ES&H Manual



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, welding, oxygen deficiency). This monitoring is offered on site by TJNAFs 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 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 TJNAF.

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, welding, oxygen deficiency), receive medical monitoring. The responsibilities and process steps for obtaining such for subcontract employees is presented in Appendix T5, Subcontract Employee Medical Monitoring.

The process steps in this appendix are performed in coordination with Chapter 6800, Occupational Medicine.

3.0          Responsibilities

Note:    Management authority may be delegated to a task-qualified TJNAF employee 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 or 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

4.1.1      Anyone at TJNAF may request a hazard evaluation for an activity or area from the Industrial Hygienist (x6381) (refer to the table in Section 5.0 below).

o   If it is determined that those performing an activity or working in an area require medical monitoring, continue to 4.4.2.

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


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


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


4.1.4      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 and Sponsors are responsible for the following process steps.


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


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


4.2.3      Ensure that the individual’s medical monitoring certification is current.

Technical representatives responsible for subcontract employees who require medical monitoring should refer to 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.

Activities and Hazard Issues Requiring Medical Monitoring

Activity and/or 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

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


6640 Hearing Conservation

Oxygen Deficiency

3 years

6540 ODH Control Program


3 years

6630 Respiratory Protection Program

Silica Worker Evaluations

3 years

6683 Silica Safety Program

Static Magnetic Field Exposure

Condition Specific

6420 Non-Ionizing Radiant Energy (i.e.: Radio Frequency (RF), Microwave, and Static Magnetic Fields)


3 years

6122 Hot Work (i.e. Welding, Cutting, Brazing, and Grinding) Safety Program

6.0          Revision History





periodic review

- changed TPOC from SChandler to KPadiyar

- removed term radiation throughout & Ionizing Radiation Hazard information from the table in 5.0

ESHM Editor performed the following:

- added Note to responsibilities section

- updated header & footer (added review cycle)

- changed revision summary to revision history, and moved to table format



updated Table 1 to include Silica Worker Evaluations per JWilliams



periodic review – no changes per TPOC


periodic review – no substantive changes required


revised to reflect current laboratory operations












ES&H Division

Krishna Padiyar



3 years



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It is the user’s responsibility to ensure that the document is the same revision as the current online file.  This copy was printed on 6/17/2022.