Section 325.51411. Medical surveillance.

(1) An employer shall institute a program of medical surveillance for each employee exposed, without regard to the use of respirators, to vinyl chloride in excess of the action level.

The employer shall provide each exposed employee with an opportunity for examinations and tests in accordance with this subrule. Both of the following shall be provided:

(a)     The  employer  shall  ensure  that  all  medical  examinations   and  procedures  be performed by or under the supervision of a licensed physician.

(b)    The medical examinations and procedures shall be provided without cost to the employee.

(2)   An employer shall ensure that at the time of initial assignment, or upon institution of medical surveillance, the following requirements are met:

(a)     A general physical examination shall be performed, with specific attention to detecting enlargement of liver, spleen or kidneys, or dysfunction in these organs, and for abnormalities in skin, connective tissues and the pulmonary system (See Appendix A of this rule).

(b)   A medical history shall be taken, to include all of the following information:

(i)   Alcohol intake.

(ii)   Past history of hepatitis.

(iii)   Work history and past exposure to potential hepatotoxic agents, including drugs and chemicals.

(iv)   Past history of blood transfusions.

(v)   Past history of hospitalizations.

(c)   ) A serum specimen shall be obtained and determinations made of all of the following:

(i)   Total bilirubin.

(ii)   Alkaline phosphatase.

(iii)   Serum glutamic oxalacetic transaminase   (SGOT).

(iv)   Serum glutamic pyruvic transaminase   (SGPT).

(v)   Gamma glutamyl transpeptidase.

(3)   An employer shall ensure that examinations provided in accordance with these rules are performed at least the following:

(a)    Every 6 months for each employee who has been employed in vinyl chloride or polyvinyl chloride manufacturing for 10 years or longer.

(b)   Annually for all other employees.

(4)   An employer shall ensure that each employee exposed to an emergency is afforded appropriate medical surveillance.

(5)     An employer shall obtain from the examining physician promptly after any examination a statement of each employee’s suitability for continued exposure to vinyl chloride including use of protective equipment and respirators. An employer shall provide a copy of the physician’s statement to each employee.

(6)   An employer shall withdraw an employee from possible contact with vinyl chloride if the employee’s health would be materially impaired by continued exposure.

(7)    An employer shall  ensure that laboratory analyses  for all  biological  specimens included in medical examinations be performed by accredited laboratories.

(8)   If the examining physician determines that alternative medical examination to those required by subrule (2) of this rule will provide at least equal assurance of detecting medical conditions pertinent to the exposure to vinyl chloride, then the employer may accept the alternative examinations as meeting the requirements of subrule (2) of this rule. The employer shall obtain a statement from the examining physician setting forth the alternative examinations and the rationale for substitution. This statement shall be available upon request for examination and copying by the director.

History: 2000 AACS; 2013 AACS.