Section 325.51873. Medical exams for fitness to use respirators, for exposure due to emergency, and at termination.

(1) To determine an employee’s fitness for respirator use, an employer shall provide a medical examination that includes the elements specified in this subrule. The examination shall be provided before an employee is assigned to a job that requires the use of a respirator or not more than 90 days after September 16, 1993, whichever date is later, to any employee who has not had a medical examination within the preceding 12 months that satisfies the requirements of this subrule. The medical exam shall include all of the following:

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

(i)   Past exposure to cadmium.

(ii)   Smoking history and current status.

(iii)      Any history of renal, cardiovascular, respiratory, hematopoietic, or musculo- skeletal system dysfunction.

(iv)   A description of the job for which the respirator is required.

(v)   Answers to questions 3-11 and 25-32 in appendix D to these rules.

(b)   A blood pressure test.

(c)     Biological monitoring of the employee’s levels of CdU, CdB, and ß2-M in accordance with the requirements of R 325.51869(2)(b), unless the results have been obtained within the previous 12 months.

(d)  Any other test or procedure that the examining physician deems appropriate.

(2)  All of the following provisions pertain to the medical examination for respirator use:

(a)     After reviewing all of the information obtained from the medical examination required in subrule (1) of this rule, the physician shall determine whether the employee is fit to wear a respirator.

(b)    If an employee has exhibited difficulty in breathing during a respirator fit test or during use of a respirator, an employer shall provide the employee, as soon as possible, with a periodic medical examination in accordance with R 325.51871(2) to determine the employee’s fitness to wear a respirator.

(c)   If the results of the examination required by subrule (1) of this rule or subdivision (a) or (b) of this subrule are abnormal, the medical limitation or prohibition of respirator use shall be considered. If the employee is allowed to wear a respirator, the employee’s ability to continue to do so shall be periodically evaluated by a physician.

(3)   In addition to the medical surveillance required by R 325.51869 to R 325.51873(2), an employer shall provide a medical examination, as soon as possible, to any employee who may have been acutely exposed to cadmium because of an emergency. The examination shall include the information required pursuant to R 325.51871(2), with an emphasis on the respiratory system, other organ systems considered appropriate by the examining physician, and symptoms of acute overexposure, as reviewed in appendix A to these rules.

(4)   At termination of employment, an employer shall provide a medical examination in accordance with R 325.51871(2), including a chest X ray where necessary, to any employee to whom, at any prior time, an employer was required to provide medical surveillance pursuant to R 325.51868(1) or subrule (3) of this rule. However, if the last

examination satisfied the requirements of R 325.51871(2) and was less than 6 months before the date of termination, then another examination is not required unless otherwise specified by R 325.51870 or R 325.51872(1) or (2). If the employer has discontinued all periodic medical surveillance as provided by the provisions of R 325.51871(4), the termination of employment medical examination is not required.

History: 1993 AACS; 2013 AACS.