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 (asbestos exposure history; pulmonary, cardiovascular, and gastrointestinal status)
  • Standardized respiratory symptoms questionnaire (Appendix D)
  • Complete physical examination — emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • 14×17 PA chest X-ray, classified per the ILO International Classification (Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: Examination made available at least annually. Chest X-ray frequency set by Table 2 (age × years since first exposure); the most-frequent tier (annual chest X-ray) is reached at approximately age 40+ or 10+ years since first exposure — slightly broader than the federal 45+/10-year tier (exact CA Table 2 cell values not transcribed cell-by-cell).

  • Medical and work history (asbestos exposure history; pulmonary, cardiovascular, and gastrointestinal status)
  • Standardized respiratory symptoms questionnaire (Appendix D)
  • Complete physical examination — emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
  • 14×17 PA chest X-ray, classified per the ILO International Classification (Appendix E)
  • Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
🚪 Exit / Termination

At termination of employment in asbestos work

  • Termination medical examination within 30 calendar days before or after termination
  • Medical and work history
  • Standardized respiratory questionnaire (Appendix D)
  • Complete physical examination
  • Chest X-ray (per Table 2 frequency)
  • Pulmonary function tests (FVC, FEV1)

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 records retained for the duration of employment plus 30 years (8 CCR 3204 generally requires duration of employment plus 30 years).

Medical Removal Protection

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

Construction

Who is covered: Class I, II, or III asbestos work OR exposed at/above the PEL for a combined 30+ days/year [1529(m)(1)(A)1]; OR employees otherwise required to wear a negative-pressure respirator [1529(m)(1)(A)2]

Evaluation performed by: Licensed physician (employer-selected)

🩺 Baseline / Pre-Placement

Pre-placement, prior to assignment (and prior to assignment where negative-pressure respirators are worn) [1529(m)(2)(A)]

  • Medical and work history with pulmonary, cardiovascular, and gastrointestinal emphasis
  • Standardized respiratory questionnaire (Appendix D)
  • Physical examination including a chest roentgenogram (chest X-ray)
  • Pulmonary function tests (FVC, FEV1)
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least annually [1529(m)(2)(A)].

  • Medical and work history
  • Standardized respiratory questionnaire (Appendix D)
  • Physical examination including a chest roentgenogram (chest X-ray)
  • Pulmonary function tests (FVC, FEV1)
🚪 Exit / Termination

At termination of employment in asbestos work

  • Termination medical examination within 30 days before or after termination
  • Medical and work history
  • Standardized respiratory questionnaire (Appendix D)
  • Physical examination with chest roentgenogram
  • Pulmonary function tests (FVC, FEV1)

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 retained for the duration of employment plus 30 years (8 CCR 3204).

Medical Removal Protection

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

How this compares to Federal OSHA: Substantively aligned — same 0.1 f/cc PEL and 1.0 f/cc excursion limit, the same Appendix D respiratory questionnaire, ILO-classified chest X-ray, annual periodic, and 30-day termination window. CA GI Table 2 reaches annual chest X-rays at a slightly younger/lower tier (~40+/10 yr) than federal Table 1 (45+/10 yr). California maintains no separate maritime/shipyard asbestos section analogous to federal 1915.1001 (shipyard asbestos work is governed by 5208/1529; unverified). Exact CA reporting time limits and Table 2 cell values were not transcribed and are marked unverified.

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.