General Industry
Who is covered: Covered employees (1910.120(f)(2)): (i) exposed at/above the PEL or published exposure level (without regard to respirator use) for 30+ days/year; (ii) wear a respirator 30+ days/year or as required by 1910.134; (iii) injured, ill, or developing signs/symptoms of overexposure from an emergency or hazardous-waste operation; (iv) members of HAZMAT teams.
Evaluation performed by: Licensed physician (exam by or under the supervision of a licensed physician)
🩺 Baseline / Pre-Placement
Prior to assignment to covered work — (f)(3)(i)(A)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1910.120(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1910.120(f)(4)(ii)
🕒 Periodic / Routine
Interval-based while covered — NOT result-triggered
Schedule: At least once every 12 months for each covered employee, UNLESS the attending physician believes a longer interval (not greater than biennial / every 2 years) is appropriate — (f)(3)(i)(B)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1910.120(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1910.120(f)(4)(ii)
🚪 Exit / Termination
At termination of employment or reassignment to an area without medical-surveillance coverage, if the employee has not had an exam within the last 6 months — (f)(3)(i)(C)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1910.120(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1910.120(f)(4)(ii)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee notifies the employer of signs/symptoms indicating possible overexposure to hazardous substances/health hazards, OR an emergency/incident involving exposure above PEL/published level without respiratory protection 1910.120(f)(3)(i)(D), (f)(3)(ii): Provide a medical examination AS SOON AS POSSIBLE; content determined by the attending physician based on the exposure. Tests: Medical and work history with emphasis on symptoms related to the exposure and fitness for duty, Physical examination and any tests the attending physician determines are indicated by the exposure (no fixed panel)
Reporting Requirements
| Who performs the evaluation | Licensed physician (examinations performed by or under the supervision of a licensed physician, at no cost, without loss of pay, at a reasonable time and place) — 1910.120(f)(5). |
|---|---|
| Reported to employer | Employer obtains the physician's WRITTEN OPINION covering: any detected medical condition that would increase the employee's risk of material health impairment from work; recommended exposure/work limitations and on respirator/PPE use; results of the exam (if the employee requests); and a statement that the employee was informed of the results and of any condition requiring further evaluation/treatment. Findings unrelated to occupational exposure are NOT included — 1910.120(f)(7). |
| Reported to / for the employee | Employee informed of exam results and of any medical condition requiring further evaluation or treatment; a copy of the written opinion is provided — 1910.120(f)(7). |
| Time limits | No fixed numeric turnaround stated; written opinion obtained before the employer assigns/continues the employee in the covered work. |
| Recordkeeping | Medical surveillance records retained for the duration of employment plus 30 years per 29 CFR 1910.1020 — 1910.120(f)(8) cross-references the records rule. |
Medical Removal Protection
No MRP. Physician-discretion exam content; physician written opinion on fitness for duty and PPE use. Emergency/post-symptom exams are handled as soon as possible (see abnormal_protocols).
Construction
Who is covered: Covered employees (1926.65(f)(f)(2)): (i) exposed at/above the PEL or published exposure level (without regard to respirator use) for 30+ days/year; (ii) wear a respirator 30+ days/year or as required by the respiratory protection standard; (iii) injured, ill, or developing signs/symptoms of overexposure from an emergency or hazardous-waste operation; (iv) members of HAZMAT teams.
Evaluation performed by: Licensed physician (exam by or under the supervision of a licensed physician)
🩺 Baseline / Pre-Placement
Prior to assignment to covered work — (f)(3)(i)(A)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1926.65(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1926.65(f)(4)(ii)
🕒 Periodic / Routine
Interval-based while covered — NOT result-triggered
Schedule: At least once every 12 months for each covered employee, UNLESS the attending physician believes a longer interval (not greater than biennial / every 2 years) is appropriate — (f)(3)(i)(B)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1926.65(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1926.65(f)(4)(ii)
🚪 Exit / Termination
At termination of employment or reassignment to an area without medical-surveillance coverage, if the employee has not had an exam within the last 6 months — (f)(3)(i)(C)
- Medical and work history with special emphasis on symptoms related to handling hazardous substances and health hazards, and on fitness for duty including the ability to wear required PPE under expected work conditions — 1926.65(f)(4)
- Physical examination and the specific tests/studies the ATTENDING PHYSICIAN determines are appropriate for the exposures (no fixed mandatory test panel) — 1926.65(f)(4)(ii)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee notifies the employer of signs/symptoms indicating possible overexposure to hazardous substances/health hazards, OR an emergency/incident involving exposure above PEL/published level without respiratory protection 1926.65(f)(3)(i)(D), (f)(3)(ii): Provide a medical examination AS SOON AS POSSIBLE; content determined by the attending physician based on the exposure. Tests: Medical and work history with emphasis on symptoms related to the exposure and fitness for duty, Physical examination and any tests the attending physician determines are indicated by the exposure (no fixed panel)
Reporting Requirements
| Who performs the evaluation | Licensed physician (examinations performed by or under the supervision of a licensed physician, at no cost, without loss of pay, at a reasonable time and place) — 1910.120(f)(5). |
|---|---|
| Reported to employer | Employer obtains the physician's WRITTEN OPINION covering: any detected medical condition that would increase the employee's risk of material health impairment from work; recommended exposure/work limitations and on respirator/PPE use; results of the exam (if the employee requests); and a statement that the employee was informed of the results and of any condition requiring further evaluation/treatment. Findings unrelated to occupational exposure are NOT included — 1910.120(f)(7). |
| Reported to / for the employee | Employee informed of exam results and of any medical condition requiring further evaluation or treatment; a copy of the written opinion is provided — 1910.120(f)(7). |
| Time limits | No fixed numeric turnaround stated; written opinion obtained before the employer assigns/continues the employee in the covered work. |
| Recordkeeping | Medical surveillance records retained for the duration of employment plus 30 years per 29 CFR 1910.1020 — 1910.120(f)(8) cross-references the records rule. |
Medical Removal Protection
No MRP. Physician-discretion exam content; physician written opinion on fitness for duty and PPE use. Emergency/post-symptom exams are handled as soon as possible (see abnormal_protocols).