MEDICAL SURVELLANCE

Question 1

Developing a Site-Specific Medical Program

Answer 1

should be individually planned for each site and is based on specific needs location and exposure at the site.
When developing an individual program the following should be done.
4. A qualified physician must direct the medical program
1. site conditions
2. monitoring the needs of each work
3. routine job tasks

Question 2

Medical plan

Answer 2

identifies toxic substances eg - asbestos, metals and herbicides and the limitations of occupational medical tests. May not be based on
presence of specific identifyable of

occupational medical tests.
specific identifiable hazardous chemicals
low level to several chemicals. exposure can be worse than an high level chemical exposure.

Risk can vary for individuals based on items such as age, size, weight, and offsite exposures. etc.

Question 3

site specific med program

Answer 3

Must include the following:
medical surveillance
treatment
record keeping
program review

Question 4

medical survellance

Answer 4

pre-employment screening
occupational and medical history
prior exposure to chemical and physical examinations 
physicians written opinion
periodic medical examinations
termination exams

Question 5

Pre employment screening

Answer 5

2 functions
determination of ee’s fitness for duty 9incl work while wearing the equip)
provision of base line data for comparison with future medical data

Question 6

Workers at Hazardous sites

Answer 6

perform strenuous tasks when wearing PPE
if not physically fit heat stress and other physical problems
Pre employment screening
occupational and medical history
this is a baseline for comparison with future exams

Question 7

Occupational and Medical History

Answer 7

Each worker Must complete the questionnaire
review and discuss prior to physical
special attention to prior exposure to chem and phy hazards
past illness and diseases topical exema asthma lung and cardivascular
symptoms - shortness of breath labored breathing on exerciston high blood pressure chest pain and heat intolerance
chronic respiratory systems
vulnerability to
severe asmtha reaction to a sepcific chemical
lifestyle habits
alcohol, cigarette smoking and drug use and hobbies

Question 8

Physical Examination

Answer 8

should be comprehensive
with cover all body organs 
pertinent should be noted
heat stroke
obesity lack of physical exercise
respirator use
missing or arthritic fingers 
dentures
poor eye sight 
perforated ear drums

Question 9

Physicians Written Opinion

Answer 9

Must be provided to the ER
The EE must get this report written opinion
that may place the EE at risk
the EE has the right to the results of themedical exam or any tests completed.
Dr’s recommendations are based on the assigned tasks
the written should not reveal specific diagnoses or findings unrelated to
occupational exposures

Question 10

Periodic Medical Exams

Answer 10

must be done and compared to pre employment screening exams used as a baseline
compared to determine early signs of adverse health effets
must be done annually or following the report of the EE’s symptoms or at the recommendation of a physician

Question 11

Termination Examination

Answer 11

end of employment all personnel must have a medical exam
the exam can be limited to obtaining the interval exam consisting of medical history of the period - medical history, physical exam, laboratory tests
the last full exam in the last 6 months
no exposure since last exam
no symptoms of exposure since the last exam
if any are not met a full examination will be necessary at the termination of employment.

Question 12

Treat,ment

Answer 12

Pre planning is essential for er and non-er treatment.
Actual and potential hazards specific to the site treatment plans should be considered. consider workers, contractors, visitors and other personnel

Question 13

Non-ER medical treatment

Answer 13

off site evaluate any illness

investigare and treat non job illness could put the worker at risk based on task requriements.

Question 14

Arrangements

Answer 14

Arrangements shall be made for non emergency medical care for hazardous site workers.
Off site medical care personnel
evaluated in the context of the worker
s exposure.
a bad cold or flue
a copy of the medical records will be kept onsite with provisions for security and confidentiality and when appropriate at a nearby hospital.

Question 15

ER Medical Treatment

Answer 15

must be integrated with the overall site ER response program
A team of site personnel must be trained in first aid
including CPR

Question 16

Training

Answer 16

Train a team of site personnel on er first aid
cPR
First Aid treatment for explosion, burn injusries
Heat stress
EMT
on decontamination procedures in coordination with the er response plan

Question 17

Location

Answer 17

establish protocol for managing heat stress
first aid station on site stabilization
general first aid for sprains, minor cuts and minor injuries
location in a clean area to facilitate emergency decontamination

Question 18

On site preparation

Answer 18

on site first aid kit or equivalent supplies
emergency
deluge showers
ice
er eye wash
decpmtamination solutions
restock supplies immediately after each use check regularly
AN AED can be kept on work sites but train ee’s as part of the cpr and first aid training

Question 19

Medical Support

Answer 19

Physician that is on call for 24 hours basis  on call of er set up a team of medical specialists for consultations 
toxicologist
dermatologist
heamotologist
neurologist
allergist
opthalmologist
cardiologist

make arrangementmes for er transportation and treatment at a nearby medical facility

if working at a remote location - note gps coordinaties
local hospitals capacity of burn and chemical units

faster to drive an injured worker to medical services
Prior to each project determine how to reach an appropriate medical facility for the injuries that may be exposed to with the project team.

Question 20

recordkeeping

Answer 20

some of the effects may not be seen for years.
30 yeras post employment for ee’s - 29CFR 1910 1020
make records available to worker, rep and OSHA - 29 CFR 1910 1020
maintain occupational injury and illness log - 29 CFR 1904

Question 21

Program Review

Answer 21

regular evaluation is required to ensure effectiveness
annually acertain that accidents are investigation and changes are made
recommendations
evaluate the efficiency of specific medical testing
add or delete medical tests
update er procedures
review management commitment to worker health and safetyprocedures

Question 22

Effictiveness

Answer 22

to be effective Managment must
ensure ee’s confidentialiaty
require workers to report exposures regardless of degree to medical as well as andy unusal physical or psychological problems

with open channels of communication companies better informed and prepared to deal with medical issues as they arise