General Industry
Who is covered: Employees exposed at or above the action level. Two exemptions: (1) employees not exposed at or above the action level for 30 or more days in any 12 consecutive months AND not exposed on any day above 10 µg/m³ as an 8-hour TWA; (2) employees not exposed at or above the action level for 15 or more days in any 12 consecutive months AND not exposed on any day above 20 µg/m³ as an 8-hour TWA (8 CCR 5198(j)(1)).
Evaluation performed by: Licensed physician (employer-selected; multiple-physician review available to employee)
🩺 Baseline / Pre-Placement
Prior to assignment, or when work first becomes covered — unless a BLL was tested within the prior 2 months
- Detailed work + medical history (prior lead exposure; reproductive history; GI, hematologic, neurologic, renal, cardiovascular status)
- Physical examination — emphasis on teeth/gums, hematologic, GI, renal, neurologic, and cardiovascular systems; pulmonary status evaluated if respiratory protection will be used (5198(j)(3)(B)2)
- Blood pressure measurement
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (required when the employee's last BLL was ≥20 µg/dl (5198(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Hemoglobin, hematocrit, red-cell indices, peripheral blood smear
- BUN and serum creatinine
- Routine urinalysis with microscopic examination
🕒 Periodic / Routine
Interval-based BLL testing while covered; plus a result-triggered medical examination as soon as possible for each employee for whom a BLL result of 20 µg/dl or greater is received (8 CCR 5198(j)(3)(A)1)
Schedule: BLL at least every 2 months for the first 6 months, then at least every 6 months (the 2-month cycle restarts after a change in work task or process likely to increase lead exposure). Accelerated: at least every 2 months while the last BLL is 10–19 µg/dl, until two consecutive results taken at least 30 days apart are below 10 µg/dl; at least monthly while the last BLL is ≥20 µg/dl and during any medical-removal period (8 CCR 5198(j)(2)(A)1-5).
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (with each medical exam when the last BLL was ≥20 µg/dl (8 CCR 5198(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Annual medical examination — triggered as soon as possible for each employee for whom a BLL result of 20 µg/dl or greater is received, if no lead-specific medical examination was done for that employee in the preceding 12 months, and at least annually thereafter until the employee's BLL is below 20 µg/dl (8 CCR 5198(j)(3)(A)1)
- Annual medical examination — detailed work history and medical history, with particular attention to past lead exposure (occupational and non-occupational), personal habits (smoking, hygiene), and past gastrointestinal, hematologic, renal, cardiovascular, reproductive and neurological problems (8 CCR 5198(j)(3)(B)1)
- Annual medical examination — thorough physical examination, with particular attention to teeth, gums, hematologic, gastrointestinal, renal, cardiovascular, and neurological systems; pulmonary status evaluated if respiratory protection will be used (8 CCR 5198(j)(3)(B)2)
- Annual medical examination — pregnancy testing or laboratory evaluation of male fertility, included if requested by the employee (8 CCR 5198(j)(3)(B)2)
- Annual medical examination — blood pressure measurement (8 CCR 5198(j)(3)(B)3)
- Annual medical examination — hemoglobin and hematocrit determinations, red cell indices, and examination of peripheral smear morphology (8 CCR 5198(j)(3)(B)4.b)
- Annual medical examination — blood urea nitrogen and serum creatinine (8 CCR 5198(j)(3)(B)4.d–e)
- Annual medical examination — routine urinalysis with microscopic examination (8 CCR 5198(j)(3)(B)5)
- Annual medical examination — any laboratory or other test relevant to lead exposure that the examining PLHCP deems necessary by sound medical practice (8 CCR 5198(j)(3)(B)6)
🚪 Exit / Termination
None — 8 CCR 5198 imposes no termination-of-employment or exit medical examination requirement
- No exit or termination medical examination is required. 8 CCR 5198(j)(3)(A) states the complete schedule on which the employer must make medical examinations and consultations available — prior to first assignment to an area at or above the action level; on receipt of a BLL result of 20 µg/dl or greater; upon employee notification of signs or symptoms of lead intoxication, a desire for medical advice about the ability to procreate a healthy child, or difficulty breathing during a respirator fit test or during use; and upon medical removal or a final medical determination limiting exposure. Termination of employment is not among them, and no other subsection of 5198 imposes a separation, exit, or final examination duty
- Medical surveillance obligations run only while the employee remains covered under 8 CCR 5198(j)(1)(A), and no examination is owed at separation
⚠ Emergency / Post-Exposure
As soon as possible upon employee notification of: signs or symptoms commonly associated with lead intoxication, a desire for medical advice about the effects of current or past lead exposure on the ability to procreate a healthy child, or difficulty in breathing during a respirator fit test or during use (8 CCR 5198(j)(3)(A)3); and as soon as possible, then as medically appropriate, following medical removal (5198(j)(3)(A)4)
- Detailed work + medical history (prior lead exposure; reproductive history; GI, hematologic, neurologic, renal, cardiovascular status)
- Physical examination — emphasis on teeth/gums, hematologic, GI, renal, neurologic, and cardiovascular systems; pulmonary status evaluated if respiratory protection will be used (5198(j)(3)(B)2)
- Blood pressure measurement
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (required when the employee's last BLL was ≥20 µg/dl (5198(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Hemoglobin, hematocrit, red-cell indices, peripheral blood smear
- BUN and serum creatinine
- Routine urinalysis with microscopic examination
- Pregnancy testing or laboratory evaluation of male fertility — required if requested by the employee (5198(j)(3)(B)2)
- Any laboratory or other test relevant to lead exposure that the examining PLHCP deems necessary by sound medical practice (5198(j)(3)(B)6)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- BLL ≥10 µg/dl 8 CCR 5198(j)(2)(E): Employer establishes and implements a written elevated blood lead level response plan describing the specific means used to reduce and maintain the employee's BLL below 10 µg/dl, and provides training and instruction as needed to correct work practices identified in the plan. Exception: not required when a BLL ≥10 µg/dl is detected only in the employee's blood lead test done prior to their first assignment to covered work.
