STANDARDS PRESENTATION Page 12 of 19 TO
CALIFORNIA OCCUPATIONAL SAFETY AND HEALTH STANDARDS BOARD
TITLE 8 , DIVISION 1 , CHAPTER 4
( A ) The employer shall make medical surveillance available at no cost to the employee , and at a reasonable time and place , for each employee who will be occupationally exposed to respirable crystalline silica at or above the action level for 30 or more days per year .
( B ) The employer shall ensure that all medical examinations and procedures required by this section are performed by a PLHCP as defined in subsection ( b ).
( 2 ) Initial examination . The employer shall make available an initial ( baseline ) medical examination within 30 days after initial assignment , unless the employee has received a medical examination that meets the requirements of this section within the last three years . The examination shall consist of :
( A ) A medical and work history , with emphasis on : Past , present , and anticipated exposure to respirable crystalline silica , dust , and other agents affecting the respiratory system ; any history of respiratory system dysfunction , including signs and symptoms of respiratory disease ( e . g ., shortness of breath , cough , wheezing ); history of tuberculosis ; and smoking status and history ;
( B ) A physical examination with special emphasis on the respiratory system ;
( C ) A chest X-ray ( a single posteroanterior radiographic projection or radiograph of the chest at full inspiration recorded on either film ( no less than 14 x 17 inches and no more than 16 x 17 inches ) or digital radiography systems ), interpreted and classified according to the International Labour Office ( ILO ) International Classification of Radiographs of Pneumoconioses by a NIOSH-certified B Reader ;
( D ) A pulmonary function test to include forced vital capacity ( FVC ) and forced expiratory volume in one second ( FEV1 ) and FEV1 / FVC ratio , administered by a spirometry technician with a current certificate from a NIOSH-approved spirometry course ;
( E ) Testing for latent tuberculosis infection ; and ( F ) Any other tests deemed appropriate by the PLHCP .
( 3 ) Periodic examinations . The employer shall make available medical examinations that include the procedures described in subsection ( ji )( 2 ) ( except subsection ( ji )( 2 )( E )) at least every three years , or more frequently if recommended by the PLHCP .
( 4 ) Information provided to the PLHCP . The employer shall ensure that the examining PLHCP has a copy of this standard and shall provide the PLHCP with the following information :
OSHSB-98 ( 2 / 98 )