling |
Counseling on exam results and conditions of increased risk. Post exposure counseling regarding HBV vaccine and follow-up. |
Medical Removal | No requirement in standard |
B. Chemical Laboratory | |
---|---|
Reference | OSHA 29 CFR § 1910.1450 |
Frequency | Variable or Exposure-Determined Examination |
Laboratory |
1. Discretionary:
a. Blood Chemistry Profile
b. Complete Blood Count (CBC) c. Chest X-ray d. Pulmonary Function e. Urinalysis f. Visual Acuity |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Multiple organs, especially eyes, skin, liver |
Written Opinion | Standard Written Opinion required |
Employee Counseling | Counseling on exam results and conditions of increased risk |
Medical Removal | No requirement in standard |
C. Hazardous Waste Operations and Emergency Response | |
---|---|
Reference | OSHA 29 CFR § 1910.120, Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Audiogram (Baseline) 2. Visual Acuity, Color Discrimination, Visual Fields 3. Complete Blood Count (CBC) 4. Blood Chemistry 5. Urinalysis 6. Chest X-Ray (Baseline) 7. Discretionary Tests:
a. ECG
b. Exercise Stress Test c. Pulmonary Function d. Other based on specific exposure (see Guidance Manual) e. Chest X-Ray (Follow-up) |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on worker's fitness, including ability to wear any required PPE, back or musculoskeletal problems, heat stress, claustrophobia 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use 4. Employee may also be covered by Bloodborne Pathogen standard |
Target Organs | Multiple organs |
Written Opinion |
Standard Written Medical Opinion required including:
a. Statement that the employee has sufficient strength, endurance, and emotional stability to perform the work
b. Opinion that no medical condition was detected which would place the employee at increased risk of material impairment of the employee's health or would be a hazard to self or others from hazardous waste operations, emergency response, or respirator use c. Any limitations in job functions or ability to wear PPE d. The results of the medical examination and tests were also provided if requested by the employee |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | No requirement in standard |
NOTE regarding eligibility |
Protocol covers the following employees:
a. Potentially exposed to hazardous substances, without regard to the use of respirator, for more than 30 days per year
Employees Not Covered in Standard:b. Required to use a respirator more than 30 days per year c. Injured from exposure of hazardous substances during an emergency incident d. Members of a HazMat team
a. Emergency responders not designated members of HazMat team (e.g., security, firefighters)
|
D. Healthcare Provider | |
---|---|
Reference | OSHA 20 CFR § 1910.1030 |
Frequency |
1. Baseline Examination 2. Variable or Exposure-Determined Examination |
Laboratory |
1. Hepatitis B Vaccine (required or declination letter shall be completed) or demonstrated immunity 2. TB Screening required for baseline, periodic testing is discretionary based on risk assessment for the facility 3. Discretionary:
a. Hepatitis Profile
b. Measles, Mumps, Rubella Vaccine c. Diphtheria, Tetanus, and Pertussis (Td, Tdap) d. Varicella Vaccine (if no history of chicken pox) e. Influenza Vaccine offered annually |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination (discretionary) 3. Employee also covered by Bloodborne Pathogen Standard |
Target Organs | Respiratory, blood, liver, skin |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | No requirement in standard |
E. Ionizing Radiation | |
---|---|
Reference | OSHA 29 CFR § 1910.1096, 10 CFR § 20.1502 |
Frequency | Variable or Exposure-Determined Examination |
Laboratory | Complete Blood Count (CBC) with Differential |
Physical Exam |
1. Medical and Occupational History including exposure 2. Focused Physical Examination |
Target Organs | Exposure determined |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | No requirement in standard |
F. Lasers | |
---|---|
Reference |
ANSI Z 136.1 (2014), Required for Class 3B and Class 4 Lasers NOTE: Baseline examinations are not mandatory but encouraged to serve as a basis for comparison in the event of a mishap. Centers should establish a uniform policy applicable to all employees working with Class 3B and 4 lasers. |
Frequency |
1. Baseline Examination (per Center Policy) 2. Variable or Exposure-Determined Examination (within 48 hours) |
Laboratory |
1. Visual Acuity with refraction corrections to 20/20 (6/6) far and near vision (more extensive examination indicated if this is not met - see standard) 2. Amsler Grid (or similar pattern to test macular function for vision distortions and scotomas) 3. Color Vision Discrimination (Ishihara or similar color vision test) 4. Ocular fundus Examination with Ophthalmoscope or appropriate Fundus Lens at a Slit Lamp if visual acuity, macular function, or color vision is abnormal. Dilated exam required if abnormalities found. |
Physical Exam |
1. Medical, Occupational, and Ocular History 2. Focused Physical Examination performed by or under supervision of ophthalmologist, optometrist, or other qualified physician 3. Limited skin examination |
Target Organs | Eye, skin |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | No requirement in standard |
G. Noise | |
---|---|
Reference | OSHA 29 CFR § 1910.95, NPR 1800.1 Chapter 4.8 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Exit/Reassignment Examination |
Laboratory |
1. Baseline Audiogram or within 30 days 2. Audiogram Annually 3. Retest (audiogram) within 30 days if there is a STS |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination with focus on external and tympanic membrane |
Target Organs | Ears and hearing system |
Written Opinions | Required within 21 days of Standard Threshold Shift (STS) determination including statement that STS has occurred, whether further evaluation and testing indicated, and opinion on work relatedness or aggravation by occupational noise exposure, and limitation in use of protective hearing equipment |
Employee Counseling | Counseling if STS or suspected ear pathology |
Medical Removal | No requirement in standard |
H. Pesticide | |
---|---|
Reference | NIOSH Pocket Guide the Chemical Hazards |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination 4. Exit/Reassignment Examination |
Laboratory |
1. Baseline (required before occupational exposure)
Plasma and RBC cholinesterase baselines should be established by performing each test twice (3 to 7 days between tests) and averaging the result for the baseline for each.
