Cal/OSHA · dir.ca.gov
Fibrogenic Dusts

Asbestos Medical Surveillance

Asbestos causes asbestosis, lung cancer, and mesothelioma; affects workers in construction/demolition, shipyards, insulation, brake/friction work, and abatement.

PEL0.1 fiber/cc (8-hr TWA); excursion limit 1.0 fiber/cc over 30 minutes [5208(c)]

General Industry

Who is covered: All employees exposed at/above the TWA and/or excursion limit [5208(l)(1)(A)]

Evaluation performed by: Licensed physician (employer-selected)

🩺 Baseline / Pre-Placement

Pre-placement, before assignment to an asbestos-exposed occupation

  • Medical and work history
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
  • Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
  • Chest X-ray (in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 5208 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
  • Any additional tests deemed appropriate by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: Made available annually [5208(l)(3)(A)]; chest X-ray at the Table 2 frequency (age × years since first exposure) — table shown in this section.

  • Medical and work history
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
  • Chest X-ray (in accordance with Table 2; oblique x-rays need only be performed every 3 years (Table 2 footnote)) (regulatory term: chest roentgenogram, 8 CCR 5208 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
  • Any additional tests deemed appropriate by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🚪 Exit / Termination

At termination of employment, for employees exposed at or above the TWA and/or excursion limit [5208(l)(4)(A)]

  • Termination medical examination within 30 calendar days before or after termination, in accordance with the periodic-examination requirements [5208(l)(4)(B)]
  • Medical and work history
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
  • Chest X-ray (in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 5208)
  • Pulmonary function tests (FVC, FEV1)
  • Any additional tests deemed appropriate by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

Reporting Requirements

Who performs the evaluationLicensed physician (employer-selected)
Reported to employerWritten opinion limited to: whether the employee has any detected medical condition placing them at increased risk from asbestos; recommended PPE/respirator limitations; a statement that the employee was informed of exam results; and a statement that the employee was informed of the increased lung-cancer risk from combined smoking and asbestos exposure. Unrelated findings must not be revealed.
Reported to / for the employeeEmployee informed of exam results and of the increased smoking+asbestos lung-cancer risk; furnished a copy of the written opinion. Smoking-cessation resources provided via training.
Time limitsEmployer shall provide a copy of the physician's written opinion to the affected employee within 30 days of its receipt [5208(l)(7)(C)].
Second-opinion / multi-physician reviewNo formal multiple-physician review mechanism specified.
RecordkeepingMedical surveillance records maintained for the duration of employment plus thirty (30) years, in accordance with Section 3204 [5208(m)(3)(C)].

Medical Removal Protection

No medical removal protection scheme; physician's written opinion conveys increased-risk findings and limitations.

Construction

Who is covered: Employees who, for a combined total of 30 or more days per year, engage in Class I, II, or III work or are exposed at or above the PEL [1529(m)(1)(A)1.] — days with one hour or less of Class II/III work on intact material under full required work practices do not count toward the 30 days. Employees otherwise required to wear a negative-pressure respirator must be determined physically able to perform the work and use the equipment, under the supervision of a physician [1529(m)(1)(A)2.]

Evaluation performed by: Licensed physician (employer-selected)

🩺 Baseline / Pre-Placement

Prior to assignment to an area where negative-pressure respirators are worn [1529(m)(2)(A)1.]; otherwise within 10 working days following the 30th day of exposure [1529(m)(2)(A)2.]

  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 1529 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least annually [1529(m)(2)(A)3.]; chest X-ray at the Table 2 frequency (age × years since first exposure) — table shown in this section.

  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2; oblique x-rays need only be performed every 3 years (Table 2 footnote)) (regulatory term: chest roentgenogram, 8 CCR 1529 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🚪 Exit / Termination

At termination of employment, for employees exposed at or above the PEL and/or excursion limit [1529(m)(2)(A)6.]. 1529 does not prescribe specific content for the termination examination (the (m)(2)(B) component list covers only pre-placement and annual examinations).

  • Termination medical examination within 30 calendar days before or after termination [1529(m)(2)(A)6.]
  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 1529 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Reporting Requirements

Who performs the evaluationLicensed physician (employer-selected)
Reported to employerWritten opinion limited to: increased-risk determination from asbestos exposure; recommended PPE/respirator limitations; statement that the employee was informed of results and of the increased smoking+asbestos lung-cancer risk. Unrelated findings must not be revealed.
Reported to / for the employeeEmployee informed of results and increased smoking+asbestos risk; furnished a copy of the written opinion.
Time limitsEmployer shall provide a copy of the physician's written opinion to the affected employee within 30 days of its receipt [1529(m)(4)(C)].
Second-opinion / multi-physician reviewNo formal multiple-physician review mechanism specified.
RecordkeepingMedical records maintained for the duration of employment plus thirty (30) years, in accordance with Section 3204 [1529(n)(3)(C)]. The record must include a copy of the employee's medical examination results, including the medical history, questionnaire responses, results of any tests, and physician's recommendations [1529(n)(3)(B)2.].

