Cal/OSHA · dir.ca.gov
Heavy Metals

Beryllium Medical Surveillance

Beryllium causes chronic beryllium disease (CBD), beryllium sensitization, and lung cancer; affects workers in machining, foundry/smelting, ceramics, dental labs, and aerospace/defense manufacturing.

Action Level0.1 µg/m³ (8-hr TWA)
PEL0.2 µg/m³ (8-hr TWA); STEL 2.0 µg/m³ (15-min)

General Industry

Who is covered: Employees (1) exposed at/above the AL for more than 30 days/year; (2) showing signs or symptoms of CBD or other beryllium-related health effects; (3) exposed to beryllium during an emergency; or (4) recommended for periodic surveillance in a PLHCP/physician's written opinion

Evaluation performed by: PLHCP, with the written medical report authored by a licensed physician; CBD evaluation by a CBD diagnostic center (pulmonologist/pulmonary specialist with BAL and transbronchial biopsy capability)

🩺 Baseline / Pre-Placement

Within 30 days after the employee meets an eligibility criterion, unless the employee received a beryllium medical exam within the preceding 2 years

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination with emphasis on the respiratory system
  • Physical examination of the skin for rashes
  • Pulmonary function tests per ATS guidelines: forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁)
  • Standardized BeLPT (or equivalent test) at the first examination
  • Low-dose CT scan when recommended by the PLHCP after considering exposure history and other risk factors
  • Any other test deemed appropriate by the PLHCP
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least every 2 years.

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination with emphasis on the respiratory system
  • Physical examination of the skin for rashes
  • Pulmonary function tests per ATS guidelines (FVC, FEV₁)
  • Standardized BeLPT (or equivalent) at least every 2 years, unless the employee is confirmed positive
  • Low-dose CT scan when recommended by the PLHCP
  • Any other test deemed appropriate by the PLHCP
🚪 Exit / Termination

At termination of employment for an employee meeting an eligibility criterion

  • Termination medical examination — required unless a beryllium medical exam was provided during the 6 months prior to termination
  • Standardized BeLPT (per exam content)
⚠ Emergency / Post-Exposure

Within 30 days after an emergency beryllium exposure, if no exam was provided within the preceding 2 years

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination (respiratory system, skin)
  • Pulmonary function tests (FVC, FEV₁)
  • Standardized BeLPT
  • Low-dose CT scan when recommended by the PLHCP
Abnormal results & exposure-event protocols

Abnormal Results & Exposure-Event Protocols

  • BeLPT result is abnormal or borderline (and the employee is not already confirmed positive) Follow-up BeLPT on abnormal/borderline result: Offer a follow-up BeLPT within 30 days of receiving the result. Tests: Follow-up standardized BeLPT
  • PLHCP recommends referral, or the employee presents a medical report showing a confirmed positive finding or a CBD diagnosis CBD diagnostic center referral: With the employee's authorization, the employer offers an evaluation at a CBD diagnostic center within 30 days; the center provides a written report. Tests: CBD diagnostic-center evaluation (pulmonary function testing, bronchoalveolar lavage, transbronchial biopsy as indicated)
  • Employee working at/above the AL who provides a written medical report of a confirmed positive beryllium-sensitization finding or a CBD diagnosis, OR receives a written PLHCP/physician recommendation for removal Medical Removal Protection: Remove the employee from beryllium exposure. The employer either transfers the employee to comparable work below the AL (if available and the employee is qualified or can be trained within ~1 month) or maintains the employee's base earnings, seniority, and other rights/benefits for 6 months from the time of removal, or until comparable below-AL work becomes available, whichever comes first. Tests: Continued medical surveillance per the standard during removal

Reporting Requirements

Who performs the evaluationPLHCP for the exam; a licensed physician authors the written medical report; CBD diagnostic center for CBD evaluation
Reported to employerWithin 45 days, a written medical opinion containing only the date of the exam, a statement that the exam met the standard, any recommended PPE/respirator limitations, and confirmation that the PLHCP explained the results to the employee. Any further content (exposure limitations, CBD-center referral, removal recommendation) is included ONLY with the employee's written authorization.
Reported to / for the employeeWithin 45 days, a written medical report from the licensed physician containing exam results, any detected CBD/sensitization or related condition, recommendations (respirator/PPE/exposure limits), and — if confirmed positive or CBD — a recommendation for CBD-center referral, continued surveillance, and medical removal. Employee also receives a copy of the employer opinion within 45 days; CBD-center report copy within 30 days.
Time limitsWritten medical report to the employee and written opinion to the employer within 45 days of the exam; CBD diagnostic-center report within 30 days.
Second-opinion / multi-physician reviewNo formal multiple-physician review; the CBD diagnostic-center evaluation serves as the specialist confirmation pathway.
RecordkeepingRecords maintained per 8 CCR 3204, including all licensed physicians' written medical opinions and information provided to the PLHCP.

Medical Removal Protection

Removal for a confirmed positive beryllium sensitization, a CBD diagnosis, or a written removal recommendation; benefits = comparable below-AL position OR maintained base earnings/seniority/benefits for 6 months (or until comparable work is available) — notably shorter than lead/cadmium's 18 months.

