General Industry
Who is covered: All employees exposed at or above the TWA and/or excursion limit [1910.1001(l)(1)(i)]
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 (covered-status triggered) — NOT result-triggered
Schedule: Examination made available at least annually. Chest X-ray frequency set by Table 1 (age × years since first exposure): age 45+ with 10+ years since first exposure = every 1 year; age 35–45 with 10+ years = every 2 years; all other tiers = every 5 years [1910.1001(l)(3)(ii), Table 1].
- 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 the age/exposure frequency table)
- Pulmonary function tests (FVC, FEV1)
Reporting Requirements
| Who performs the evaluation | Licensed physician (employer-selected) |
|---|---|
| Reported to employer | Written opinion limited to: whether the employee has any detected medical condition that places them at increased risk of material health impairment from asbestos; any recommended limitations on the employee's use of personal protective equipment/respirators; a statement that the employee has been informed of the results of the medical examination; and a statement that the employee has been informed of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure. The opinion must NOT reveal specific findings or diagnoses unrelated to asbestos exposure. |
| Reported to / for the employee | Employee informed by the physician of the examination results and of the increased lung-cancer risk from combined smoking and asbestos exposure; employer furnishes a copy of the written opinion to the employee. Smoking-cessation program information (names, addresses, phone numbers of public health organizations) is provided as part of training. |
| Time limits | Employer must provide a copy of the physician's written opinion to the affected employee within 30 days of receipt [1910.1001(l)(7)(iii)]. |
| Second-opinion / multi-physician review | Standard does not establish a formal multiple-physician review mechanism; the employer selects the examining physician. |
| Recordkeeping | Medical surveillance records retained for the duration of employment plus 30 years [1910.1001(m)(3)(iii)]. |
Medical Removal Protection
No medical removal protection scheme. The physician's written opinion conveys increased-risk findings and PPE/respirator limitations.
Construction
Who is covered: Employees exposed at/above the PEL and/or excursion limit, OR who for a combined total of 30+ days/year engage in Class I, II, or III asbestos work, OR who wear a negative-pressure respirator [1926.1101(m)(1)(i)]
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 (covered-status triggered) — NOT result-triggered
Schedule: Examination made available at least annually. Chest X-ray frequency set by an age × years-since-first-exposure table consistent with the general-industry Table 1 (annual at age 45+/10+ years).
- 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 the age/exposure frequency table)
- Pulmonary function tests (FVC, FEV1)
Reporting Requirements
| Who performs the evaluation | Licensed physician (employer-selected) |
|---|---|
| Reported to employer | Written opinion limited to: whether the employee has any detected medical condition that places them at increased risk of material health impairment from asbestos; any recommended limitations on the employee's use of personal protective equipment/respirators; a statement that the employee has been informed of the results of the medical examination; and a statement that the employee has been informed of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure. The opinion must NOT reveal specific findings or diagnoses unrelated to asbestos exposure. |
| Reported to / for the employee | Employee informed by the physician of the examination results and of the increased lung-cancer risk from combined smoking and asbestos exposure; employer furnishes a copy of the written opinion to the employee. Smoking-cessation program information (names, addresses, phone numbers of public health organizations) is provided as part of training. |
| Time limits | Employer must provide a copy of the physician's written opinion to the affected employee within 30 days of receipt [1910.1001(l)(7)(iii)]. |
| Second-opinion / multi-physician review | Standard does not establish a formal multiple-physician review mechanism; the employer selects the examining physician. |
| Recordkeeping | Medical surveillance records retained for the duration of employment plus 30 years [1910.1001(m)(3)(iii)]. |
Medical Removal Protection
No medical removal protection scheme. The physician's written opinion conveys increased-risk findings and PPE/respirator limitations.
Shipyard / Maritime
Who is covered: Employees exposed at/above the PEL and/or excursion limit, OR who wear a negative-pressure respirator for a combined total of 30+ days/year [1915.1001(m)(1)]
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 (covered-status triggered) — NOT result-triggered
Schedule: Examination made available at least annually. Chest X-ray frequency set by an age × years-since-first-exposure table consistent with the general-industry Table 1 (annual at age 45+/10+ years).
- 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 the age/exposure frequency table)
- Pulmonary function tests (FVC, FEV1)
Reporting Requirements
| Who performs the evaluation | Licensed physician (employer-selected) |
|---|---|
| Reported to employer | Written opinion limited to: whether the employee has any detected medical condition that places them at increased risk of material health impairment from asbestos; any recommended limitations on the employee's use of personal protective equipment/respirators; a statement that the employee has been informed of the results of the medical examination; and a statement that the employee has been informed of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure. The opinion must NOT reveal specific findings or diagnoses unrelated to asbestos exposure. |
| Reported to / for the employee | Employee informed by the physician of the examination results and of the increased lung-cancer risk from combined smoking and asbestos exposure; employer furnishes a copy of the written opinion to the employee. Smoking-cessation program information (names, addresses, phone numbers of public health organizations) is provided as part of training. |
| Time limits | Employer must provide a copy of the physician's written opinion to the affected employee within 30 days of receipt [1910.1001(l)(7)(iii)]. |
| Second-opinion / multi-physician review | Standard does not establish a formal multiple-physician review mechanism; the employer selects the examining physician. |
| Recordkeeping | Medical surveillance records retained for the duration of employment plus 30 years [1910.1001(m)(3)(iii)]. |
Medical Removal Protection
No medical removal protection scheme. The physician's written opinion conveys increased-risk findings and PPE/respirator limitations.