(ii) The content of medical examinations or consultations made available to employees pursuant to paragraph (f) shall be determined by the attending physician. The guidelines in the Occupational Safety and Health Guidance Manual for Hazardous Waste Site Activities (See appendix D, Reference #10) should be consulted.
(5) Examination by a physician and costs. All medical examinations and procedures shall be performed by or under the supervision of a licensed physician, preferably one knowledgeable in occupational medicine, and shall be provided without cost to the employee, without loss of pay, and at a reasonable time and place.
(6) Information provided to the physician. The employer shall provide one copy of this standard and its appendices to the attending physician, and in addition the following for each employee:
(i) A description of the employee's duties as they relate to the employee's exposures.
(ii) The employee's exposure levels or anticipated exposure levels.
(iii) A description of any personal protective equipment used or to be used.
(iv) Information from previous medical examinations of the employee which is not readily available to the examining physician.
(v) Information required by §1910.134.
(7) Physician's written opinion, (i) The employer shall obtain and furnish the employee with a copy of a written opinion from the attending physician containing the following:
(A) The physician's opinion as to whether the employee has any detected medical conditions which would place the employee at increased risk of material impairment of the employee's health from work in hazardous waste operations or emergency response, or from respirator use.
(B) The physician's recommended limitations upon the employee's as signed work.
(C) The results of the medical examination and tests if requested by the employee.
(D) A statement that the employee has been informed by the physician of the results of the medical examination and any medical conditions which require further examination or treatment.
(ii) The written opinion obtained by the employer shall not reveal specific findings or diagnoses unrelated to occupational exposures.
(8) Recordkeeping. (i) An accurate record of the medical surveillance required by paragraph (f) of this section shall be retained. This record shall be retained for the period specified and meet the criteria of 29 CFR 1910.20.
(ii) The record required in paragraph(f) (8) (i) of this section shall include at least the following information:
(A) The name and social security number of the employee;
(B) Physician's written opinions, recommended limitations, and results of examinations and tests;
(C) Any employee medical complaints related to exposure to hazardous substances;
(D) A copy of the information provided to the examining physician by the employer, with the exception of the standard and its appendices.
(g) Engineering controls, work practices, and personal protective equipment for employee protection. Engineering controls, work practices, personal protective equipment, or a combination of these shall be implemented in accordance with this paragraph to protect employees from exposure to hazardous substances and safety and health hazards.
(1) Engineering controls, work practices and PPE for substances regulated in subparts G and Z. (i) Engineering controls and work practices shall be instituted to reduce and maintain employee exposure to or below the permissible exposure limits for substances regulated by 29 CFR part 1910, to the extent required by subpart Z, except to the extent that such controls and practices are not feasible.
NOTE TO (g) (1) (i): Engineering controls which may be feasible include the use of pressurized cabs or control booths on equipment, and/or the use of remotely operated material handling equipment. Work practices that may be feasible are removing all non-essential employees from potential exposure during opening of drums, wetting down dusty operations and locating employees upwind of possible hazards.
