Section 325.51870. Initial biological monitoring; medical removal; applicability of subrules (4) and (5).

(1) If the results of  the   initial  biological   monitoring  tests specified in R 325.51869(2)(b) show the employee's CdU  level  to  be   at  or below 3 g/g Cr, the 2-M

level to be at or below 300 g/g Cr, and the CdB level to be at or below 5 g/lwb, then the employer shall comply with the  following provisions, as applicable:

(a)     For currently exposed employees who are subject to medical surveillance pursuant to the provisions of R 325.51868(1)(a) or (2)(a) and (b), an employer shall provide the minimum level of periodic medical surveillance in accordance with the requirements in R 325.51871.

(b)        For previously exposed employees who  are  subject  to  medical surveillance pursuant to the provisions of R 325.51868(1)(b) or (2)(c), an employer shall provide biological monitoring for CdU, 2-M, and CdB 1 year after the initial biological monitoring and then the employer shall comply

with the requirements of R 325.51871(4).

(2)    For all employees who are subject to medical surveillance pursuant to the provisions of R 325.51868(1) or (2), if the results of the  initial biological monitoring tests show the level of CdU to be more than 3 g/g Cr, the level of 2-M to be more than 300 g/g Cr, or the level of CdB to be more than 5 g/lwb, then an employer shall comply with  all  of  the  following provisions:

(a)     Within 2 weeks after receipt of biological monitoring results, reassess the employee's occupational exposure to cadmium as follows:

(i) Reassess the employee's work practices and personal hygiene.

(ii)   Reevaluate the employee's respirator use, if any, and  the respirator program.

(iii)      Review the hygiene facilities required pursuant to the provisions of R 325.51866.

(iv)     Reevaluate the maintenance and effectiveness of the relevant engineering controls.

(v)   Assess the employee's smoking history and status.

(b)   Within 30 days after the exposure reassessment specified in subdivision

(a) of this subrule, take reasonable steps to correct any deficiencies found in the reassessment that may be responsible for the employee's  excess exposure to cadmium.

(c)Within 90 days after receipt of biological monitoring results, provide a full medical examination to the employee in accordance with the requirements of R 325.51871(2). After completing the medical examination, the examining physician shall determine, in a written medical opinion, whether to medically remove the employee. If the physician determines that medical removal is not necessary, then until the employee's CdU level falls to or below 3 g/g Cr, the 2-M level falls to or below 300 g/gCr, and the CdB level falls to or below 5 g/lwb, an employer shall do both of the following:

(i) Provide biological monitoring in accordance with the provisions of R 325.51869(2)(b) on a semiannual basis.

(ii)    Provide annual medical examinations in accordance with the provisions of R 325.51871(2).

(3)    For all employees who are subject to medical surveillance pursuant to the provisions of R 325.51868(1) or (2), if the results of the  initial biological monitoring tests show the level of CdU to be more than 15 g/g Cr, or the level of CdB to be more than 15 g/lwb, or the level of 2-M to be more than 1,500 g/g Cr, then an employer shall comply  with   the  requirements   of subrule (2)(a) and (b)  of  this   rule.  Within  90   days

after receipt of biological monitoring results, the employer shall provide a  full medical examination to the employee in accordance with the requirements of R 325.51871(2). After completing the medical examination,  the  examining physician shall determine, in a written medical opinion, whether to medically remove the employee. However, if the initial biological monitoring results and the biological monitoring results obtained during the medical examination both show the level of CdU to be more than 15 g/g Cr, the level of CdB to be more than 15 g/lwb, or the level of 2-M to be more than 1500g/gCr and, in addition, the level of CdU is more than 3 g/g Cr or CdB is more than 5g/lwb, then the physician shall medically remove  the  employee  from  exposure to cadmium at or above the action level. If the second set of biological monitoring results obtained during the medical examination does not show that a mandatory removal trigger level has been exceeded, then the employee is not required to be removed by the mandatory provisions of this subrule. If the employee is not required to be removed by the mandatory provision of this subrule or by the physician's determination, then until the employee's CdU level falls to or below 3 g/g Cr, the 2-M level falls to or below 300 g/g Cr,

and   the  CdB level  falls  to  or  below  5 g/lwb,  an  employer  shall  do   all  of     the following:

(a)  ) Periodically reassess the employee's occupational exposure to cadmium.

(b)     Provide biological monitoring in accordance with the provisions of R 325.51869(2)(b) on a quarterly basis.

(c))Provide    semiannual    medical    examinations    in      accordance      with      the provisions of R325.51871(2).

