TITLE:	ES&H Manual
DOCUMENT ID:	6800 Appendix T5 Subcontract Employee Medical Monitoring

1.0 Purpose

Medical monitoring is required for subcontract employees who perform certain work; 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 subcontract employee or their subcontracted company. Those who decline on-site services are responsible for providing Jefferson Lab’s Occupational Medicine Department 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 (x7539).

2.0 Scope

This document outlines the responsibilities and process steps use to obtain medical monitoring for subcontract employees.

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

Jefferson Lab notifies subcontract employees of work areas with hazard issues that require medical monitoring. When applicable, Occupational Medicine ensures that subcontract employees receive appropriate 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 Subcontracting Officer’s Technical Representative (SOTR)

· Recognize activities and hazard issues that require medical monitoring in work areas.

· Inform subcontract employees that:

o They are to report any suspected hazard issue, so it can be determined whether medical monitoring is required.

o Initial and/or routine medical monitoring is required if they perform certain work; or are exposed to certain hazard issues (e.g.: high noise, radiation, welding, oxygen deficiency).

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

· Inform Occupational Medicine of new subcontract employees; any changes in health status; or altered job activity that might require occupational medicine assistance, work restrictions, and/or medical monitoring.

· Schedule appointments for medical monitoring with Occupational Medicine (when required) and prior to expiration of any current certification.

3.2 Occupational Medicine

· Schedule and conduct medical monitoring for subcontract employees who require it.

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

· When applicable update subcontract employees’ Skills Requirements List (SRL) based on medical monitoring.

· 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.

· Provide subcontract employees with their medical records upon request.

4.0 Process Steps

4.1 Medical Monitoring for New, Loaned, or Transferred Subcontract Employees

The SOTR is responsible for the following process steps.

Step 1: Evaluate the subcontract employees’ assigned work area and note any activities or hazard issues that require medical monitoring.

Step 2: Inform the subcontract employee of hazard issues and medical monitoring requirements.

Step 3: Schedule appointments with Occupational Medicine and ensure that medical monitoring is received.

Step 4: Ensure that the subcontract employees’ required medical monitoring certification(s) remains current for the duration of the work.

5.0 Reference

Jefferson Lab provides medical monitoring for the below stated hazard issues at specific intervals.

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 - Periodic Review – 05/20/2013 – Reconciled Table 1 with Appendix T1 Table; no substantive changes required.

Revision 0 – 05/10/2010 - This is new content.

ISSUING AUTHORITY	TECHNICAL POINT-OF-CONTACT	APPROVAL DATE	REVIEW REQUIRED DATE	REV.
ESH&Q Division	Smitty Chandler	05/10/10	05/10/16	1

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