TITLE:	ES&H Manual
DOCUMENT ID:	6800 Appendix T1 Medical Monitoring

1.0 Purpose

Medical monitoring is required for individuals who perform certain work and/or are exposed to certain hazard issues (e.g., high noise, radiation, welding, oxygen deficiency). This monitoring is offered on site by Jefferson Lab’s Occupational Medicine Department at no cost to employees. Those who decline on-site services are responsible for providing Occupational Medicine with comparable medical examination documentation from an outside medical facility. Independent examinations must align with Jefferson Lab protocols. Forms and other requirements are obtained from Occupational Medicine (ext. 7539).

2.0 Scope

This document outlines the responsibilities and process steps for obtaining medical monitoring for employees, users, and students who perform certain activities or are exposed to hazard issues that require routine medical monitoring by Jefferson Lab.

NOTE: Individuals under the age of 18 are not allowed to work with hazard issues and are not offered medical monitoring.

Subcontract employees who perform certain work; or are exposed to certain hazard issues (e.g., high noise, radiation, welding, oxygen deficiency) at Jefferson Lab receive medical monitoring. The responsibilities and process steps for obtaining medical monitoring for subcontract employees is presented in ES&H Manual Chapter 6800 Appendix T5 Subcontract Employee Medical Monitoring.

The process steps in this appendix are performed in coordination with ES&H Manual Chapter 6800 Occupational Medicine.

3.0 Responsibilities

NOTE: Management authority may be delegated at the discretion of the responsible manager.

3.1 Everyone at Jefferson Lab

· Inform your supervisor/sponsor of any suspected hazard issue that needs to be evaluated for medical monitoring.

· Schedule and receive required medical monitoring prior to expiration of current certification as required by your Employee Job Task Analysis (EJTA).

· Adhere to any health related restrictions imposed by the physician.

3.2 Supervisor/Sponsor

· Recognize activities and hazard issues that require medical monitoring in your area of responsibility.

· Ensure that individuals who perform activities or work in areas that require medical monitoring have current medical certifications prior to authorizing work.

· Inform Occupational Medicine of new hires or transfers; changes in health status; or altered job activity that requires medical monitoring.

· Enforce any necessary health-related work restrictions.

3.3 Occupational Medicine

· Conduct initial medical evaluations and schedule monitoring for individuals who perform activities or work in areas that expose them to hazard issues that require medical monitoring.

· Provide the necessary information and certification forms to individuals receiving off-site consultations.

· Maintain medical records in accordance with 10 CFR 851 Worker Safety and Health Program, 36 CFR 1223 Managing Vital Records, and DOE O 243.2 Vital Records.

· Update individuals’ Skills Requirements List (SRL) based on medical monitoring.

· Provide individuals with their medical records upon request.

3.4 Human Resources

· Inform new employees that initial medical monitoring is required and that many employees need ongoing hazard-based medical monitoring.

4.0 Process Steps

Responsibilities for each process step are defined within the procedure.

4.1 Initial Hazard Issue Evaluation for an Area

Step 1: Anyone at Jefferson Lab may request a hazard evaluation for an activity or area from the Industrial Hygienist (x6381) (see Table 1. Activities/Hazard Issues Requiring Medical Monitoring).

o If it is determined that those performing an activity or working in an area require medical monitoring, continue to Step 2.

o If no activity/hazard is found – the evaluator informs the concerned party(s) of the determination.

Step 2: The evaluator informs the worker’s supervisor/sponsor of the activity/hazard requiring medical monitoring.

Step 3: The supervisor/sponsor informs affected individuals of the activity/hazard and ensures that medical monitoring is scheduled for individuals working in the area.

Step 4: The supervisor/sponsor ensures that warning signs are posted in accordance with the hazard issue.

4.2 Medical Monitoring Evaluation for New, Loaned, or Transferred Individuals

Supervisors/sponsors are responsible for the following process steps.

Step 1: Evaluate the individual’s assigned work area and note any activity/hazard that requires medical monitoring.

Step 2: Inform the individual of the activity/hazard requiring medical monitoring and ensure that medical monitoring is scheduled.

Step 3: Ensure that the individual’s medical monitoring certification is current.

SOTRs, responsible for subcontract employees who require medical monitoring, refer to ES&H Manual Chapter 6800 Appendix T5 Subcontract Employee Medical Monitoring.

5.0 Reference

Individuals who perform activities or work in areas that expose them to certain hazard issues are required by Jefferson Lab to submit to medical monitoring at specific intervals. The frequency of medical monitoring for an individual may be increased at the discretion of the Occupational Medicine physician.

The table below shows the activities and/or hazard issues that trigger medical monitoring, typical monitoring frequencies, and relevant ES&H Manual chapters.

Table 1. Activities/Hazard Issues Requiring Medical Monitoring

Activity/Hazard Issue	Typical Frequency of Monitoring	ES&H Manual Chapter
Aerial Lift Operators	3 years	6147 Aerial Work Platforms
Beryllium Associated Work	3 years	6682 Beryllium Handling and Exposure
Crane Operators	3 years	6141 Cranes and Hoists
Forklift Operators	3 years	6145 Forklift Safety
Ionizing Radiation	3 years	6310 Protection from Ionizing Radiation
Lasers – Class 3b and 4	Initially and after any suspected injury	6410 Laser Safety Program
Lead Associated Work	3 years	6680 Lead Handling
Nanoparticle Technology (Engineered)	3 years	6650 Engineered Nanoparticle Policy
Noise Exposure	Annually	6640 Hearing Conservation
Oxygen Deficiency	3 years	6540 ODH Control Program
Respirator	3 years	6630 Respiratory Protection Program
Static Magnetic Field Exposure	Condition Specific	6420 Non-Ionizing Radiant Energy (i.e.: Radio Frequency (RF), Microwave, and Static Magnetic Fields)
Welding	3 years	6122 Hot Work (i.e. Welding, Cutting, Brazing, and Grinding) Safety Program

6.0 Revision Summary

Revision 1 – 05/10/10 – Revised to reflect current laboratory operations.

ISSUING AUTHORITY	TECHNICAL POINT-OF-CONTACT	APPROVAL DATE	EXPIRATION DATE	REV.
ESH&Q Division	Smitty Chandler	05/10/10	05/10/13	1

This document is controlled as an on line file. It may be printed but the print copy is not a controlled document. It is the user’s responsibility to ensure that the document is the same revision as the current on line file. This copy was printed on 7/16/2012.