Section 325.51869. Initial medical examination.

(1) An employer shall provide an initial medical examination to all employees who  are  covered   by   the   medical   surveillance   program   required   pursuant   to R 325.51868(1) or (2). The examination shall be provided to covered employees within 30 days after initial assignment to a job with exposure to cadmium or not later than 90 days after September 16, 1993, whichever date is later.

(2)  The initial medical examination shall include both of the following elements:

(a)   ) A detailed medical and work history, with an emphasis on all of the following:

(i)   Past, present, and anticipated future exposure to cadmium.

(ii)    Any history of renal, cardiovascular, respiratory, hematopoietic, reproductive, or musculoskeletal system dysfunction.

(iii)   Current use of medication that has potential nephrotoxic side effects.

(iv)   Smoking history and current status.

(b)   Biological monitoring that includes all of the following tests:

(i)   Cadmium in urine (CdU), standardized to grams of creatinine (g Cr).

(ii)       Beta-2 microglobulin in urine (B2-M), standardized to grams of creatinine (g Cr) with Ph specified, as described in appendix F.

(iii)   Cadmium in blood (CdB), standardized to liters of whole blood (lwb).

(3)    An initial medical examination is not required to be provided if adequate records show that an employee has been examined in accordance with the  requirements  of subrule (2) of this rule within the past 12 months. If an employee has been examined in accordance with the requirements of subrule (2) of this rule within the past 12 months, the records shall be maintained as part of the employee’s medical record and the exam shall be  treated  as  if  it   were  an  initial  medical  examination  for  the  purposes  of R 325.51870 and R 325.51871.

History: 1993 AACS; 2013 AACS.