Environment, Health and Safety Manual - Chapter 05.02: Occupational Safety Policies - Medical Surveillance


Environment, Health and Safety Manual - Chapter 05.02: Occupational Safety Policies - Medical Surveillance


OSHA regulations require medical examinations for certain types of work involving exposure to hazardous or toxic substances.

General Requirements

  1. All required medical examinations and procedures will be performed by or under the supervision of a licensed physician and will be provided without cost to the employee.
  2. The examination will include the personal history of employee and family, and occupational background including genetic and environmental factors.
  3. The Environment, Health and Safety Office will maintain a record of each employee subject to medical surveillance. This record will include:
    1. A copy of the physician’s written opinion as to the employee’s suitability for employment in specific exposure conditions, or the employee’s refusal to take the medical examination.
    2. Any medical complaint by the employee related to exposure to a hazard or toxic substance.
    3. A copy of the required information pertaining to employee exposure which the University must provide to the physician.
    4. A copy of the employee’s work history.
  4. The University will maintain this record for the duration of employment plus 30 years, as required by the applicable OSHA standard.

Standards Requiring Medical Surveillance

29 CFR 1910.95 Occupational Noise Exposure

Annual audiometric tests will be required for employees exposed to an 8 hour time weighted average of 85 dBA or more.

29 CFR 1910.134 Respiratory Protection

Employees who are required to wear a respirator will be provided pre-assignment and periodic (e.g. annual) reviews by a physician to determine that the employee is physically able to wear a respirator.

29 CFR 1910.411 Commercial diving operations

Employees are not allowed to dive during any temporary physical impairment or condition which is likely to adversely affect the safety or health of the employee.

29 CFR 1910.120 Hazardous Waste Operations and Emergency Response

Pre-assignment and annual medical exams will be provided to members of HAZMAT teams. Medical exams also will be provided to employees who work in hazardous waste facilities and are exposed over the Permissible Exposure Limit (PEL) of an OSHA regulated substance, wear respirators, are exposed to a hazardous chemical during a spill or release, or experience signs or symptoms of exposure.

29 CFR 1910.1001 Asbestos

Pre-assignment, annual, and termination medical examinations will be provided to employees who are exposed at or above the PEL for asbestos.

29 CFR 1910.1025 Lead

Medical surveillance will be provided for employees who are exposed to lead at the action level for more than 30 days per year. Medical surveillance includes pre-assignment and annual medical examinations and analysis of blood lead levels. Medical exams also will be provided for employees who experience signs and symptoms associated with lead intoxication.

29 CFR 1910.1030 Bloodborne Pathogens

Hepatitis B virus vaccinations will be offered to all employees who are occupationally exposed to human blood or other potentially infectious materials (OPIM). Medical evaluation and follow-up are required for occupational exposures to blood or OPIM.

29 CFR 1910.1048 Formaldehyde

Medical surveillance will be provided to employees who are exposed to formaldehyde at or above the action level. Medical surveillance consists of an evaluation of a medical disease questionnaire. Medical examinations will be provided to employees who the physician feels requires further evaluation based on the medical disease questionnaire; who are required to wear respirators; who experience signs or symptoms of exposure to formaldehyde; or who are exposed in emergencies.

29 CFR 1910.1450 Laboratory Standard

Medical consultations and medical examinations will be provided when an employee develops signs or symptoms associated with a chemical to which the employee may have been exposed in the laboratory, when exposure monitoring reveals an exposure is routinely above the action level or PEL of an OSHA regulated substance, or whenever there is a likelihood that an employee was exposed as a result of an accidental spill or release.

49 CFR 391.41 Commercial Driver’s License

A medical history and physical examination will be provided employees who are required to have a commercial driver’s license. The purpose of the history and exam is to detect the presence of physical, mental or organic defects that affect the applicant’s ability to operate a motor vehicle.

Other Jobs Recommended for Medical Surveillance

Animal Handlers

  • Employees of the Department of Laboratory Animal Medicine will be provided annual medical exams.
  • Laboratory employees who work with animals will be registered in a medical surveillance program that includes a health history questionnaire reviewed by an occupational physician, an annual TB test, and a tetanus vaccination.
  • Employees who handle dogs, cats, or wild animals will be provided rabies vaccinations. A baseline serum sample will be banked for employees working with primates and pregnant sheep.

Vaccination of Laboratory Workers

Laboratory workers who handle pathogens for which there is an effective vaccine available will be provided vaccinations for those agents.

Contact Information

Policy Contact

Environment, Health and Safety
1120 Estes Drive
Campus Box #1650
Chapel Hill, NC 27599-1650
Phone: 919-962-5507

Back to Chapter 05.01 - Industrial Hygiene Program Requirements

Proceed to Chapter 05.03 - Hearing Conservation Program


Article ID: 131956
Thu 4/8/21 9:20 PM
Mon 7/4/22 1:50 PM
Effective Date
If the date on which this document became/becomes enforceable differs from the Origination or Last Revision, this attribute reflects the date on which it is/was enforcable.
01/28/2019 12:00 AM
Issuing Officer
Name of the document Issuing Officer. This is the individual whose organizational authority covers the policy scope and who is primarily responsible for the policy.
Issuing Officer Title
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Executive Director
Last Review
Date on which the most recent document review was completed.
01/28/2019 12:00 AM
Last Revised
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01/28/2019 12:00 AM
Next Review
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09/01/2026 12:00 AM
Date on which the original version of this document was first made official.
04/01/2012 12:00 AM
Responsible Unit
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Environment, Health and Safety