OCCUPATIONAL HEALTH PROGRAM
Medical Monitoring Program
Guidelines for medical monitoring of employees are contained
in a number of sections in Title 8, California Code of
The University requires faculty and staff to participate in
this program if it has been determined their exposure(s) to
hazardous conditions or chemicals may exceed or has exceeded the
recommended levels. Once the baseline medical levels have been
established, participants in the program are periodically
examined for changes in health status.
Appropriate administrators and Risk Management and Safety
staff are responsible for identifying individuals who may have
occupational overexposures. Employees must also be responsible
for reporting their potential overexposure(s). RM&S staff will
determine if the employee's potential overexposure warrants
inclusion in the program and will advise the employee and the
appropriate administrator(s) accordingly. Once an employee has
been identified for inclusion in the campus medical monitoring
program, EH&S will assume responsibility for scheduling the
medical exams and record keeping.
The University has established a Medical Monitoring Program
consistent with the 1996 CSU Office of the Chancellor "Employee
Medical Monitoring Program Manual".
Medical monitoring by the university medical provider is at
no cost to the employee.
For Further Information
Contact RM&S at 750-4502 or x4502 (On-Campus).
As part of the Occupational Health Program at CSUSM,
RM&S has established a health monitoring program. The reference California Code of
Regulations is Title 8:
Section 5097 for employees exposed to hazardous levels of
Section 5144 for respiratory protective equipment
Section 5191 for employees engaged in the use of hazardous materials in laboratories
Section 5209 for employees engaged in work involving carcinogens
Section 5217 for employees exposed to formaldehyde National Institutes of Health for
employees required to handle animals 10 CFR, 20 for employees exposed to radiation from
Tritium or other sources of radiation 49 CFR, Part 391 for employees driving passenger
The purpose for performing medical monitoring of employees is to detect physiological
changes in an employee, that may be the result of exposure to hazardous levels of
physical, chemical or radioactive stresses the employee may experience on the job.
Supervisors will make every effort to minimize the occupational exposure of employees to
hazardous environmental stresses, by utilizing engineering and administrative controls on
processes. Medical monitoring of employees is also used to measure the effectiveness of
engineering and administrative controls. Biological monitoring is a part of the medical
monitoring program. Biological monitoring can provide a reasonable indication of exposures
to hazardous environmental stresses the employee might encounter on the job. Biological
monitoring is also an attempt to quantify an employee's exposure for a period of time
either prior to, or as a result of employment at CSUSM.
This program was compiled from data contained in; The
California State University Employee Medical Monitoring Program, sample plan, NIOSH/OSHA
Occupational Health Guidelines for Chemical Hazards, 29 CFR 1910 series, Title 8,
California Code of Regulations, Sections 5097, 5208, 5144, 5191, 5209, 5210, 5213, 5216,
5217, 5218, 5220, 6053, 6728 and 6760, and 49 CFR, Part 391.
OSHA STANDARDS AND REGULATORY COMPLIANCE
CSUSM is under the mandate of the California Occupational
Safety and Health Act (CAL/OSHA). In addition, other branches of the federal and state
government promulgate regulations pertinent to certain CSUSM employees. Examples of
regulations pertinent to CSUSM employees include California General Industry Safety
Orders, Title 8, Sections 5097, 5208, 5209 through 5216, 5217, 5218, 5220 and 5144. Title
3 of the California Code of Regulations, Sections 6728 and 6760, are pertinent to
pesticide workers. Code of Federal Regulations 29, parts 1910 and 1920, mandate
comprehensive medical examinations for employees involved in hazardous waste operations
and emergency response. The comparable state regulation, Title 8, CCR, Section 5192, has
been finalized. Title 17 of the CCR, Section 30277, deals with radiation protection, and
each user may be required to undergo bio-assays and medical review. Recently, biological
hazards have been addressed in CFR 1910.1030. The state regulation dealing with biohazards
is addressed in Title 8, CCR, Section 5231. Title 8 CCR sections 5193 and 5194 address
some areas relating to biohazards. No specific regulations are promulgated regarding
animal handlers, but medical monitoring programs are recommended by the National
Institutes of Health. Regulations have also been promulgated by CAL/OSHA for employees
operating video display terminals. Commercial drivers medical monitoring programs are
located in 49 CFR, Part 391.
Appendix A contains an evaluation of the following
regulations, including a synopsis of the medical monitoring requirement.