2. Blood Chemistry 3. Urinalysis (dipstick) 4. Discretionary Tests:
a. Pulmonary Function
b. RBC cholinesterase levels for recent exposure c. Plasma cholinesterase for acute exposure |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on the skin and nervous system 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Target Organs | Kidney, liver, CNS, skin, lung |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | If plasma or RBC cholinesterase activity is decreased by 30 percent or greater from baseline the employee should be removed from exposure until follow-up test levels are at least 80 percent of baseline. |
I. Spray Painting | |
---|---|
Reference | |
Frequency |
1. Baseline Examination 2. Variable or Exposure-Determined Examination |
Laboratory |
Discretionary Tests:
a. Blood Chemistry Profile
b. CBC c. Chest X-ray d. Urinalysis e. Pulmonary Function Test |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination (discretionary) 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use 4. Evaluation of other potential exposures, e.g. lead |
Target Organs | Exposure determined |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | Exposure determined, e.g. lead |
J. Water and Sewage | |
---|---|
Reference | NIOSH Publication 2002-149 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination |
Laboratory |
1. Immunizations offered:
a. Tetanus Diphtheria (Td) Vaccine
2. Discretionary Tests:b. Hepatitis A and B Vaccine
a. Blood Chemistry Profile b. Complete Blood Count (CBC) c. Chest X-ray |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination (discretionary) |
Target Organs | Liver, gastrointestinal, blood |
Written Opinion | No requirement |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
Medical Removal | No requirement |
K. Welding | |
---|---|
Reference | NIOSH Criteria Document No. 88-110 |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination |
Laboratory |
1. Pulmonary Function (Base only) 2. Blood Chemistry Profile 3. Complete Blood Count (CBC) 4. Urinalysis 5. Visual Acuity, Depth Perception, and Color Discrimination 6. Chest X-ray (Baseline)
Skin exam (burns, chronic damage)
|
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on skin, respiratory, macular, cornea, fundus, and any condition that may interfere with ability to perform duties 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination Occupational Respirator Use 4. Evaluation of other potential exposures, e.g. metals, flux, compounds |
Target Organs | Respiratory, eyes, varies with exposure type |
Written Opinion | No requirement in standard |
Employee Counseling | Counseling on exam results and conditions of increased risk, including smoking. |
Medical Removal | Exposure determined, e.g. lead |
A. Childcare Workers | |
---|---|
Reference | |
Frequency |
1. Baseline Examination 2. Variable or Exposure-Determined Examination |
Laboratory |
1. Annual TB Screening 2. Discretionary Vaccines offered:
a. Influenza
b. Measles, Mumps, and Rubella (MMR) c. Tetanus/Diphtheria (Td) d. Polio e. Hepatitis A f. Chickenpox g. Hepatitis B |
Physical Exam |
1. Medical and Occupational/Immunization History 2. Physical Exam with focus on ability to lift and bend repetitively |
Target Organs | Musculoskeletal |
Written Opinion | Job Certification with any limitations | .
Employee Counseling | Counseling on exam results and conditions of increased risk | .
