Specifications include, but are not limited to: Occupational Health Services Medical monitoring of employees who may be exposed to chemical, biological and/or physical hazards is conducted for individuals in a variety of job titles and for many types of hazard exposures including: solvents, lead, heavy metals, silica, asbestos, HIV, TB, rabies, hepatitis, noise, and radiation. Examinations to determine an individual worker's ability to wear personal protective equipment, such as a respirator, are also conducted. Typical examinations may include a medical/occupational history, complete physical examination, routine blood and hearing tests, and pulmonary function tests. The Proposer’s medical examiner will determine whether the employee has developed an occupationally related illness and make recommendations for further evaluation and/or remediation. All testing will be done at Proposer’s facility. 2.3.1 Respiratory Medical Clearance The primary method of medical evaluation used by the Proposer will be a review of an OSHA Respirator Medical Evaluation Questionnaire. 29 CFR 1910.134 allows for the medical evaluation to be performed by a physician or other licensed health care professional (“PLHCP”) utilizing a questionnaire that is the same as or equivalent to 29 CFR 1910.134 Appendix C or by an initial medical examination that obtains the same information as the medical questionnaire. The Proposer, in reviewing medical questionnaires, shall consider all respiratory equipment that the Authority typically supplies its employees. This equipment includes but may not be limited to: half-face and full-face negative pressure air purifying respirators; powered air purifying respirators (“PAPR’s”) with one of the following: a face sealing mask, a welding helmet, a shroud that is snug to the neck, or a loosefitting hood or helmet. PLHCP will complete “Respirator Use Medical Evaluation TA-N3707” (Attachment 1) and “Respirator Fit Test” TA-N3708 (Attachment 2). 2.3.2 Respirator Fit testing Respirator fit testing shall be performed to meet requirements set forth in 29 CFR 1910.134 and its appendices. The Proposer must be able to perform either quantitative or qualitative fit testing; however, the preferred method of fit testing is quantitative. 2.3.3 Blood Lead Testing (including zinc protoporphyrin) The Proposer shall provide on-site blood drawing capabilities for the purpose of blood lead monitoring. Testing must adhere to stipulations set forth in 29 CFR 1910.1025 and its appendices. Test results shall be supplied to the New York State Department of Health as required by regulation. 2.2.4 Audiometric Testing The Proposer shall perform audiometric testing in accord with 29 CFR 1910.95. The Proposer shall provide a testing summary of all workers tested at each location and a report summarizing the testing results of all the employees. For each employee tested, the Proposer shall prepare an audiometric test record that includes the employee’s name and job classification, the date, the examiner’s name, the date of the acoustic or exhaustive calibration, measurements of the background sound pressure levels in the testing area, and the employee’s most recent noise exposure measurement. For employees noted to have a Standard Threshold Shift (“STS”), the Proposer will prepare the following: • Individual summary and STS notification letter for each employee. • STS report • OSHA Recordable Shift report 2.3.5 Medical, work history, and physical evaluation with emphasis on respirable crystalline silica PLHCPs who manage silica medical surveillance programs must have a thorough understanding of silicarelated diseases and health effects. At each clinical encounter, the PLHCP should consider silica-related health outcomes, with particular vigilance for acute and accelerated silicosis. The required components of medical surveillance are under OSHA 29 CFR 1926.1153 Appendix B. PLHCPs will assess medical and work history, with an emphasis on: past, present, and anticipated exposure to respirable crystalline silica, dust, and other agents affecting the respiratory system; any history of respiratory system dysfunction, including signs and symptoms of respiratory disease (e.g., shortness of breath, cough, wheezing); history of TB; and smoking status and history. The respirable crystalline silica standard should be reviewed, along with additional guidance and recommendations for PLHCPs performing medical surveillance examinations for silica-exposed employees.
