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a time and place that is reasonable and gency. The medical evaluation must convenient to the worker.
include the requirements of paragraph (1) Baseline medical evaluation. The responsible employer must provide a (c) Multiple physician review. The rebaseline medical evaluation to beryl sponsible employer must establish a lium-associated workers. This evalua- multiple physician review process tion must include:
beryllium-associated workers that al(i) A detailed medical and work his
lows for the review of initial medical tory with emphasis on past, present, findings, determinations, or recand anticipated future exposure to be ommendations from any medical evalryllium;
uation conducted pursuant to para(ii) A respiratory symptoms questionnaire;
(1) If the responsible employer selects (iii) A physical examination with
the initial physician to conduct any special emphasis on the respiratory
medical examination or consultation system, skin and eyes;
provided to a beryllium-associated (iv) A chest radiograph (posterior-an
worker, the worker may designate a terior, 14 x 17 inches) interpreted by a
second physician to: National Institute for Occupational
(i) Review any findings, determinaSafety and Health (NIOSH) B-reader of
tions, or recommendations of the inipneumoconiosis or a board-certified ra
tial physician; and diologist (unless a baseline chest
(ii) Conduct such examinations, conradiograph is already on file);
sultations and laboratory tests, as the (v) Spirometry consisting of forced
second physician deems necessary to vital capacity (FVC) and forced expira
facilitate this review. tory volume at 1 second (FEV1);
(2) The responsible employer must (vi) A Be-LPT; and (vii) Any other tests deemed appro
promptly notify a beryllium-associated priate by the examining physician for
worker in writing of the right to seek evaluating beryllium-related health ef
a second medical opinion after the inifects.
tial physician provided by the respon(2) Periodic evaluation. (i) The respon
sible employer conducts a medical exsible employer must provide to beryl
amination or consultation. lium workers a medical evaluation an
(3) The responsible employer may nually, and to other beryllium-associ
condition its participation in, and payated workers a medical evaluation
ment for multiple physician review every three years. The periodic medical
upon the beryllium-associated worker evaluation must include:
doing the following within fifteen (15) (A) A detailed medical and work his
days after receipt of the notice, or retory with emphasis on past, present,
ceipt of the initial physician's written and anticipated future exposure to be
opinion, whichever is later: ryllium;
(i) Informing the responsible em(B) A respiratory symptoms ques- ployer in writing that he or she intends tionnaire;
to seek a second medical opinion; and (C) A physical examination with em (ii) Initiating steps to make an apphasis on the respiratory system;
pointment with a second physician. (D) A Be-LPT; and
(4) If the findings, determinations, or (E) Any other medical evaluations recommendations of the second physideemed appropriate by the examining cian differ from those of the initial physician for evaluating beryllium-re- physician, then the responsible emlated health effects.
ployer and the beryllium-associated (ii) The responsible employer must worker must make efforts to encourage provide to beryllium-associated work and assist the two physicians to reers a chest radiograph every five years. solve any disagreement.
(3) Emergency evaluation. The respon- (5) If, despite the efforts of the resible employer must provide a medical sponsible employer and the berylliumevaluation as soon as possible to any associated worker, the two physicians worker who may have been exposed to are unable to resolve their disagreeberyllium because of a beryllium emer- ment, then the responsible employer
and the worker, through their respec- plained to the worker the results of the tive physicians, must designate a third medical evaluation, including all tests physician to:
results and any medical condition re(i) Review any findings, determina lated to beryllium exposure that retions, or recommendations of the other quires further evaluation or treatment. two physicians; and
(2) The SOMD's written medical opin(ii) Conduct such examinations, con- ion must not reveal specific records, sultations, laboratory tests, and con- findings, and diagnoses that are not resultations with the other two physi- lated to medical conditions that may cians, as the third physician deems be affected by beryllium exposure. necessary to resolve the disagreement (f) Information provided to the berylamong them
lium-associated worker. (1) The SOMD (6) The SOMD must act consistently must provide each beryllium-associwith the findings, determinations, and ated worker with a written medical recommendations of the third physi opinion containing the results of all cian, unless the SOMD and the beryl- medical tests or procedures, an explalium-associated worker reach an agree- nation of any abnormal findings, and ment that is consistent with the rec- any recommendation that the worker ommendations of at least one of the be referred for additional testing for other two physicians.
