Federal OSHA · osha.gov
Heavy Metals

Hexavalent Chromium (Cr VI) Medical Surveillance

Cr VI causes lung cancer, nasal septum perforation/ulceration, dermatitis, and respiratory sensitization; affects workers in welding stainless steel, electroplating, chromate pigment/paint, and chrome-plating operations.

Action Level2.5 µg/m³ (8-hr TWA)
PEL5 µg/m³ (8-hr TWA)

General Industry

Who is covered: Employees occupationally exposed to Cr(VI) at/above the AL for 30 or more days per year; any employee who shows signs/symptoms of adverse Cr(VI) effects; any employee exposed in an emergency

Evaluation performed by: PLHCP (physician or other licensed health care professional)

🩺 Baseline / Pre-Placement

Within 30 days after initial assignment, unless the employee received a qualifying exam meeting these requirements within the prior 12 months

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP (no mandatory Cr biomarker)
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least annually.

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP
🚪 Exit / Termination

At termination of employment

  • Termination medical examination — required unless the last qualifying exam was within the preceding 6 months
⚠ Emergency / Post-Exposure

Within 30 days after an emergency exposure (uncontrolled release); also whenever the employee shows signs or symptoms of adverse Cr(VI) health effects

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP
Abnormal results & exposure-event protocols

Abnormal Results & Exposure-Event Protocols

  • Examining PLHCP recommends an additional medical examination Additional examination on PLHCP recommendation: Provide the recommended additional examination within 30 days of the written recommendation. Tests: Examination as specified by the PLHCP

Reporting Requirements

Who performs the evaluationPLHCP (physician or other licensed health care professional)
Reported to employerWritten opinion containing only: whether the employee has a detected medical condition that places the employee at increased risk from further Cr(VI) exposure; any recommended exposure limitations or PPE/respirator restrictions; and a statement that the PLHCP explained the results to the employee, including any condition requiring further evaluation. PLHCP must NOT reveal findings or diagnoses unrelated to occupational Cr(VI) exposure.
Reported to / for the employeeEmployer provides a copy of the written opinion to the employee within 2 weeks of receiving it; PLHCP explains results directly to the employee.
Time limitsEmployer obtains the written opinion within 30 days of each exam; furnishes a copy to the employee within 2 weeks of receipt.
Second-opinion / multi-physician reviewNo multiple-physician review mechanism specified in the Cr(VI) standard.
RecordkeepingRecords maintained per 29 CFR 1910.1020 (duration of employment plus 30 years), including PLHCP written opinions.

Construction

Who is covered: Identical to GI 1910.1026: at/above AL for 30+ days/year; signs/symptoms; emergency exposure

Evaluation performed by: PLHCP (physician or other licensed health care professional)

🩺 Baseline / Pre-Placement

Within 30 days after initial assignment, unless the employee received a qualifying exam meeting these requirements within the prior 12 months

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP (no mandatory Cr biomarker)
🕒 Periodic / Routine

Interval-based while covered — NOT result-triggered

Schedule: At least annually.

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP
🚪 Exit / Termination

At termination of employment

  • Termination medical examination — required unless the last qualifying exam was within the preceding 6 months
⚠ Emergency / Post-Exposure

Within 30 days after an emergency exposure (uncontrolled release); also whenever the employee shows signs or symptoms of adverse Cr(VI) health effects

  • Medical + work history covering past, present, and anticipated future exposure to Cr(VI); history of respiratory-system dysfunction; history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history
  • Physical examination of the skin and respiratory tract
  • Any additional tests deemed appropriate by the examining PLHCP
Abnormal results & exposure-event protocols

Abnormal Results & Exposure-Event Protocols

  • Examining PLHCP recommends an additional medical examination Additional examination on PLHCP recommendation: Provide the recommended additional examination within 30 days of the written recommendation. Tests: Examination as specified by the PLHCP

Reporting Requirements

Who performs the evaluationPLHCP (physician or other licensed health care professional)
Reported to employerWritten opinion containing only: whether the employee has a detected medical condition that places the employee at increased risk from further Cr(VI) exposure; any recommended exposure limitations or PPE/respirator restrictions; and a statement that the PLHCP explained the results to the employee, including any condition requiring further evaluation. PLHCP must NOT reveal findings or diagnoses unrelated to occupational Cr(VI) exposure.
Reported to / for the employeeEmployer provides a copy of the written opinion to the employee within 2 weeks of receiving it; PLHCP explains results directly to the employee.
Time limitsEmployer obtains the written opinion within 30 days of each exam; furnishes a copy to the employee within 2 weeks of receipt.
Second-opinion / multi-physician reviewNo multiple-physician review mechanism specified in the Cr(VI) standard.
RecordkeepingRecords maintained per 29 CFR 1910.1020 (duration of employment plus 30 years).
How this compares to Cal/OSHA: Aligned. All four standards (federal 1910.1026 / 1926.1126; California 5206 / 1532.2) share AL 2.5 µg/m³, PEL 5 µg/m³, the same exam schedule (initial within 30 days, annual periodic, 30-day additional/emergency, 6-month termination window), the same history + skin/respiratory physical exam, no mandatory biomarker, and NO automatic medical-removal-protection trigger levels. The only protection mechanism is the PLHCP additional-exam recommendation. CA adds explicit pesticide/portland-cement/low-release exceptions.

Occu-Med handles Hexavalent Chromium (Cr VI) surveillance end-to-end

Scheduling, exams, lab panels, physician review, removal/return determinations, and audit-ready recordkeeping — fully compliant with Federal OSHA requirements.