Construction

Who is covered: Employees (1) exposed at/above the AL for more than 30 days/year; (2) showing signs or symptoms of CBD or other beryllium-related health effects; (3) exposed to beryllium during an emergency; or (4) recommended for periodic surveillance in a PLHCP/physician's written opinion

Evaluation performed by: PLHCP, with the written medical report authored by a licensed physician; CBD evaluation by a CBD diagnostic center (pulmonologist/pulmonary specialist with BAL and transbronchial biopsy capability)

🩺 Baseline / Pre-Placement

Within 30 days after the employee meets an eligibility criterion, unless the employee received a beryllium medical exam within the preceding 2 years

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination with emphasis on the respiratory system
  • Physical examination of the skin for rashes
  • Pulmonary function tests per ATS guidelines: forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁)
  • Standardized BeLPT (or equivalent test) at the first examination
  • Low-dose CT scan when recommended by the PLHCP after considering exposure history and other risk factors
  • Any other test deemed appropriate by the PLHCP
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least every 2 years.

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination with emphasis on the respiratory system
  • Physical examination of the skin for rashes
  • Pulmonary function tests per ATS guidelines (FVC, FEV₁)
  • Standardized BeLPT (or equivalent) at least every 2 years, unless the employee is confirmed positive
  • Low-dose CT scan when recommended by the PLHCP
  • Any other test deemed appropriate by the PLHCP
🚪 Exit / Termination

At termination of employment for an employee meeting an eligibility criterion

  • Termination medical examination — required unless a beryllium medical exam was provided during the 6 months prior to termination
  • Standardized BeLPT (per exam content)
⚠ Emergency / Post-Exposure

Within 30 days after an emergency beryllium exposure, if no exam was provided within the preceding 2 years

  • Medical and work history with emphasis on past and present airborne exposure to or dermal contact with beryllium, smoking history, and any history of respiratory-system dysfunction
  • Physical examination (respiratory system, skin)
  • Pulmonary function tests (FVC, FEV₁)
  • Standardized BeLPT
  • Low-dose CT scan when recommended by the PLHCP
Abnormal results & exposure-event protocols

Abnormal Results & Exposure-Event Protocols

  • BeLPT result is abnormal or borderline (and the employee is not already confirmed positive) Follow-up BeLPT on abnormal/borderline result: Offer a follow-up BeLPT within 30 days of receiving the result. Tests: Follow-up standardized BeLPT
  • PLHCP recommends referral, or the employee presents a medical report showing a confirmed positive finding or a CBD diagnosis CBD diagnostic center referral: With the employee's authorization, the employer offers an evaluation at a CBD diagnostic center within 30 days; the center provides a written report. Tests: CBD diagnostic-center evaluation (pulmonary function testing, bronchoalveolar lavage, transbronchial biopsy as indicated)
  • Employee working at/above the AL who provides a written medical report of a confirmed positive beryllium-sensitization finding or a CBD diagnosis, OR receives a written PLHCP/physician recommendation for removal Medical Removal Protection: Remove the employee from beryllium exposure. The employer either transfers the employee to comparable work below the AL (if available and the employee is qualified or can be trained within ~1 month) or maintains the employee's base earnings, seniority, and other rights/benefits for 6 months from the time of removal, or until comparable below-AL work becomes available, whichever comes first. Tests: Continued medical surveillance per the standard during removal

Reporting Requirements

Who performs the evaluationPLHCP for the exam; a licensed physician authors the written medical report; CBD diagnostic center for CBD evaluation
Reported to employerWithin 45 days, a written medical opinion containing only the date of the exam, a statement that the exam met the standard, any recommended PPE/respirator limitations, and confirmation that the PLHCP explained the results to the employee. Any further content (exposure limitations, CBD-center referral, removal recommendation) is included ONLY with the employee's written authorization.
Reported to / for the employeeWithin 45 days, a written medical report from the licensed physician containing exam results, any detected CBD/sensitization or related condition, recommendations (respirator/PPE/exposure limits), and — if confirmed positive or CBD — a recommendation for CBD-center referral, continued surveillance, and medical removal. Employee also receives a copy of the employer opinion within 45 days; CBD-center report copy within 30 days.
Time limitsWritten medical report to the employee and written opinion to the employer within 45 days of the exam; CBD diagnostic-center report within 30 days.
Second-opinion / multi-physician reviewNo formal multiple-physician review; the CBD diagnostic-center evaluation serves as the specialist confirmation pathway.
RecordkeepingRecords maintained per 8 CCR 3204, including written medical opinions. Mirrors federal 1926.1124 and CA GI 5205.

Medical Removal Protection

Removal for a confirmed positive beryllium sensitization, a CBD diagnosis, or a written removal recommendation; benefits = comparable below-AL position OR maintained base earnings/seniority/benefits for 6 months (or until comparable work is available) — notably shorter than lead/cadmium's 18 months.

How this compares to Federal OSHA: Aligned. California (5205 GI, 1535.1 construction) adopted the federal beryllium standard (1910.1024 / 1926.1124) with no substantive medical-surveillance difference: AL 0.1 µg/m³, PEL 0.2 µg/m³, STEL 2.0 µg/m³; initial within 30 days (unless exam within 2 years), biennial periodic, standardized BeLPT at first exam and every 2 years with a 30-day follow-up BeLPT on abnormal results, PFTs, and low-dose CT when recommended; CBD diagnostic-center referral pathway; and Medical Removal Protection with a 6-month benefit period (verified identical in CA 5205 and 1535.1). Note section number is 5205 (not 5203).

Occu-Med handles Beryllium surveillance end-to-end

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