evidence of CBD, within 10 working (d) Alternate physician determination. days after the SOMD's receipt of the The responsible employer and the be- results of the medical tests or proceryllium-associated worker or the work- dures. er's designated representative may (2) The responsible employer must, agree upon the use of any alternate within 30 days after a request by a beform of physician determination in lieu ryllium-associated worker, provide the of the multiple physician review proc worker with the information the reess provided by paragraph (c) of this sponsible employer is required to prosection, so long as the alternative is vide the examining physician under expeditious and at least as protective paragraph (a)(6) of this section. of the worker.
(g) Reporting. The responsible em(e) Written medical opinion and rec- ployer must report on the applicable ommendation. (1) Within two weeks of OSHA reporting form beryllium senreceipt of results, the SOMD must pro sitization, CBD, or any other abnormal vide to the responsible employer a condition or disorder of workers caused written, signed medical opinion for or aggravated by occupational expoeach medical evaluation performed on sure to beryllium. each beryllium-associated worker. The (h) Data analysis. (1) The responsible written opinion must take into ac- employer must routinely and systemcount the findings, determinations and atically analyze medical, job, and exporecommendations of the other exam sure data with the aim of identifying ining physicians who may have exam individuals or groups of individuals poined the beryllium-associated worker. tentially at risk for CBD and working The SOMD's opinion must contain: conditions that are contributing to
(i) The diagnosis of the worker's con that risk. dition relevant to occupational expo
(2) The responsible employer must sure to beryllium, and any other med use the results of these analyses to ical condition that would place the identify additional workers to whom worker at increased risk of material the responsible employer must provide impairment to health from further ex medical surveillance and to determine posure to beryllium;
the need for additional exposure con(ii) Any recommendation for removal trols. of the worker from DOE beryllium ac
$850.35 Medical removal. activities or duties or use of personal (a) Medical removal protection. The reprotective equipment, such as a res- sponsible employer must offer a berylpirator; and
lium-associated worker medical re(iii) A statement that the SOMD or moval from exposure to beryllium if examining physician has clearly ex- the SOMD determines in a written
medical opinion that it is medically (ii) If a beryllium-associated worker appropriate to remove the worker from is removed permanently from berylsuch exposure. The SOMD's determina lium exposure based on the SOMD's tion must be based on one or more recommendation pursuant to this secpositive Be-LPT results, chronic beryl tion, the responsible employer must lium disease diagnosis, an examining provide the worker the medical rephysician's recommendation, or any moval protection benefits specified in other signs or symptoms that the paragraph (b) of this section. SOMD deems medically sufficient to (3) Worker consultation before temremove a worker.
porary or permanent medical removal. If (1) Temporary removal pending final the SOMD determines that a berylmedical determination. The responsible lium-associated worker should be tememployer must offer a beryllium-asso porarily or permanently removed from ciated worker temporary medical re exposure to beryllium, the SOMD moval from exposure to beryllium on must: each occasion that the SOMD deter (i) Advise the beryllium-associated mines in a written medical opinion worker of the determination that medthat the worker should be temporarily ical removal is necessary to protect the removed from such exposure pending a worker's health; final medical determination of whether (ii) Provide the beryllium-associated the worker should be removed perma worker with a copy of this rule and its nently.
preamble, and any other information (i) In this section, “final medical de the SOMD deems necessary on the termination" means the outcome of risks of continued exposure to berylthe multiple physician review process lium and the benefits of removal; or the alternate medical determination (iii) Provide the beryllium-associated process provided for in paragraphs (c) worker the opportunity to have any and (d) of 8 850.34.