Medical Removal Protection

No medical removal protection scheme; physician's written opinion includes an increased-risk determination [1529(m)(4)(A)].

Shipyard / Maritime

Who is covered: Employees who, for a combined total of 30 or more days per year, engage in Class I, II, or III work or are exposed at or above the PEL [8358(m)(1)(A)1.] — days with one hour or less of Class II/III work on intact material under full required work practices do not count toward the 30 days. Employees otherwise required to wear a negative-pressure respirator must be determined physically able to perform the work and use the equipment, under the supervision of a physician [8358(m)(1)(A)2.]

Evaluation performed by: Licensed physician (employer-selected)

🩺 Baseline / Pre-Placement

Prior to assignment to an area where negative-pressure respirators are worn [8358(m)(2)(A)1.]; otherwise within 10 working days following the 30th day of exposure [8358(m)(2)(A)2.]

  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 8358 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least annually [8358(m)(2)(A)3.]; chest X-ray at the Table 2 frequency (age × years since first exposure) — table shown in this section.

  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2; oblique x-rays need only be performed every 3 years (Table 2 footnote)) (regulatory term: chest roentgenogram, 8 CCR 8358 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Table 2 — Frequency of chest X-ray (Cal/OSHA) 8 CCR 5208 Table 2; 8 CCR 1529 Table 2; 8 CCR 8358 Table 2

Years since first exposureAge under 40Age 40 and older
0 to 10 yearsEvery 3 yearsEvery year
10 or more yearsEvery yearEvery year

Oblique x-rays need only be performed every 3 years (Table 2 footnote, verbatim). Table 2 governs the pre-placement chest roentgenogram as well as periodic frequency.

🚪 Exit / Termination

At termination of employment — applies to all covered employees (no exposure qualifier) [8358(m)(2)(A)5.]. 8358 does not prescribe specific content for the termination examination (the (m)(2)(B) component list covers only pre-placement and annual examinations).

  • Termination medical examination within 30 calendar days before or after termination [8358(m)(2)(A)5.]
  • Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
  • Physical examination directed to the pulmonary and gastrointestinal systems
  • Chest X-ray (administered in accordance with Table 2) (regulatory term: chest roentgenogram, 8 CCR 8358 Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
  • Any other examinations or tests deemed necessary by the examining physician

Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D

A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.

Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E

The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.

Reporting Requirements

Who performs the evaluationLicensed physician (employer-selected)
Reported to employerWritten opinion limited to: whether the employee has any detected medical condition placing them at increased risk from asbestos; recommended PPE/respirator limitations; a statement that the employee was informed of exam results and of the increased smoking+asbestos lung-cancer risk [8358(m)(4)(A)]. Unrelated findings must not be revealed.
Reported to / for the employeeEmployee informed of exam results and of the increased smoking+asbestos lung-cancer risk; furnished a copy of the written opinion.
Time limitsEmployer shall provide a copy of the physician's written opinion to the affected employee within 30 days of its receipt [8358(m)(4)(C)].
Second-opinion / multi-physician reviewNo formal multiple-physician review mechanism specified.
RecordkeepingMedical records maintained for the duration of employment plus thirty (30) years, in accordance with Section 3204 [8358(n)(3)(C)]. The record must include a copy of the employee's medical examination results, including the medical history, questionnaire responses, results of any tests, and physician's recommendations [8358(n)(3)(B)2.].

Medical Removal Protection

No medical removal protection scheme; physician's written opinion conveys increased-risk findings and limitations.

How this compares to Federal OSHA: General industry standards are substantively aligned — same 0.1 f/cc PEL and 1.0 f/cc excursion limit, the same Appendix D respiratory questionnaire (Part 1 initial / Part 2 periodic), ILO-classified chest X-ray (Appendix E; standard film or digital), periodic examinations made available annually, and a termination exam within 30 calendar days of termination. They differ on chest X-ray frequency: federal Table 1 (1910.1001 only) reaches annual films only at age 45+ with 10+ years since first exposure (every other combination is every 5 years, except every 2 years at age 35+–45 with 10+ years), while California Table 2 requires annual films for every combination except employees under 40 with under 10 years since first exposure (every 3 years), and — California only — oblique x-rays need only be performed every 3 years. Outside general industry the gap widens: the federal construction (1926.1101) and shipyard (1915.1001) standards leave the chest X-ray to the physician's discretion, contain no X-ray frequency table, and require no termination examination, whereas all three California sections — 8 CCR 5208 (general industry), 1529 (construction), and 8358 (ship repairing, shipbuilding, and shipbreaking) — administer the X-ray in accordance with Table 2 and require a termination examination (examination content is prescribed only in 5208). Construction/shipyard coverage triggers match across jurisdictions: a combined total of 30+ days per year of Class I/II/III work or exposure at/above the PEL, plus a physician-supervised physical-ability determination for employees otherwise required to wear a negative-pressure respirator.

Occu-Med handles Asbestos surveillance end-to-end

Scheduling, exams, lab panels, physician review, removal/return determinations, and audit-ready recordkeeping — fully compliant with Cal/OSHA requirements.