Medical Surveillance Requirements
Some hazards harm health slowly, so OSHA requires employers to check exposed workers’ health at set times. These checks are called medical surveillance. They look for early signs of harm so the work can be changed before a worker is badly hurt.
- Construction
- General Industry
- Health Hazards
What it is, and what it isn’t
- It’s a series of exams and tests (for example a work and health history, a lung function test, a blood test or a hearing test) tied to a specific hazard.
- It is not a general physical, a drug test or a fitness-for-duty exam. It’s a health check focused on the hazard you work around.
- It doesn’t replace controlling the hazard. Controls come first. See Hierarchy of Controls.
Examples of standards that require it
Many OSHA health standards include medical surveillance. Triggers differ, so check the standard for your hazard.
| Hazard | Who is usually covered (general idea) |
|---|---|
| Respirator use | Workers who must wear a respirator get a medical evaluation before fit testing and use. See Respirator Medical Evaluation |
| Silica (construction and general industry) | Workers who must wear a respirator for 30 or more days a year under the rule, with exams offered about every 3 years. See Silica |
| Asbestos | Workers exposed at or above the limits for 30 or more days a year, or who must wear negative-pressure respirators. See Asbestos |
| Lead | Workers exposed at or above the action level for more than 30 days a year, with blood lead and other tests. See Lead |
| Noise | Workers in a hearing conservation program get a baseline hearing test and a yearly test. See Noise |
| Other substances | Standards for cadmium, benzene, formaldehyde, hexavalent chromium, methylene chloride, hazardous waste work and others have their own medical requirements |
Exact thresholds, timing and tests are in each standard. The table is a simplified overview, not a substitute for the rule.
Who pays and when
- OSHA medical surveillance must be provided at no cost to the worker, at a reasonable time and place, and usually during work hours or paid time.
- The exams must be done by, or under the supervision of, a licensed physician or other licensed health care professional (PLHCP).
- Exams usually happen at hire (a baseline), at set intervals, when symptoms appear, and at the end of employment for some hazards.
Your privacy and your results
- Employers generally get a limited written opinion on whether you can do the work with limits or restrictions. They usually don’t get your full medical details unless you agree or a standard requires it.
- You have the right to see and get a copy of your own medical and exposure records. Employers must keep them for the length of employment plus 30 years in most cases (29 CFR 1910.1020). See Access to Records and Training Records.
- Many standards let you get a second medical opinion if you disagree with the first.
- If a doctor recommends limits on your work, some standards include medical removal protection that protects your pay and benefits for a time. Check the standard for your hazard.
If your employer doesn’t offer it
- Ask your supervisor or safety manager if a medical program covers your hazard.
- Keep any exposure monitoring results and exam notices you receive.
- Contact OSHA at 1-800-321-OSHA (6742) or your state plan if required exams aren’t provided, and remember retaliation for asking is illegal. See Whistleblower Protection.
- Tell a doctor about your work hazards at any visit. Some illnesses show up years later.
Workers’ checklist
- I know which hazards I work around that have a medical program
- I got my baseline exam and know when the next is due
- I haven’t been charged for exams or lost pay for going
- I know how to ask for my records
- I report symptoms early, even between scheduled exams
Standards & references
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