General Industry
Evaluation performed by: Licensed physician (employer-selected)
Pre-placement, before assignment to an asbestos-exposed occupation
- Medical and work history
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
- Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
- Chest X-ray (posterior-anterior; 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1910.1001 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
- Any additional tests deemed appropriate by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
Interval-based while covered (covered-status triggered) — NOT result-triggered
Schedule: Made available annually [1910.1001(l)(3)(i)]; chest X-ray at the frequency set by Table 1 (age × years since first exposure) — table shown in this section.
- Medical and work history
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
- Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
- Chest X-ray (posterior-anterior; 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1910.1001 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume in one second (FEV1)
- Any additional tests deemed appropriate by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
Table 1 — Frequency of chest X-ray (Federal OSHA) 29 CFR 1910.1001, Table 1
| Age | 0 to 10 years since first exposure | 10 or more years since first exposure |
|---|---|---|
| 15 to 35 | Every 5 years | Every 5 years |
| 35+ to 45 | Every 5 years | Every 2 years |
| 45+ | Every 5 years | Every 1 year |
Applies to the general industry standard (1910.1001) only — the construction (1926.1101) and shipyard (1915.1001) standards contain no X-ray frequency table; there, the chest X-ray is administered at the discretion of the physician. The periodic examination itself is made available annually.
At termination of employment, for employees exposed at or above the TWA and/or excursion limit [1910.1001(l)(4)(i)]
- Termination medical examination within 30 calendar days before or after termination
- Medical and work history
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
- Complete physical examination of all systems — emphasis on the respiratory system, cardiovascular system, and digestive tract
- Chest X-ray (posterior-anterior; 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1910.1001)
- Pulmonary function tests (FVC, FEV1)
- Any additional tests deemed appropriate by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Table 1 — Frequency of chest X-ray (Federal OSHA) 29 CFR 1910.1001, Table 1
| Age | 0 to 10 years since first exposure | 10 or more years since first exposure |
|---|---|---|
| 15 to 35 | Every 5 years | Every 5 years |
| 35+ to 45 | Every 5 years | Every 2 years |
| 45+ | Every 5 years | Every 1 year |
Applies to the general industry standard (1910.1001) only — the construction (1926.1101) and shipyard (1915.1001) standards contain no X-ray frequency table; there, the chest X-ray is administered at the discretion of the physician. The periodic examination itself is made available annually.
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
Evaluation performed by: Licensed physician (employer-selected)
Prior to assignment to an area where negative-pressure respirators are worn [1926.1101(m)(2)(i)(A)]; otherwise within 10 working days following the 30th day of exposure [1926.1101(m)(2)(i)(B)]
- Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
- Physical examination directed to the pulmonary and gastrointestinal systems
- Chest X-ray (at the discretion of the physician; posterior-anterior, 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1926.1101 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
- Any other examinations or tests deemed necessary by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
Interval-based while covered (covered-status triggered) — NOT result-triggered
Schedule: At least annually [1926.1101(m)(2)(i)(C)]; chest X-ray administered at the discretion of the physician — 1926.1101 contains no X-ray frequency table.
- Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
- Physical examination directed to the pulmonary and gastrointestinal systems
- Chest X-ray (at the discretion of the physician; posterior-anterior, 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1926.1101 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
- Any other examinations or tests deemed necessary by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
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 from its receipt [1926.1101(m)(4)(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, in accordance with 29 CFR 1910.1020 [1926.1101(n)(3)(iii)]. The record must include a copy of the employee's medical examination results, including the medical history, questionnaire responses, test results, and physician's recommendations [1926.1101(n)(3)(ii)(B)]. |
Medical Removal Protection
No medical removal protection scheme. The physician's written opinion conveys increased-risk findings and PPE/respirator limitations.
Shipyard / Maritime
Evaluation performed by: Licensed physician (employer-selected)
Prior to assignment to an area where negative-pressure respirators are worn [1915.1001(m)(2)(i)(A)]; otherwise within 10 working days following the 30th day of exposure [1915.1001(m)(2)(i)(B)]
- Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 1) (regulatory term: respiratory disease standardized questionnaire)
- Physical examination directed to the pulmonary and gastrointestinal systems
- Chest X-ray (at the discretion of the physician; posterior-anterior, 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1915.1001 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
- Any other examinations or tests deemed necessary by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
Interval-based while covered (covered-status triggered) — NOT result-triggered
Schedule: At least annually [1915.1001(m)(2)(i)(C)]; chest X-ray administered at the discretion of the physician — 1915.1001 contains no X-ray frequency table.
- Medical and work history — special emphasis on the pulmonary, cardiovascular, and gastrointestinal systems
- A standardized questionnaire about breathing symptoms, smoking history, and past job exposures (Part 2) (regulatory term: respiratory disease standardized questionnaire)
- Physical examination directed to the pulmonary and gastrointestinal systems
- Chest X-ray (at the discretion of the physician; posterior-anterior, 14×17-inch or other reasonably-sized standard film or digital) (regulatory term: chest roentgenogram, 29 CFR 1915.1001 Appendix E)
- Pulmonary function tests — forced vital capacity (FVC) and forced expiratory volume at one second (FEV1)
- Any other examinations or tests deemed necessary by the examining physician
Appendix D — Standardized respiratory symptoms questionnaire 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. D; 8 CCR 5208 / 1529 / 8358 App. D
A standardized respiratory-symptom questionnaire (initial and periodic versions) covering shortness of breath, cough, phlegm, wheeze, chest illness, smoking history, and occupational exposure history. The physician administers it to detect early respiratory impairment.
Appendix E — How the chest X-ray is read (B-reader / ILO) 29 CFR 1910.1001 / 1926.1101 / 1915.1001 App. E; 8 CCR 5208 / 1529 / 8358 App. E
The chest film is read by a physician certified by NIOSH as a "B-reader" and graded on the ILO International Classification 0-3 scale for small opacities and pleural changes. This standardized reading is what distinguishes the required film from an ordinary chest X-ray. Standard film or digital images are acceptable.
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 from its receipt [1915.1001(m)(4)(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, in accordance with 29 CFR 1910.1020 [1915.1001(n)(3)(iii)]. The record must include a copy of the employee's medical examination results, including the medical history, questionnaire responses, test results, and physician's recommendations [1915.1001(n)(3)(ii)(B)]. |
Medical Removal Protection
No medical removal protection scheme. The physician's written opinion conveys increased-risk findings and PPE/respirator limitations.