B. Permit-Entry Confined Space/Tank Entry | |
---|---|
Reference | 29 CFR § 1910.134 |
Frequency | 1. Variable or Exposure-Determined Examination |
Laboratory |
1. Audiogram 2. Visual Acuity, Depth Perception, and Color Vision (or demonstration of employee's ability to see and hear warnings, such as flashing lights, buzzers, and sirens) 3. Discretionary Tests:
a. ECG
b. Chest X-ray (Baseline) c. Urinalysis (dipstick) d. Pulmonary Function |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on employee's ability to carry out assigned duties and detection of any disease or abnormality that would make it difficult to work within confined spaces 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use 4. Evaluation of other exposures may be required |
Written Opinion | Job Certification with any limitations |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
C. Crane Operators/Riggers NOTE: Includes ground floor, remote operation, high, cabin, pulpit |
|
---|---|
Reference |
National Commission for the Certification of Crane Operators NASA STD 8719.9 49 CFR subpt. E |
Frequency |
1. Baseline Examination 2. Every 3 years |
Laboratory |
1. Audiogram: Hearing threshold average in better ear < 40 dB (500, 1000, 2000 Hz) 2. Visual Acuity: Minimum of 20/40 Snellen in each eye without correction or separately corrected to 20/40 Snellen in both eyes with or without corrective lenses 3. Depth Perception 4. Field of vision at least 70 degrees in the horizontal median in each eye 5. Color Vision 6. Discretionary Tests:
a. ECG
b. Urinalysis c. Pulmonary function d. Hemoglobin (Hgb) and Hematocrit (Hct ) e. HbA1C (discretionary) |
Physical Exam |
Complete examination: 1. History to ascertain any condition that may cause any sudden incapacitation or inability to perform duties 2. Evaluation for reaction time, manual dexterity, and coordination 3. No tendencies to seizures, dizziness, claustrophobia, sudden incapacitation, loss of physical control, or similar undesirable conditions such as insulin controlled diabetes 4. No evidence of physical defects, or emotional instability, that in the opinion of the examiner, would present a hazard to self or others |
Written Opinion | Job Certification with any limitations or referral for additional specialized clinical evaluation or testing
If an employee has Insulin Treated Diabetes Mellitus (ITDM) a Federal Motor Carrier Safety Administration (FMCSA)-compliant waiver is required to obtain a 12-month certification. Each Center with drivers requiring Department of Transportation (DOT) certification will have a Certified Medical Examiner. The Center's Certified Medical Examiner, civil service or contractor (per the contractor's contract) will review 1. The FMCSA ITDM Assessment Form MCSA-5870 from the employee's treating physician, per 49 CFR pt. 46. 2. A letter from employee's supervisor stating. a. The workplace is able to meet requirements to accommodate the employee such as mitigating hypoglycemic symptoms, monitoring glucose levels, and training the employee to recognize hypoglycemic episodes. b. If the crane has a dead-man switch. OCHMO will issue certifications for Centers without a Certified Medical Examiner. Occupational health clinic physicians at Centers without a Certified Medical Examiner will submit the information requested in paragraphs 1 and 2 above, along with a waiver recommendation to OCHMO within 30 days of receipt of the required FMCSA ITDM Assessment Form. |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
D. Diver | |
---|---|
Reference | 29 CFR §§ 1910.401-441, subpt. T |
Frequency |
1. Baseline Examination 2. Annual Exam |
Laboratory |
1. Audiogram 2. Baseline and Annual ECG 3. Baseline Chest X-ray (PA and lateral) 4. Pulmonary Function (Vital Capacity) 5. Urinalysis (dipstick) 6. Blood Chemistry 7. Complete Blood Count (CBC) 8. TB Screening 9. Visual Acuity and Color Discrimination 10. Discretionary Tests:
a. Exercise Stress Test
|
Physical Exam |
1. Medical and Occupational History to include predisposition to unconsciousness, vomiting, cardiac arrest, impairment of oxygen transport, serious blood loss, or anything that interferes with effective underwater work 2. Physical Examination |
Written Opinion | Job Certification with any limitations, or recommend further specialized clinical evaluation or testing |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
E. DOT/Commercial Driver License/ Motor Vehicle Certification/Multiple Passenger Van |
|
---|---|
Reference | 49 CFR subpt. E |
Frequency |
1. Baseline Examination 2. Biennial Exam unless more frequent examination is required by the examining provider (per DOT regulations) |
Laboratory |
1. Forced whisper voice in better ear at not less than 5 feet with or without hearing aid or Audiogram: Hearing threshold average loss in better ear not > 40 dB at 500, 1,000, 2,000 Hz with or without hearing aid 2. Visual Acuity: At least 20/40 (Snellen) in each eye without corrective lenses or visual acuity separately corrected to 20/40 or better with corrective lenses, distant binocular acuity of at least 20/40 in both eyes with or without corrective lenses 3. Depth perception 4. Gross field of vision: 70 degrees in each eye 5. Traffic signal color perception 6. Urinalysis (dipstick) 7. Discretionary Tests:
a. Chest X-ray
b. Complete Blood Count (CBC) c. Blood Chemistry Profile d. ECG e. Exercise Stress Test f. Pulmonary Function |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on any condition that may cause any sudden incapacitation or inability to perform duties, tendencies to seizures, dizziness, claustrophobia, loss of physical control, or similar undesirable conditions (Cannot qualify if diabetic on insulin or if currently on medication for seizure disorder/epilepsy) |
Written Opinion |
Job Certification with any limitations or referral for additional specialized clinical evaluation or testing
If an employee has Insulin Treated Diabetes Mellitus (ITDM) a FMCSA-compliant waiver is required to obtain a 12-month certification. Each Center with drivers requiring Department of Transportation (DOT) certification will have a Certified Medical Examiner. The Center's Certified Medical Examiner, civil service or contractor (per the contractor's contract) will review 1. The FMCSA ITDM Assessment Form MCSA-5870 from the employee's treating physician, per 49 CFR pt. 46. 2. A letter from employee's supervisor stating the workplace is able to meet requirements to accommodate the employee such as mitigating hypoglycemic symptoms, monitoring glucose levels, and training the employee to recognize hypoglycemic episodes. OCHMO will issue certifications for Centers without a Certified Medical Examiner. Occupational health clinic physicians at Centers without a Certified Medical Examiner will submit the information requested in paragraphs 1 and 2 above, along with a waiver recommendation to OCHMO within 30 days of receipt of the required FMCSA ITDM Assessment Form. |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
F. Down Range/Shipboard Duty | |
---|---|
Reference | 46 CFR subpts. 10.205; 12.02-27; 12.25 |
Frequency |
1. Baseline Examination (temporary assignment to ships, submarines, or NASA Test Range shipboard) 2. Annual Examination (for Masters, Chief Mates, Chief Engineers, 1st Assistant Engineer, Food Handlers, or anyone 60 years and up, or temporary assignments) 3. Variable (if none of the above):
a. Every 5 years for 17 to 24 years of age
b. Every 3 years for 25-49 years of age c. Every 2 years for 50 to 59 years of age |
Laboratory |
1. Audiogram 2. Visual Acuity: 20/200 correctable to 20/40 (Snellen) for deck responsibility; correctable to 20/50 for engineering responsibility 3. TB Screening 4. Gross Visual Fields: If otherwise qualified, may have lost vision in one eye if remaining good eye's vision is passing 5. Color Perception (Pseudoisochromatic Plates or Eldridge--Green Color Perception Lantern) 6. Discretionary Tests:
a. Chest X-ray
b. ECG c. Travel Immunizations (offered) |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination 3. Shipboard food handlers must abide by the Food Handler protocol |
Written Opinion | Job Certification with limitations |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
G. Fire Fighter | |
---|---|
Reference | National Fire Protection Association (NFPA) 1582 |
Frequency |
1. Baseline Examination 2. Annual Examination, if 40 or older 3. Biennial Examination, if between ages 30-39 4. Triennial Examination, if 29 or younger |
Laboratory |
1. Audiogram: Average hearing loss in the unaided better ear less than 40 dB at 500, 1000, 2000, and 3000 Hz. 2. Comprehensive Metabolic Panel (including cholesterol, HDL, LDL, triglycerides, lipid ratios, LFTs) 3. CBC 4. Chest X-Ray:
a. Baseline
5. ECGb. Every 5 years 6. Pulmonary Function: Ratio of FEV1/FVC must be greater than 0.70 if both FEV1 and FVC are below normal 7. Urinalysis (dipstick) 8. Visual Acuity: Far (Snellen) at least 20/40 binocular corrected and at least 20/100 binocular uncorrected for those routinely using corrective lenses. 9. Color Perception 10. Stress test if clinically indicated by history or symptoms 11. Mammography: annually age 40 and older 12. Discretionary Tests:
a. TB Screen b. Hepatitis C screen c. Immunizations offered:
(i) Hepatitis B Vaccine
d. HIV screen(ii) Tetanus/diphtheria (Td) Vaccine (iii) MMR Vaccine (iv) Polio Vaccine (v) Varicella Vaccine (vi) Influenza Vaccine e. Depth perception f. Gross visual fields |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on any condition that may cause any sudden incapacitation or inability to perform duties, tendencies to seizures, dizziness, claustrophobia, loss of physical control, or similar undesirable conditions 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Written Opinion |
Job Certification with: a. Statement that the employee has sufficient strength, endurance, and emotional stability to perform the work b. An opinion the employee would not be a hazard to self or others c. Any limitations in job functions or ability to wear PPE |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
H. Food Handler | |
---|---|
Reference | 21 CFR § 10.115; 29 CFR § 1910.141(h) |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. TB Screening, baseline, then discretionary 2. Hepatitis A (Center may offer) 3. Discretionary Tests:
a. CBC
b. Chest X-Ray |
Physical Exam |