(4)     This subrule applies only to general industry and agricultural operations. Beginning on January 1, 1999, for all employees to whom medical surveillance is provided, an employer shall comply with all of the following provisions rather than subrules (1) to (3) of this rule:

(a)   If the results of the initial biological monitoring tests show the employee's CdU level to be at or below 3 g/g Cr, the 2-M level to be at or below 300 g/g Cr, and the CdB level to be at or below 5 g/lwb, then, for currently exposed employees, an employer shall comply with the requirements of subrule (1)(a) of this rule, and, for previously exposed employees, the employer shall comply with the requirements of subrule(1)(b) of this rule.

(b)   If the results of the initial biological monitoring   tests  show  the level of CdU to be more than 3 g/g Cr, the level of 2-M to be more than 300g/g Cr, or the level of CdB to be more than 5 g/lwb, then an employer shall comply with the requirements of subrule (2) of this rule.

(c)If the results of the initial biological monitoring tests show the level of CdU to be more than 7 g/g Cr, or the level of CdB to  be  more  than  10 g/lwb, or the level of 2-M to be more than 750g/gCr, then an  employer  shall do all of the following, if applicable:

(i)   Comply with the requirements of subrule (2)(a) and (b) of this  rule and, within 90 days after receipt of biological monitoring results, provide a full medical examination for the employee in accordance with the requirements of R 325.51871(2).

(ii)    After completing the medical examination, the examining physician shall determine, in a written medical opinion, whether to  medically remove the employee.

(iii)    If the initial biological monitoring results  and  the   biological monitoring results obtained during the medical examination both show that the level of CdU is more than 7 g/g Cr, the level of CdB is more than 10 g/lwb, or the level of 2-M is more than 750g/g Cr and, in addition, the level of CdU

is more than 3 g/g Cr or the level of CdB is more than 5 g/lwb, then the physician shall medically remove the employee from exposure to cadmium at or above the action level.

(iv)    If the second set of biological monitoring results obtained during the medical examination does not show that a mandatory removal trigger level has been exceeded, then the employee is not required to be removed by the mandatory provisions of this subrule.

(v)   If the employee is not   required  to  be  removed  by  the  mandatory provisions of this subrule or by the physician's determination, then until the employee's CdU level falls to or below 3 g/g Cr, the 2-M level falls to or below 300g/g Cr, and the CdB level falls to or below 5 g/lwb, an employer shall do all of the following:

(A)  ) Periodically reassess the employees's occupational exposure to cadmium.

(B)     Provide biological monitoring in accordance with the provisions of R 325.51869(2) every 3 months.

(C)Provide semiannual medical  examinations  in   accordance  with   the provisions of R325.51871(2).

(5)   This subrule applies only to the construction industry. Beginning on January 1, 1999, for all employees to whom medical surveillance is provided, an employer shall comply with all of the following provisions rather than the provisions of subrules (1) to

(3)   of this rule:

(a)   If the results of initial biological monitoring tests  show  the employee's CdU level to be more than 7 g/g Cr, or the 2-M level to be more than 750g/g Cr, or the CdB level to be more than 10 g/lwb, an employer shall comply with the requirements of subrule (2) of this rule.

(b)   Within 90 days after receipt of biological monitoring results, an employer shall provide a full medical examination to the employee in accordance with the requirements of R 325.51871(2).

(c))After   completing   the   medical   examination,    the   examining    physician     shall determine, in a written medical opinion, whether to medically remove  the employee.

(d)   If the initial biological monitoring results and the biological monitoring results obtained during the medical examination both show that the level of CdU is more than 7 g/g Cr, the level of CdB is more than 10 g/lwb, or the level of 2-M is more than 750g/g Cr and, in addition, the level of CdU

is more than 3 g/g Cr or the level of CdB is more than 5g/lwb, then the physician shall medically remove the employee from exposure to cadmium at or above the action level.

(e)   If the second set of biological monitoring results obtained during the medical examination does not show that a mandatory removal trigger level has been exceeded, then the employee is not required to be removed by the mandatory provisions of this subrule.

(f)  If the employee is not   required  to  be  removed  by  the  mandatory provisions of this subrule or by the physician's   determination,  then   until the employee's CdU level

falls to or below 3 g/g Cr, the 2-M level falls to or below 300 g/g Cr, and the CdB level falls to or below 5 g/lwb, an employer shall do all of the following:

(i)   Periodically reassess the employee's occupational exposure to cadmium.

(ii)      Provide  biological   monitoring  in  accordance  with  the   provisions     of     R 325.51869(2) every 3 months.

(iii)     Provide    semiannual     medical      examinations       in    accordance    with    the provisions of R325.51871(2).

History: 1993 AACS; 1998 AACS.