- BLL 10–19 µg/dl 8 CCR 5198(j)(2)(A)4: BLL at least every 2 months until two consecutive results, taken at least 30 days apart, are below 10 µg/dl. Tests: Blood lead level (BLL)
- BLL ≥20 µg/dl 8 CCR 5198(j)(2)(A)5; (j)(3)(A)1: BLL at least monthly (and at least monthly during any medical-removal period). Medical examination as soon as possible if none was done in the preceding 12 months, then at least annually until the BLL is below 20 µg/dl; exams include ZPP while the last BLL is ≥20 µg/dl. Tests: Blood lead level (BLL), ZPP (exam element), Full medical examination
- Single BLL ≥30 µg/dl (eff. Jan 1, 2026 also: two consecutive tests ≥20, or 6-month average ≥20 unless last <15) 8 CCR 5198(k)(1); (k)(3)(A): Remove from exposure; MRP wage/benefit protection up to 18 months. Return at two tests ≥30 days apart both <15 µg/dl. Tests: Periodic BLL during removal to determine return eligibility
Reporting Requirements
| Who performs the evaluation | Licensed physician |
|---|---|
| Reported to employer | Written medical opinion limited to fitness, recommended limitations, and removal/return recommendations; must not disclose unrelated findings. |
| Reported to / for the employee | Employee informed of exam results and of any condition needing further evaluation; furnished a copy of the written opinion. |
| Elevated blood lead level response | Whenever an employee's blood lead level is at or above 10 µg/dl, the employer must establish and implement a written elevated blood lead level response plan describing the specific means that will be used to reduce and maintain that employee's BLL below 10 µg/dl, and provide training and instruction as needed to correct any work practices identified in the plan (8 CCR 5198(j)(2)(E)). Exception: not required when a BLL at or above 10 µg/dl is detected only in the employee's blood lead test done prior to their first assignment to covered work. |
| Time limits | Blood lead level results: employer notifies in writing within 5 working days after receipt of blood lead test results for every employee, regardless of level (8 CCR 5198(j)(2)(C)). Written medical report: the examining PLHCP explains the results and provides each employee a written medical report within 30 days of each medical examination (8 CCR 5198(j)(5)). The 15-day figure in 5198 is the employee's window to initiate a second-physician opinion (8 CCR 5198(j)(3)(C)2), not a medical-surveillance notification deadline; the 15-day air/exposure monitoring figure is exposure monitoring, not medical surveillance. |
| Second-opinion / multi-physician review | Multiple-physician review available to the employee. |
| Recordkeeping | Medical records retained for at least 40 years, or for the duration of employment plus 20 years, whichever is longer (8 CCR 5198(n)(3)(D)). The employer must keep, or ensure the examining PLHCP keeps, the medical examination results including the medical and work history, a description of the laboratory procedures and any standards or guidelines used to interpret the results, and the blood lead testing results (8 CCR 5198(n)(3)(C)); the employer separately maintains an accurate medical surveillance record for each covered employee containing the employee's name and unique identifier, a description of the employee's duties, copies of the PLHCP's written opinions, the airborne lead monitoring results and representative exposure level supplied to the PLHCP, and any employee medical complaints related to lead exposure (8 CCR 5198(n)(3)(A)-(B)). Access, not retention period, is governed by 8 CCR 3204: environmental monitoring, medical removal, and medical records required by this section must be provided upon request to employees, designated representatives, and authorized representatives of the Chief in accordance with section 3204 (8 CCR 5198(n)(7)(B)). |
Medical Removal Protection
Removal at single BLL ≥30 µg/dl; (eff. Jan 1, 2026) two consecutive tests both ≥20, or 6-month average ≥20 unless last test <15; return at two consecutive tests ≥30 days apart both <15 µg/dl; up to 18 months benefits.
