Once a decision has been made to develop a medical surveillance program, its components must be organized. A physician must be selected and employees must be informed of the program. The surveillance program must be provided at no cost to the employee, including proper equipment. Some hazardous substances have specific OSHA standards. One example would be cotton dust, often used as a standard for other harmful dust exposures (CFR Part 191R, part Z). Medical surveillance physicals must be conducted by a licensed physician. The health care provider must be given the employee's job description, what type of personal protective equipment is to be used, chemical exposures on the job including exposure levels for each substance, the MSDS, and ergonomic exposures to the job. The examination, depending on the substance involved, may also include x-rays, pulmonary testing, blood tests, and even cardiac testing.
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