Medical surveillance screenings

  1. Medical surveillance programs monitor and evaluate employees over time to detect early signs of medical conditions that can arise due to exposure to work-related hazards.
  2. OSHA medical screenings are used to detect conditions before an individual would normally seek medical care (i.e. before symptoms appear).
  3. The conclusions provide an employer with information about how well their medical surveillance program measures up to OSHA regulations.
  4. In medical surveillance programs, employees undergo a review of their work and medical history as well as initial OSHA medical screenings to define their baseline measures.
  5. Future tests would then either remain the same or reveal a shift from the baseline which may require medical intervention and a review of current prevention programs.

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Screening and Surveillance Overview

Medical surveillance programs involve the monitoring and evaluation of employees over time in order to detect early signs of any conditions that may be related to tasks being performed and exposure to hazardous agents through work-related activities. The information gleaned from analysis, usually undertaken by a trained physician, provides an employer with information related to the effectiveness of the organization’s hazard prevention programs. It can also identify new problems related to OSHA requirements that need to be addressed. Medical surveillance programs are not required for all jobs, but they are mandatory for those where exposure to hazardous materials or chemicals occurs on a regular or daily basis.

OSHA Regulations

Health screening is typically used to detect disease or conditions before an individual would normally develop signs and symptoms and seek medical care. For example, biological screenings would involve the collection of bodily samples such as blood, urine, expired air or sputum to look for evidence of exposure to chemicals or their breakdown products before any health concerns develop. OSHA medical surveillance involves the collection, analysis and evaluation of data in relation to aspects of occupational disease and is usually undertaken for workers who have likely been exposed to hazards that can result in particular conditions.

One example would be the detection of hearing threshold shifts, through audiometric testing, in workers exposed to high levels of noise. The implementation of a medical surveillance program begins when an employer ascertains that there are significant exposures to chemical, biological, physical or biomechanical hazards in the workplace. Those employees considered at risk would then normally undergo a review of their work and medical history and initial screenings to discover a baseline measure of the worker’s health. Future tests would then either remain the same or reveal a shift from the baseline pattern that may require medical intervention and a review of current prevention programs.

Specific medical surveillance guidelines and standards can be found on the OSHA website. For example, there are OSHA regulations for asbestos (non mandatory; 1910.1001 App H), inorganic arsenic (1910.1018 App C), benzene (1910.1028 App C) and acrylonitrile (1910.1045 App C), among others. Your occupational health solutions provider will be able to advise on the specific health screening and medical surveillance programs that would be appropriate for the workers within your business.

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Essential links

OSHA Safety and Health Topic: Medical Screening and Surveillance
OSHA topic medical screening and surveillance

National Institute for Occupational Safety and Health
NIOSH Topic Area – Surveillance

Business Owner Briefing
OSHA paper: Screening and surveillance: a guide to OSHA standards

Medical Director Review
Medical Surveillance in Work-Site Safety and Health Programs – May 1, 2000 – American Academy of Family Physicians

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