Construction
Who is covered: Employees exposed at/above the AL or performing defined lead trigger tasks (limited exceptions for ≤30 days/yr at ≤10 µg/m³)
Evaluation performed by: Licensed physician (employer-selected; multiple-physician review available to employee)
🩺 Baseline / Pre-Placement
Before assignment or before trigger-task work — unless a BLL was tested within the prior 2 months
- Detailed work + medical history (prior lead exposure; reproductive history; GI, hematologic, neurologic, renal, cardiovascular status)
- Physical examination — emphasis on teeth/gums, hematologic, GI, renal, neurologic, and cardiovascular systems; pulmonary status evaluated if respiratory protection will be used (1532.1(j)(3)(B)2)
- Blood pressure measurement
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (required when the employee's last BLL was ≥20 µg/dl (1532.1(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Hemoglobin, hematocrit, red-cell indices, peripheral blood smear
- BUN and serum creatinine
- Routine urinalysis with microscopic examination
🕒 Periodic / Routine
Interval-based while covered — NOT result-triggered
Schedule: BLL at least every 2 months for the first 6 months after initial placement, then at least every 6 months (the 2-month cycle restarts after a change in task likely to increase lead exposure). Accelerated: at least every 2 months while the last BLL is 10–19 µg/dl, until two consecutive results taken at least 30 days apart are below 10 µg/dl; at least monthly while the last BLL is ≥20 µg/dl, during any medical-removal period, while performing level 3 trigger tasks, and while airborne exposure is above 500 µg/m³ as an 8-hour TWA (8 CCR 1532.1(j)(2)(A)1-6).
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (with each medical exam when the last BLL was ≥20 µg/dl (8 CCR 1532.1(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Annual full medical exam (when triggered): as soon as possible after any BLL ≥20 µg/dl if no lead-specific exam was done in the preceding 12 months, then at least annually until the BLL is below 20 µg/dl (8 CCR 1532.1(j)(3)(A)1) — repeats the full baseline history, physical examination, and lab panel
🚪 Exit / Termination
None — 8 CCR 1532.1 imposes no termination, separation, or end-of-lead-work medical examination requirement
- No termination examination required — 8 CCR 1532.1(j)(3)(A) sets out the complete schedule on which the employer must make medical examinations and consultations available, and separation from employment or from lead work is not among the listed triggers
- The four listed triggers are: a BLL result of 20 µg/dl or greater where no lead-specific medical examination was done in the preceding 12 months, and at least annually thereafter until the BLL is below 20 µg/dl; prior to assignment for each covered employee (unless a lead-specific examination was done in the preceding two months); as soon as possible upon employee notification of signs or symptoms commonly associated with lead intoxication, a desire for medical advice about the effects of current or past lead exposure on the ability to procreate a healthy child, pregnancy, or difficulty in breathing during a respirator fit test or during use; and as soon as possible, then as medically appropriate, after medical removal or a final medical determination limiting exposure (8 CCR 1532.1(j)(3)(A)1–4)
- The only end-of-work testing 1532.1 requires is a blood test taken within 3 days after discontinuing all level 3 trigger task work, and within 3 days after discontinuing all work associated with airborne exposure above 500 µg/m³ as an 8-hour TWA — a task-completion test, not a termination examination (8 CCR 1532.1(j)(2)(A)5–6)
⚠ Emergency / Post-Exposure
As soon as possible upon employee notification of: signs or symptoms commonly associated with lead intoxication, a desire for medical advice about the effects of current or past lead exposure on the ability to procreate a healthy child, pregnancy, or difficulty in breathing during a respirator fit test or during use (8 CCR 1532.1(j)(3)(A)3); and as soon as possible, then as medically appropriate, following medical removal (1532.1(j)(3)(A)4)
- Detailed work + medical history (prior lead exposure; reproductive history; GI, hematologic, neurologic, renal, cardiovascular status)
- Physical examination — emphasis on teeth/gums, hematologic, GI, renal, neurologic, and cardiovascular systems; pulmonary status evaluated if respiratory protection will be used (1532.1(j)(3)(B)2)
- Blood pressure measurement
- Blood test measuring the amount of lead in your blood (BLL) (regulatory term: blood lead level)
- Blood test (ZPP) that flags lead's effect on red-blood-cell production (required when the employee's last BLL was ≥20 µg/dl (1532.1(j)(3)(B)4.c)) (regulatory term: zinc protoporphyrin)
- Hemoglobin, hematocrit, red-cell indices, peripheral blood smear
- BUN and serum creatinine
- Routine urinalysis with microscopic examination
- Pregnancy testing or laboratory evaluation of male fertility — required if requested by the employee (1532.1(j)(3)(B)2)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- BLL ≥10 µg/dl 8 CCR 1532.1(j)(2)(E): Employer establishes and implements a written elevated blood lead level response plan describing the specific means used to reduce and maintain the employee's BLL below 10 µg/dl, and provides training and instruction as needed to correct work practices identified in the plan. Exception: not required when a BLL ≥10 µg/dl is detected only in the employee's initial blood lead testing.