1. Medical and Occupational History focusing upon transmittable infectious diseases 2. Focused Physical Examination 3. Examiner should provide counseling regarding hygiene and prevention of cross contamination/fecal-oral diseases |
Written Opinion | Job Certification with statement that employee is medically cleared as indicated in the Food Safety section of this document. |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
NOTE: | For Crew Food Handler, refer to Primary Crew Contact Physical |
I. Locomotive Engineer | |
---|---|
Reference | 49 CFR § 240.121 and Appendix F |
Frequency |
1. Baseline Examination 2. Triennial Examination |
Laboratory |
1. Audiogram: Hearing loss in better ear < 40 dB at 500, 1,000, 2,000 Hz with or without hearing aid 2. Visual Acuity: 20/40 with or without corrective lenses 3. Visual Fields: at least 70 degrees in each eye 4. Color: Recognize and distinguish between the colors of railroad signals |
Physical Exam |
1. Medical and Occupational History 2. Focused Physical Examination with focus on assessing any condition affecting vision and/or hearing that may cause any sudden incapacitation or inability to perform duties, tendencies to seizures, loss of physical control, or similar undesirable conditions |
Written Opinion | Job Certification with any limitations |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
J. Motive (Heavy) Equipment Operator NOTE: includes specialized maintenance and construction equipment such as bulldozers, dump trucks, etc. |
|
---|---|
Reference | 49 CFR subpt. E |
Frequency |
1. Pre-placement/Baseline Examination 2. Biennial Exam 3. If Commercial Driver License required, refer to DOT/CDL |
Laboratory |
1. Audiogram: Hearing threshold average in better ear < 40 dB (500, 1000, 2000 Hz) 2. ECG-baseline, and clinically indicated 3. Visual Acuity: 20/40 with or without corrective lenses 4. Gross Visual Fields: 70 degrees in each eye 5. Color: Recognize and distinguish between the colors 6. Urinalysis (dipstick) 7. Discretionary Tests:
a. Chest X-Ray
b. Pulmonary Function c. Blood Chemistry Profile d. Complete Blood Count (CBC) e. HbA1C (discretionary) |
Physical Exam |
1. Occupational and Medical History 2. Physical Examination with focus on assessing any condition affecting vision and/or hearing that may cause any sudden incapacitation or inability to perform duties, tendencies to seizures, loss of physical control, or similar undesirable conditions |
Written Opinion |
Job Certification with any limitations or referral for additional specialized clinical evaluation or testing
If an employee has Insulin Treated Diabetes Mellitus (ITDM) a FMCSA-compliant waiver is required to obtain a 12-month certification. Each Center with drivers requiring Department of Transportation (DOT) certification will have a Certified Medical Examiner. The Center's Certified Medical Examiner, civil service or contractor (per the contractor's contract) will review 1. The FMCSA ITDM Assessment Form MCSA-5870 from the employee's treating physician, per 49 CFR pt. 46. 2. A letter from employee's supervisor stating. a. The workplace is able to meet requirements to accommodate the employee such as mitigating hypoglycemic symptoms, monitoring glucose levels, and training the employee to recognize hypoglycemic episodes. b. If the heavy equipment has a dead-man switch. OCHMO will issue certifications for Centers without a Certified Medical Examiner. Occupational health clinic physicians at Centers without a Certified Medical Examiner will submit the information requested in paragraphs 1 and 2 above, along with a waiver recommendation to OCHMO within 30 days of receipt of the required FMCSA ITDM Assessment Form. |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
K. Occupational Respirator Use | |
---|---|
Reference | OHSA 29 CFR § 1910.134, and 29 CFR § 1910.134 Appendices A, B1, B2 , C |
Frequency |
1. Baseline Examination 2. Baseline and annual respirator questionnaire 3. Variable or Exposure-Determined Examination |
Laboratory | 1. Discretionary |
Physical Exam |
1. OSHA Respirator Medical Evaluation Questionnaire (Mandatory: 29 CFR § 1910.134 Appendix A) annually 2. Focused Physical Examination with a focus on employee's ability to use a respirator for baseline 3. Annual Focused Physical Examinations required only if positive responses to Questions 1-8, Section 2, Part A of Appendix C, or at the discretion of the physician 4. Discretionary Tests:
a. Chest X-ray
b. Pulmonary Function (spirometry) |
Written Opinion |
Required Standard Written Medical Opinion including:
a. Statement employee is medically able to use the respirator, or any limitations on respirator use related to a medical condition or related to workplace conditions in which respirator will be used
b. The need for any medical follow-up c. A statement that employee has been given a copy of the written opinion d. If the respirator is a negative pressure respirator and the PLHCP finds a medical condition that may place the employee's health at increased risk if the respirator is used, the employer shall provide a PAPR if the medical evaluation finds that the employee can use such a respirator; if a subsequent medical evaluation finds that the employee is medically able to use a negative pressure respirator, then the employer is no longer required to provide a PAPR |