Occupational Noise 8 CCR 5097
Hazardous Waste Workers 8 CCR 5192
Respirator User 8 CCR 5144
Laboratories 8 CCR 5191
Carcinogens 8 CCR 5209
Asbestos 8 CCR 5208
Vinyl Chloride 8 CCR 5210
Acrylonitrile 8 CCR 5213
Lead 8 CCR 5216
Formaldehyde 8 CCR 5217
Benzene 8 CCR 5218
Ethylene Oxide 8 CCR 5220
Divers 8 CCR 6053
Pesticides and Pest
Control Operations 3 CCR 6728, 6760
Ionizing Radiation 17 CCR 30277
Animal Handlers No Regulation
Biohazards 8 CCR 5231 (proposed), 8CCR 5193,5194 (CFR 1910 1030)
Fetal Protection No Regulation
Commercial Drivers 49CFR, Part 391
In addition to regulations mandating medical monitoring,
other regulations exist dealing with confidentiality and access to medical records. A
complete understanding and knowledge of these regulations is required for the
Environmental Health and Occupational Safety personnel administering an employee medical
monitoring program. The personnel of Human Resources Management will manage the health
records. A synopsis of Title 8, CCR, Section 3204, Access to Employee Exposure and Medical
Records, and a complete copy of the regulation, are provided in Appendix A.
RECORDKEEPING AND CONFIDENTIALITY
An important part of the Employee Medical Monitoring
Program is the confidentiality of the medical information generated by the program. This
program has been carefully designed to ensure that the medical information for individual
employees be made available only to medical professionals (including medical record
keeping personnel and the employee). Specifically, individual medical information is not
available to CSUSM management personnel, and, in the absence of a subpoena, will not be
made available to any person other than the employee or his/her designated representative,
and authorized representatives of State and Federal Regulatory Agencies, e.g., Cal
To maintain the confidentiality of the data, while at the
same time ensuring that all information is thoroughly evaluated, review of all the medical
records generated by the Medical Monitoring Program and the employees' work exposure
histories, will be conducted by the contract medical provider contracted to CSUSM. To
ensure that the examinations are complete and that any possible correlation between work
exposures and adverse health effects are thoroughly investigated. The contract medical
provider will forward records to HRM, who will archive all the employee medical records in
locked file cabinets for the duration of employment. Once the employment ceases, the
records are forwarded to the Chancellor's office, per CSU Employee Medical Monitoring
Program Manual, for permanent storage for at least 30 years.
To ensure that the employee has a complete understanding
of these confidentiality procedures and the limited uses that will be made of the
employee's medical data, each CSUSM employee enrolled in the Medical Monitoring Program is
given an Authorization to Release Medical Information Form (Form EHS-003). Employees are
asked to sign the form before beginning an exam. The signed authorization form authorizes
the medical clinic to send the medical records to HREO.
Often, an employee may have undergone a previous medical
examination. This information may be of value to the physician performing the exam. If the
employee authorizes, copies of these old records may be obtained. Form EHS-004,
Authorization to Release Previous Medical Information, is to be used for this purpose.
FORMS AND INSTRUCTIONS
There are a number of forms for use in the CSUSM Employee
Medical Monitoring Program:
Employee Medical Monitoring Exam Appointment Form
This form (EHS-001) is completed by
RM&S when the
monitoring examination is scheduled. The form indicates the date, time, and location of
the medical examination. A copy of this form is forwarded to HREO by RM&S so the
record custodian knows when to anticipate other documents.
Medical Monitoring Pre-Exam Instructions Form
This form (EHS-002) explains the pre-examination form
completion and dietary instructions.
Authorization to Release Medical Information Form
This form (EHS-003) is prepared and signed by the
employee, and is used to facilitate a release of the patient's physical examination to HREO
(medical record custodian).
Authorization to Release Previous Medical Information Form
This form (EHS-004) is prepared and signed by the employee
and will be (if requested) utilized by the present examining physician to gain information
about an employee's past exposure history.
Occupational/Medical History Questionnaire Form
Prior to going for the examination, the employee shall
complete the medical questionnaire (Form EHS-005). This questionnaire contains demographic
information and the Pre-Assignment Evaluation Form. This form summarizes exposures or
anticipated exposures that the employee may incur. It is completed by the employee and the
employee's supervisor. It also serves to notify the examining physician of any tests
required in addition to the core panel.
This questionnaire is used for pre-placement, annual, and
Medical Examination Form
The form (EHS-006) is to be brought to the medical
clinic and completed by the examining physician. It shows
the results of the examining physician's physical examination, and includes an area for
notation of the vital signs, urinalysis results, visual acuity results, and evaluation of
the upper extremities and the lumbosacral spine.
Health Status Medical Report Form
This form (EHS-007) is brought to the medical clinic, by
the employee. The examining physician will evaluate all the examination data and forward
the completed form to RM&S, whose responsibility is to ensure compliance with
recommendations. Copies of this form, the questionnaire and the other exam results are
forwarded to the medical records custodian in HREO by the examining physician.
Employee Medical Exam Findings Form
This form (EHS-008) will be completed by the examining
physician. This form is sent directly to the employee along with copies of the medical
findings and recommendations.
Public Safety Officer Medical Report
This form (EHS-009) is to be completed by
Officer prior to being seen by physician.
Commercial Drivers License Form
The form DL51 (Medical Examination Report) and form DL51A
(Medical Examiner's Certificate) are utilized for this program. The required medical exam
items are listed on the form.