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851 Silica Dust Safety in Construction
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Medical Surveillance

The employer should make medical surveillance available at no cost to the employee, and at a reasonable time and place, for each employee who will be required to use a respirator for 30 or more days per year.

Medical Evaluations
  • Initial examination: Employees should get an initial (baseline) medical examination by a physician or Licensed Health Care Professional (PLHCP) within 30 days after initial assignment, unless they have received an examination that meets OSHA requirements within the last three years. The examination should consist of:
    • a medical and work history,
    • a physical examination with special emphasis on the respiratory system;
    • a chest X-ray, interpreted and classified by a NIOSH-certified B Reader;
    • a pulmonary function test, administered by a spirometry technician with a current certificate from a NIOSH-approved spirometry course;
    • testing for latent tuberculosis infection; and
    • any other tests deemed appropriate by the PLHCP.
  • Information Provided by the PLHCP: The employer should give the examining PLHCP a copy of related OSHA standards and the following information:
    • A description of the employee's former, current, and anticipated duties;
    • The employee's former, current, and anticipated levels of exposure to respirable crystalline silica;
    • A description of any personal protective equipment used or to be used by the employee, including when and for how long the employee has used or will use that equipment; and
    • Information from records of employment-related medical examinations.
  • PLHCP Report to Employee: The PLHCP should explain the results of the medical examination to the employee and give them a written medical report within 30 days of the examination.
  • PLHCP's Opinion for the Employer: The PLHCP should give the employer a written medical opinion within 30 days of the examination.
  • Employer Report to Employees: The employer should give each employee a copy of the written medical opinion within 30 days of each medical examination performed.
  • Additional examinations: If the PLHCP believes an employee should be examined by a specialist, the employer should schedule a medical examination within 30 days.

Knowledge Check Choose the best answer for the question.

6-5. How soon should employees get an initial (baseline) medical examination after initial assignment?