Employee Counseling | Counseling on exam results, conditions of increased risk and copy of written opinion provided to employer. |
Medical Removal | No requirement in standard |
L. Ordnance Handler | |
---|---|
Reference | |
Frequency |
1. Baseline Examination 2. Every 2 years |
Laboratory |
1. Audiogram 2. Visual Acuity 3. Depth Perception 4. Color Perception (as related to specific job requirements) 5. Urinalysis (dipstick) 6. Discretionary Tests:
a. ECG
e. Pulmonary Functionb. Complete Blood Count (CBC) c. Blood Chemistry Profile d. Chest X-ray |
Physical Exam | 1. Medical and Occupational History to ascertain any condition that may cause
any sudden incapacitation or inability to perform duties, tendencies to seizures, dizziness, claustrophobia, loss of physical control, or similar undesirable conditions 2. Physical Examination focusing on strength, endurance, agility, coordination, adequate visual acuity and hearing, and emotional stability |
Written Opinion | Job Certification with any limitations |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
M. Primary Animal Contact NOTE: May have to be modified to cover the animal species and specific agents being used. |
|
---|---|
Reference | |
Frequency |
1. Baseline Examination 2. Annual Examination 3. Variable or Exposure-Determined Examination |
Laboratory |
Baseline only: 1. Complete Blood Count (CBC) 2. Blood Chemistry Profile 3. Pulmonary Function 4. TB Screening 5. Tetanus every 10 years 6. Discretionary:
a. Serum Sample (10 mL) for storage
b. Rabies Titer c. Rubeola Titer d. Hepatitis A and B e. Offer Rabies Vaccine |
Physical Exam |
1. Medical and Occupational History (annual interim history) 2. Physical Examination with focus on immunization history, conditions with suppression of the immune system, allergies to animals, and prior illnesses from animal 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use |
Written Opinion | Job Certification with any limitations |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
N. Primary Crew Contact | |
---|---|
Reference | Flight Crew Health Stabilization Program JSC 22538 |
Frequency |
1. Mission specific: No earlier than L-21 every scheduled manned launch 2. Permanent Primary Contacts: Annual 3. Food Depot: Every 6 months |
Laboratory |
Required for Food Depot only:
(a) CBC
Discretionary Tests for all others:(b) Urinalysis (c) Blood Chemistry Panel and Cholesterol Panel (d) TB screening (annual) (e) Hepatitis A and Influenza Vaccine (offered)
(f) WBC count with differential
(g) Urinalysis (h) Other serological or bacteriological testing (i) TB screening |
Physical Exam | Focused Physical Examination with focus on detection of infectious disease |
Written Opinion | Certification status (JSC Form 270, KSC Form 13-116) |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
O. Security | |
---|---|
Reference | |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Audiogram 2. Visual Acuity, Color Vision, Visual Field 3. ECG 4. Urinalysis (dipstick) 5. TB Screening 6. Discretionary Tests:
a. Pulmonary Function
b. Exercise Stress Test |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on ability to perform the essential functions of the job and maintain emotional stability |
Written Opinion |
Required: a. Certification statement that the employee has emotional stability to perform the work b. In the opinion of the examiner that no medical condition was detected which would place the employee at increased risk of material impairment of the employee's health or would be a hazard to self or others c. Any limitations in job functions |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
P. Self-Contained Atmospheric Protective Ensemble (SCAPE) | |
---|---|
Reference | 29 CFR § 1910.134 |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Blood Chemistry Profile 2. Complete Blood count (CBC) 3. Baseline Chest X-ray 4. Pulmonary Function 5. Audiogram: Hearing threshold ≤ 40 dB average hearing loss at 500, 1000, 2000, and 3000 Hz in the "Better Ear" 6. Visual Acuity: a. Far (Snellen) at least 20/70 in one eye and 20/100 in the other eye corrected to 20/20 in one eye and 20/40 in the other eye b. Near vision correctable to 20/40 (Snellen equivalent) bilaterally 7. Color perception 8. Depth perception 9. Gross visual fields intact 10. Discretionary Tests:
a. Annual Chest X-ray
b Urinalysis with microscopic c. ECG |
Physical Exam |
1. OSHA Respirator Medical Evaluation Questionnaire (Mandatory: 29 CFR § 1910.134, Appendix A) 2. Physical Examination with focus on employee's ability to use a respirator under the conditions of use (i.e., temperature extremes) 3. Have sufficient strength, endurance, agility, coordination, and emotional stability to avoid interference with performance |
Written Opinion |
Required: a. Statement that the employee is medically able to use the Self-Contained Atmospheric Protective Ensemble (SCAPE), or any limitations on SCAPE use related to a medical condition or related to workplace conditions in which the SCAPE will be used b. Any need for medical follow-up c. Statement that employer/employee has been given a copy of the written opinion |
Employee Counseling | Counseling on exam results, conditions of increased risk and copy of written opinion provided to employer. |
