What are the fundamental elements of the medical
The fundamental elements of the medical surveillance
requirements include biological monitoring, medical
examination, and medical removal.
Employees exposed at or above the action level at least one
day per year must be given a blood lead test and a ZPP test.
Employees exposed at or above the action level for more than
30 days per year must receive additional blood lead and ZPP
tests at least every 2 months for the first 6 months of the
job and every 6 months afterwards.
For employees with blood lead levels at or above 50 ug/dl,
a follow-up test must be given within 2 weeks after the
employer receives the results of the first blood sampling
test. For employees on medical removal from exposure due
to an elevated blood lead level, monthly tests must be given.
Medical exams must be made available according to the following schedule to all employees exposed at or
above the action level for more than 30 days in any consecutive 12 months.
- At least annually for employees who have had a blood lead
level at or above 40 ug/dl at any time during the preceding
- As soon as possible for employees with signs or symptoms of lead intoxication,
pregnant employees, and employees who demonstrate difficulty in breathing during a respirator fit test or during respirator use; and
- As medically appropriate for employees removed from lead exposure.
Employers must remove employees who are exposed at or above the
action level on each occasion that a periodic and follow-up
blood sampling test indicates the employee's
blood levels are at or above 50 ug/dl and/or a physician makes a
determination indicating a detected medical condition increasing
health risks from lead exposure.
When workers who have been exposed to lead and were
covered by the medical surveillance program are no longer
exposed, can medical surveillance be discontinued?
Workers who are no longer exposed at or above the action level are not
subject to medical surveillance requirements. The Lead in Construction
Standard does not have a termination medical
Once medical surveillance is discontinued, what further
obligations does the employer have?
The employer has to maintain the medical records as
specified in 1910.1020.