General Industry
Who is covered: Each employee who is or will be exposed at or above the action level, without regard to respirator use
Evaluation performed by: Licensed physician
🩺 Baseline / Pre-Placement
At the time of initial assignment, or upon institution of the medical surveillance program
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
🕒 Periodic / Routine
Interval-based while covered — NOT result-triggered
Schedule: At least annually for all covered employees.
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
🚪 Exit / Termination
Prior to termination of employment, if the employee has not had an equivalent examination within the preceding 6 months
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee develops signs or symptoms that may be associated with exposure to AN 1910.1045(n)(4): Employer provides an appropriate medical examination and emergency medical treatment. Tests: Medical examination directed at presenting signs/symptoms (skin, respiratory, GI, CNS), Emergency medical treatment as indicated
Reporting Requirements
| Who performs the evaluation | Licensed physician |
|---|---|
| Reported to employer | Written opinion limited to: results of the medical examination and tests; whether the employee has any detected medical condition that would place health at increased risk of material impairment from AN; recommended limitations on AN exposure or on the use of protective clothing/equipment (e.g., respirators); and a statement that the employee was informed of the results and of any condition requiring further examination or treatment. Must NOT reveal specific findings or diagnoses unrelated to occupational AN exposure. |
| Reported to / for the employee | Employee informed by the physician of the results and any condition requiring further examination/treatment; furnished a copy of the written opinion. |
| Time limits | No explicit time limit for furnishing the written opinion is specified in 1910.1045(n). |
| Second-opinion / multi-physician review | No multiple-physician-review scheme codified in the standard. |
| Recordkeeping | Medical records retained for at least 40 years, or the duration of employment plus 20 years, whichever is longer (1910.1045(q)(3)(iii)). |
Medical Removal Protection
No mandatory removal thresholds; the physician's written opinion may recommend limitations on AN exposure or PPE use.
Construction
Who is covered: Construction work covered identically to 1910.1045 by incorporation by reference. All exam events, components, abnormal protocols, and reporting are governed by 1910.1045.
Evaluation performed by: Licensed physician
🩺 Baseline / Pre-Placement
At the time of initial assignment, or upon institution of the medical surveillance program (per 1910.1045, incorporated by reference)
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
🕒 Periodic / Routine
Interval-based while covered — NOT result-triggered
Schedule: At least annually for all covered employees.
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
🚪 Exit / Termination
Prior to termination of employment, if the employee has not had an equivalent examination within the preceding 6 months
- Work and medical history with special attention to the skin, respiratory, and gastrointestinal systems, and to nonspecific symptoms such as headache, nausea, vomiting, dizziness, weakness, or other central-nervous-system dysfunction
- Complete physical examination giving particular attention to the peripheral and central nervous system, gastrointestinal system, respiratory system, skin, and thyroid
- 14x17-inch (or other reasonably-sized standard film or digital) posterior-anterior chest X-ray
- Further tests of the intestinal tract, including fecal occult blood screening, for all workers age 40 or older (and for any other affected employees for whom the physician deems it appropriate)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee develops signs or symptoms that may be associated with exposure to AN 1910.1045(n)(4): Employer provides an appropriate medical examination and emergency medical treatment. Tests: Medical examination directed at presenting signs/symptoms (skin, respiratory, GI, CNS), Emergency medical treatment as indicated
Reporting Requirements
| Who performs the evaluation | Licensed physician |
|---|---|
| Reported to employer | Written opinion limited to: results of the medical examination and tests; whether the employee has any detected medical condition that would place health at increased risk of material impairment from AN; recommended limitations on AN exposure or on the use of protective clothing/equipment (e.g., respirators); and a statement that the employee was informed of the results and of any condition requiring further examination or treatment. Must NOT reveal specific findings or diagnoses unrelated to occupational AN exposure. |
| Reported to / for the employee | Employee informed by the physician of the results and any condition requiring further examination/treatment; furnished a copy of the written opinion. |
| Time limits | No explicit time limit for furnishing the written opinion is specified in 1910.1045(n). |
| Second-opinion / multi-physician review | No multiple-physician-review scheme codified in the standard. |
| Recordkeeping | Medical records retained for at least 40 years, or the duration of employment plus 20 years, whichever is longer (1910.1045(q)(3)(iii)). |
Medical Removal Protection
No mandatory removal thresholds; the physician's written opinion may recommend limitations on AN exposure or PPE use.