Medical Removal | No requirement in standard |
Q. Soldering | |
---|---|
Reference |
IPC J-STD-001ES, Space Applications Electronic Hardware Addendum to JPC J-STD-001E |
Frequency |
1. Baseline Examination 2. Biennial 3. Variable or Exposure-Determined |
Laboratory |
1. Pulmonary Function (Baseline only) 2. Visual Acuity, and Color Discrimination |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination with focus on skin and respiratory tract. 3. Evaluation of ability to wear respirator may be required, see protocol Section 3 K, Certification Examination. Occupational Respirator Use 4. Evaluation of other potential exposures, e.g. lead |
Target Organs | Respiratory, skin, varies with type of solder used |
Written Opinion | |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
R. Voluntary Respirator Use | |
---|---|
Reference | OSHA 29 CFR § 1910.134 Appendix A ,B1, B2, C, D |
Frequency | 1. Baseline Examination |
Physical Exam |
1. Focused physical evaluation 2. History to ascertain any condition that may cause any sudden incapacitation, inability to perform duties. 3. Evaluation of ability to wear respirator under expected use conditions (i.e., temperature extremes). 4. OSHA Respirator Medical Evaluation Questionnaire (Mandatory: 29 CFR § 1910.134 Appendix A) |
Written Opinion |
Required: a. Any limitations in job functions or ability to wear PPE |
Employee Counseling | Counseling on exam results and conditions of increased risk. |
A. Pilots, Flight Engineers, Other Primary Aircrew, Qualified Non-Crewmember, Unmanned Aircraft System (UAS) Pilots and Observers |
---|
NOTE: Refer to Section 2.2 of OCHMO 110902MED; NPR 7900.3 Aircraft Operation Management Manual; 14 CFR pt. 67 Medical Standards and Certification for certification examination requirements. |
B. Air Traffic Control Specialist (Not requiring FAA Certification) | |
---|---|
Reference | Office of Personnel Management (OPM) GS-2152 |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Audiogram: No hearing loss in either ear of more than 25 decibels at 500, 1000, or 2000 Hz. No hearing loss in these ranges of more than 20 decibels in the better ear. 2. Visual Acuity:
a. Distant 20/20 in at least one eye with or without correction
3. Visual Fields: Normalb. Near vision 20/20, Snellen equivalent, with or without correction 4. Color Vision 5. Tonometry 6. ECG 7. 8. 9. Discretionary Tests:
a. Blood Chemistry (can include fasting blood sugar and blood lipid profile).
b. Complete Blood Count (CBC) c. Chest X-ray d. Pulmonary Functions e. Urinalysis (dipstick) f. Exercise Stress Test |
Physical Exam |
1. Medical and Occupational History 2. Physical Examination (see OPM qualifications on age based blood pressure values) with focus on cardiovascular, neurological, musculoskeletal, general medical, psychiatric, and substance dependency |
Written Opinion | Certification with any limitations |
C. Second Class Airman's Medical Certificate (Air Traffic Control Tower Operator) | |
---|---|
Reference | 14 CFR pt. 67 Appendix A |
Frequency |
1. Baseline Examination 2. Annual Examination |
Laboratory |
1. Audiogram See FAA II 2. Visual Testing and Requirements: See FAA II 3. ECG (transmitted to FAA): First examination after 35 years of age, and annually after 40 years of age 4. Discretionary Tests:
a. Blood Chemistry Profile (can include fasting blood sugar and blood lipid profile)
b. Complete Blood Count (CBC) c. Chest X-ray d. Pulmonary Function e. Urinalysis (dipstick) f. Exercise Stress Test |
Physical Exam |
1. Medical and Occupational History
2. Physical Examination by FAA certified physician with
focus on any condition that may cause any sudden
incapacitation or inability to perform duties, tendencies
to seizures, dizziness, claustrophobia, loss of physical
control, or similar undesirable conditions 3. Average BP should not exceed 155mm/95mm 4. Check references above for acceptable standards, equipment, and requirements. |
Written Opinion |
a. Certification with any limitations, or referral to Aerospace
Medical Certification Division, or Regional Flight Surgeon
for possible further specialized clinical evaluation or
testing. b. See 14 CFR pt. 67 for Pilot Medical Standards |
A. Fitness For Duty (FFD) | |
---|---|
Regulation | |
Defined | Fitness for Duty (FFD) examinations are performed at the request of management when a change in work performance, productivity, or health is observed or suspected. |
Frequency | Variable upon an unexpected change in behavior or performance. The examination should be completed as soon as possible after a written request through management has been made |
Scope | The physician should evaluate whether there is a medical or psychological condition impacting work performance. A job description with the physical requirements and essential job functions is an integral part of this evaluation. Cooperation and coordination with the treating physician(s), as well as other services such as the Employee Assistance Program (EAP) can be of help to an affected employee |
Managers Responsibilities |
The supervisor/manager requesting the FFD examination should notify the employee and have their consent, provide documentation to the physician and a copy of the employee's job description.
