General Industry
Evaluation performed by: Licensed physician
Initial physical examination before/at the start of BD-exposure duties, if 12 months or more have elapsed since the last physical examination meeting these requirements
- Health questionnaire / comprehensive occupational and health history (Appendix C forms), updated annually, with particular emphasis on the hematopoietic and reticuloendothelial systems
- Complete physical examination with special emphasis on the liver, spleen, lymph nodes, and skin
- Complete blood count (CBC) as defined in 1910.1051: white blood cell count (WBC), hematocrit (Hct), red blood cell count (RBC), hemoglobin (Hgb), differential count of white blood cells, red blood cell morphology, red blood cell indices, and platelet count
Interval-based while covered — NOT result-triggered
Schedule: Health questionnaire and CBC every year; a full physical examination every 3 years after the initial physical examination.
- Annual: health questionnaire (Appendix C) with hematopoietic/reticuloendothelial emphasis
- Annual: CBC as defined in 1910.1051: white blood cell count (WBC), hematocrit (Hct), red blood cell count (RBC), hemoglobin (Hgb), differential count of white blood cells, red blood cell morphology, red blood cell indices, and platelet count
- Every 3 years: complete physical examination with special emphasis on the liver, spleen, lymph nodes, and skin
At termination of employment, if 12 months or more have elapsed since the last physical examination
- Health questionnaire / comprehensive occupational and health history (Appendix C forms), updated annually, with particular emphasis on the hematopoietic and reticuloendothelial systems
- Complete physical examination with special emphasis on the liver, spleen, lymph nodes, and skin
- Complete blood count (CBC) with differential and platelet count
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Emergency exposure to BD 1910.1051(k)(4)(ii): Provide medical screening as quickly as possible, no later than 48 hours after exposure: a CBC within 48 hours of the exposure and then monthly for three months. Tests: CBC within 48 hours of the exposure, Monthly CBC for 3 months following the exposure
- Abnormal annual health questionnaire and/or CBC result on review 1910.1051(k)(3)(i)(D): Examining physician orders additional medical examinations or tests as warranted at the physician's discretion. Tests: Physician-directed additional examinations/tests
Reporting Requirements
| Who performs the evaluation | Licensed physician |
|---|---|
| Reported to employer | Written opinion limited to: occupationally pertinent results of the medical evaluation; whether the employee has any detected medical condition that would place health at increased risk of material impairment from BD; recommended limitations on BD exposure; and a statement that the employee was informed of the results. Must NOT reveal specific records, findings, or diagnoses with no bearing on ability to work with BD. |
| Reported to / for the employee | Employee informed of the results; furnished a copy of the written opinion. |
| Time limits | Written opinion provided within 15 business days of the evaluation (1910.1051(k)(7)(i)). |
| Second-opinion / multi-physician review | No multiple-physician-review scheme codified in the standard. |
| Recordkeeping | Medical records retained for the duration of employment plus 30 years (1910.1051(m)(4)(iii); 29 CFR 1910.1020). |
Medical Removal Protection
No MRP wage-protection scheme codified; the physician provides a written opinion with recommended exposure limitations.
Required Forms & Reference Definitions
Appendix C — Medical screening and surveillance for 1,3-butadiene 29 CFR 1910.1051 App. C; 8 CCR 5201 App. C
A non-mandatory guidance appendix describing the recommended medical screening for 1,3-butadiene: an annually updated health questionnaire, a complete blood count with differential and platelet count, and a physical exam, with emphasis on the hematopoietic and reticuloendothelial systems and guidance for interpreting abnormal results.