questions concerning medical removal (ii) If a beryllium-associated worker answered; and is temporarily removed from beryllium (iv) Obtain the beryllium-associated exposure pursuant to this section, the worker's signature acknowledging that responsible employer must transfer the the worker has been advised to accept worker to a comparable job for which medical removal from beryllium expothe worker is qualified (or for which sure as provided in this section, and the worker can be trained in a short has been provided with the information period) and where beryllium exposures specified in this paragraph, on the benare as low as possible, but in no event efits of removal and the risks of conat or above the action level.
tinued exposure to beryllium. (iii) The responsible employer must (4) Return to work after medical remaintain the beryllium-associated moval. (i) The responsible employer, worker's total normal earnings, senior subject to paragraph (a)(4)(ii) of this ity, and other worker rights and bene- section, must not return a berylliumfits as if the worker had not been re associated worker who has been permamoved.
nently removed under this section to (iv) If there is no such job available, the worker's former job status unless the responsible employer must provide the SOMD first determines in a written to the beryllium-associated worker the medical opinion that continued medmedical removal protection benefits ical removal is no longer necessary to specified in paragraph (b)(2) of this sec protect the worker's health. tion, until a job becomes available or (ii) Not withstanding paragraph (a)(4) for one year, whichever comes first. (i) of this section, if, in the SOMD's
(2) Permanent medical removal. (i) The opinion, continued exposure to berylresponsible employer must offer a be- lium will not pose an increased risk to ryllium-associated worker permanent the beryllium-associated worker's medical removal from exposure to be health, and medical removal is an inapryllium if the SOMD determines in a propriate remedy in the circumstances, written medical opinion that the work the SOMD must fully discuss these er should be permanently removed matters with the worker and then, in a from exposure to beryllium.
written determination, may authorize
the responsible employer to return the (5) For the purposes of this section, worker to his or her former job status. the requirement that a responsible emThereafter, the returned beryllium-as ployer provide medical removal protecsociated worker must continue to be tion benefits is not intended to expand provided with medical surveillance upon, restrict, or change any rights to under $850.34 of this part.
a specific job classification or position (b) Medical removal protection benefits. under the terms of an applicable collec(1) If a beryllium-associated worker tive bargaining agreement. has been permanently removed from (6) The responsible employer may beryllium exposure pursuant to para condition the provision of medical regraph (a)(2) of this section, the respon- moval protection benefits upon the besible employer must provide the beryl ryllium-associated worker's participalium-associated worker:
tion in medical surveillance provided (i) The opportunity to transfer to an- in accordance with $ 850.34 of this part. other position which is available, or later becomes available, for which the
$ 850.36 Medical consent. beryllium-associated worker is quali (a) The responsible employer must fied (or for which the worker can be provide each beryllium-associated trained in a short period) and where be worker with a summary of the medical ryllium exposures are as low as pos surveillance program established in sible, but in no event at or above the $850.34 at least one week before the action level; or
first medical evaluation or procedure (ii) If the beryllium-associated work or at any time requested by the worker cannot be transferred to a com er. This summary must include: parable job where beryllium exposures (1) The type of data that will be colare below the action level, a maximum lected in the medical surveillance proof 2 years of permanent medical re
gram; moval protection benefits (specified in (2) How the data will be collected and paragraph (b)(2) of this section).
maintained; (2) If required by this section to pro (3) The purpose for which the data vide medical removal protection bene will be used; and fits, the responsible employer must (4) A description of how confidential maintain the removed worker's total data will be protected. normal earnings, seniority and other (b) Responsible employers must also worker rights and benefits, as though provide each beryllium-associated the worker had not been removed.
worker with information on the bene(3) If a removed beryllium-associated fits and risks of the medical tests and worker files a claim for workers' com examinations available to the worker pensation payments for a beryllium-re
at least one week prior to any such exlated disability, then the responsible amination or test, and an opportunity employer must continue to provide
to have the worker's questions anmedical removal protection benefits swered. pending disposition of the claim. The
(c) The responsible employer must responsible employer must receive no
have the SOMD obtain a beryllium-ascredit for the workers' compensation sociated worker's signature on the inpayments received by the worker for formed consent form found in Appendix treatment related expenses.