Managers must also decide if there is a "For Cause" need for drug testing based upon performance. Since this testing is not a medical test, the manager must contact the Drug Free Workplace (DFW) coordinator to arrange testing |
Laboratory | Discretionary |
Confidentiality | Confidentiality is of utmost importance and all recommendations and reports must be limited to work-related matters, e.g., work limitation, modifications, or accommodations. No non-work related medical diagnosis should be released in the written opinion |
Written Opinion | Required return to duty status for the employee's manager, including recommendations for work limitations or accommodations |
B. Return to Work (RTW) | |
---|---|
Regulation | |
Defined | RTW evaluations are usually performed when employees are returning to work after an illness or injury of greater than 3 business days |
Frequency | Variable or Exposure-Determined Examination |
Scope |
1. Vital signs 2. The evaluation should focus on the employee's ability to perform the essential job functions with or without work limitations, modifications, or accommodations. The information from the employee's physician is reviewed, and a decision is made whether a focused physical and/or tests are necessary |
Managers Responsibilities | The manager requesting the RTW examination must provide a copy of the employee's job description that includes the functional and physical requirements |
Laboratory | Focused laboratory based upon the prior condition/problem of the employee |
Confidentiality | Confidentiality is of utmost importance and all recommendations and reports must be limited to work-related matters, e.g., work limitation, modifications, or accommodations |
Written Opinion |
A RTW certificate for the employee's manager should indicate: a. A statement of work limitations (including modifications and duration) b. A statement of any Personal Protective Equipment (PPE) needed or limitations in use of PPE c. For an occupational related issue, safety, and health should receive a copy of the RTW statement |
C. International Traveler | |
---|---|
Reference | CDC |
Frequency |
1. Variable or Exposure-Determined Examination 2. NOTE: Medical clearance required for NASA civil service employees traveling outside the United States or its possessions, with special emphasis for those traveling to Russia or the former nations under the Soviet Union, TAL site, or any developing or medically under-served country |
Laboratory | Immunizations offered based on recommended WHO and CDC country requirements |
Physical Evaluation |
1. Medical Record Review 2. Medical and Occupational History 3. Physical Examination (discretionary) 4. Offer HRA 5. Provide education based on health risk assessment with emphasis on food and water precautions and other specific issues related to travel destination |
Written Opinion (Clearance) | As required by Center policy |
A. Preventive Health Examination | |
---|---|
Reference | U.S. Preventive Services Task Force |
Frequency |
1. Offer annually to NASA employees 2. Offer at retirement to NASA employees if not previously done |
Laboratory |
1. Vital signs 2. Total body skin examination: baseline and at providers discretion 3. BMI 4. Baseline and at providers discretion: a. Visual Acuity b. Audiogram c. Pulmonary Function d. ECG 5. Breast examination 6. PAP smear (at clinical discretion) 7. PSA test (at clinical discretion) 8. Digital Rectal examination offered to men age 40 and older 9. Complete Blood Count (CBC) 10. Blood Chemistry Profile (includes fasting blood glucose) 11. Lipid profile 12. Urinalysis 13. High Sensitivity Fecal Occult Blood |
Physical Exam |
1. Medical and Family History, if history of smoking -- offer smoking cessation 2. Physical Examination Complete baseline then focused as clinically indicated |
Counseling/ Education |
1. Tobacco cessation, if indicated 2. Healthful diet and physical activity 3. Risk factors based on age, history and examination 3. Breast or testicular self-examination 4. Mammograms every 1-2 years age 40 to 49, every 2 years for age 50 to 74 5. Colonoscopy every 10 years after age 50, earlier with family history (refer to private MD) |
Target Organs | Multiple Organs |
Written Opinion | A summary of examination and laboratory results provided to the employee along with individualized preventive health recommendations |
B. Fitness Center Clearance | |
---|---|
Reference | |
Frequency | Per Center or component facility policy |
Laboratory | Discretionary |
Physical Exam |
1. Review of Physical Activity Readiness Questionnaire (PARQ), if applicable 2. Vital signs (blood pressure, pulse) 3. Physical examination and testing as clinically indicated. Refer to primary care provider as appropriate for additional testing/documentation. Medical Director must review documentation provided by primary care provider. |
Written Opinion (Clearance) | Medical clearance may specify any limitations in clearance duration (i.e., 1-year) or Fitness Center activity |
| TOC | ChangeHistory | Preface | Chapter1 | Chapter2 | Chapter3 | Chapter4 | Chapter5 | Chapter6 | Chapter7 | AppendixA | AppendixB | AppendixC | AppendixD | AppendixE | AppendixF | AppendixG | AppendixH | ALL | |
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