- BLL 10–19 µg/dl 8 CCR 1532.1(j)(2)(A)3: BLL at least every 2 months until two consecutive results, taken at least 30 days apart, are below 10 µg/dl. Tests: Blood lead level (BLL)
- BLL ≥20 µg/dl 8 CCR 1532.1(j)(2)(A)4; (j)(3)(A)1: BLL at least monthly (and at least monthly during any medical-removal period). Medical examination as soon as possible if none was done in the preceding 12 months, then at least annually until the BLL is below 20 µg/dl; exams include ZPP while the last BLL is ≥20 µg/dl. Tests: Blood lead level (BLL), ZPP (exam element), Full medical examination
- Level 3 trigger task work, or airborne exposure above 500 µg/m³ as an 8-hour TWA (without regard to respirator use) 8 CCR 1532.1(j)(2)(A)5-6: BLL at least monthly while the condition continues, plus a blood test taken within 3 days after discontinuing all such work. Tests: Blood lead level (BLL)
- Single BLL ≥30 µg/dl (eff. Jan 1, 2026 also: last two tests ≥20, or 6-month average ≥20 unless last <15) 8 CCR 1532.1(k)(1)(A); (k)(1)(C): Remove from exposure; MRP wage/benefit protection up to 18 months. Return at two tests ≥30 days apart both <15 µg/dl. Tests: Periodic BLL during removal to determine return eligibility
Reporting Requirements
| Who performs the evaluation | Licensed physician |
|---|---|
| Reported to employer | Written medical opinion limited to fitness, recommended limitations, and removal/return recommendations; must not disclose unrelated findings. |
| Reported to / for the employee | Employee informed of exam results and of any condition needing further evaluation; furnished a copy of the written opinion. |
| Elevated blood lead level response | Whenever an employee's blood lead level is at or above 10 µg/dl, the employer must establish and implement a written elevated blood lead level response plan describing the specific means that will be used to reduce and maintain that employee's BLL below 10 µg/dl, and provide training and instruction as needed to correct any work practices identified in the plan (8 CCR 1532.1(j)(2)(E)). Exception: not required when a BLL at or above 10 µg/dl is detected only in the employee's initial blood lead testing. |
| Time limits | Blood lead level results: employer notifies each employee in writing within 5 working days after receipt of blood lead test results, regardless of level (8 CCR 1532.1(j)(2)(C)). Written medical report: the examining PLHCP explains the results and provides each employee a written medical report within 30 days of each medical examination (8 CCR 1532.1(j)(3)(E)). The 15-day figure in 1532.1 is the employee's window to initiate a second-physician opinion (8 CCR 1532.1(j)(3)(C)2), not a medical-surveillance notification deadline; air/exposure monitoring notification is exposure monitoring, not medical surveillance. |
| Second-opinion / multi-physician review | Multiple-physician review available to the employee. |
| Recordkeeping | 8 CCR 1532.1 sets no medical-record retention period of its own — 1532.1(n)(3)(D) provides that the employer shall maintain, or ensure that the PLHCP maintains, medical records in accordance with the provisions of section 3204. Under 8 CCR 3204(d)(1)(A) the medical record for each employee is preserved and maintained for at least the duration of employment plus thirty (30) years. Exposure-assessment records are maintained under the same cross-reference (1532.1(n)(1)(C)), i.e. at least thirty (30) years per 3204(d)(1)(B). Section 3204 also governs employee and designated-representative access to exposure and medical records, and 1532.1(n)(9)(D) applies 3204(h) to transfers of records. 1532.1 does fix shorter periods of its own for certain non-medical records: written compliance-program review records three years (n)(2), written elevated blood lead level response plans three years (n)(4), and training records three years (n)(6)(B); objective data relied on for an initial-monitoring exemption is kept at least 30 years (n)(7)(B). All records required by subsection (n) must be made available on request to affected employees, former employees, their designated representatives, the Chief, and NIOSH (1532.1(n)(8)). |
Medical Removal Protection
Removal at BLL ≥30 µg/dl (eff. Jan 1, 2026 also: last two tests ≥20, or 6-month average ≥20); return at two tests ≥30 days apart both <15 µg/dl; up to 18 months benefits.