A to this part, before performing med(4) The responsible employer's obliga ical evaluations or any tests. tion to provide medical removal pro
8850.37 Training and counseling. tection benefits to a removed beryllium-associated worker is reduced to (a) The responsible employer must the extent that the worker receives develop and implement a beryllium compensation for earnings lost during training program and ensure participathe period of removal either from a tion for: publicly- or employer-funded com (1) Beryllium-associated workers; pensation program, or from employ- (2) All other individuals who work at ment with another employer made pos- a site where beryllium activities are sible by virtue of the worker's removal. conducted.
(b) The training provided for workers (6) Work practice procedures limiting identified in paragraph (a)(1) of this beryllium-associated worker exposure section, must:
to beryllium; and (1) Be in accordance with 29 CFR (7) The risk of continued beryllium 1910.1200, Hazard Communication;
exposure after sensitization. (2) Include the contents of the CBDPP; and
$ 850.38 Warning signs and labels. (3) Include potential health risks to (a) Warning signs. The responsible beryllium worker family members and employer must post warning signs at others who may come in contact with each access point to a regulated area beryllium on beryllium workers or be with the following information: ryllium workers' personal clothing or DANGER other personal items as the result of a BERYLLIUM CAN CAUSE LUNG beryllium control failure at a DOE fa
CANCER HAZARD (c) The training provided for workers AUTHORIZED PERSONNEL ONLY identified in paragraph (a)(2) of this (b) Warning labels. (1) The responsible section must consist of general aware- employer must affix warning labels to ness about beryllium hazards and con all containers of beryllium, beryllium trols.
compounds, or beryllium-contaminated (d) The responsible employer must clothing, equipment, waste, scrap, or provide the training required by this debris. section before or at the time of initial (2) Warning labels must contain the assignment and at least every two following information: years thereafter.
DANGER (e) The employer must provide re CONTAMINATED WITH BERYLLIUM training when the employer has reason DO NOT REMOVE DUST BY BLOWING to believe that a beryllium worker OR SHAKING lacks the proficiency, knowledge, or CANCER AND LUNG DISEASE HAZunderstanding needed to work safely
ARD with beryllium, including at least the (c) Warning signs and labels must be following situations:
in accordance with 29 CFR 1910.1200, (1) To address any new beryllium haz Hazard Communication. ards resulting from a change to operations, procedures, or beryllium con $850. 39 Recordkeeping and use of in. trols about which the beryllium worker formation. was not previously trained; and
(a) The responsible employer must (2) If a beryllium worker's perform- establish and maintain accurate ance involving beryllium work indi records of all beryllium inventory incates that the worker has not retained formation, hazard assessments, expothe requisite proficiency.
sure measurements, exposure controls, (f) The responsible employer must de and medical surveillance. velop and implement a counseling pro (b) Heads of DOE Departmental Elegram to assist beryllium-associated ments must: workers who are diagnosed by the (1) Designate all record series as reSOMD to be sensitized to beryllium or quired under this rule as agency to have CBD. This counseling program records and, therefore, subject to all must include communicating with be applicable agency records management ryllium-associated workers concerning: and access laws; and
(1) The medical surveillance program (2) Ensure that these record series provisions and procedures;
are retained for a minimum of seventy(2) Medical treatment options;
five years. (3) Medical, psychological, and career (c) The responsible employer must counseling;
convey to DOE or its designee all (4) Medical benefits;
record series required under this rule if (5) Administrative procedures and the employer ceases to be involved in workers rights under applicable Work- the CBDPP. ers' Compensation laws and regula- (d) The responsible employer must tions;
link data on workplace conditions and