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Safety and Risk Management
Employee Medical Monitoring Program

Specific Medical Monitoring Standards and Protocols

Lead

Authority: Title 8 California Code of Regulations (CCR), Sections 5208 & 5216

Employees Covered:

• University employees engaged in lead-related work tasks that require personal exposure monitoring as defined by Cal-OSHA (8CCR, 1532.1).
• All employees occupationally exposed on any day to lead at or above the action level.
• All employees who are or may be exposed at or above the action level for more than 30 days in any consecutive 12 months.

Examination Required:

• Comprehensive medical examination
• Biological monitoring (see below for required tests)

Frequency

Medical examinations shall be performed prior to initial exposure and annually for each employee:

1. Additional Examinations and biological monitoring shall be performed as soon as possible when either the employee has developed signs or symptoms commonly associated with lead intoxication, desires medical advice concerning reproductive hazards, or the employee has demonstrated difficulty in breathing during a respirator fitting or during use and as medically appropriate for each employee removed from exposure to lead.
2. At least every 2 months for each employee whose last blood lead level was at or above 40ug/100 g until two samples in a row are less than 40ug/100g.
3. Monthly during the period an employee is removed from exposure due to an elevated blood lead level.

Biological Monitoring Shall Include

• blood lead level;
• hemoglobin and hematocrit, red cell indices and peripheral smear morphology;
• zinc protoporphyrin (ZPP);
• blood urea nitrogen and creatinine;
• Urinalysis with microscopic examination
• Any laboratory or other test which the examining physician deems necessary by sound medical practice.

Medical removal protection

The employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that a periodic and follow-up blood sampling test conducted indicate that the employee’s blood level is at or above 50 ug/100 g.

The employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that at a final medical examination the employee has a detected medical condition which places the employee at increased risk of material impairment to health form exposure.

Return to former job status

The employee shall be returned to former job status;

• if removed for a blood lead level at or above 80 ug/100 g when the employee’s blood lead level is at or below 60 mg/100 g of whole blood;
• if removed for a level at or above 70 ug/100 g when two consecutive tests indicate the blood lead level is at or below 50 mg/100 g;
• if removed for a level at or above 50 ug/100 g when two consecutive tests indicate the blood lead level is at or below 40 mg/100 g;
• when removed due to a final medical determination when a subsequent final medical determination states that the employee no longer has a detected medical condition which places the employee at increased risk of material impairment to health.