lead exposure for construction. health hazards of lead exposure v pure lead (pb) is a heavy metal...

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Lead Exposure Lead Exposure for for Construction Construction

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Lead Exposure for Lead Exposure for ConstructionConstruction

Health hazards of lead Health hazards of lead exposureexposure

Pure lead (Pb) is a heavy metal Pure lead (Pb) is a heavy metal and a chemical elementand a chemical element

Lead can combine with other Lead can combine with other chemicals to form numerous lead chemicals to form numerous lead compoundscompounds

Lead can enter the body by Lead can enter the body by inhalation and ingestioninhalation and ingestion

1a

Health hazards of lead Health hazards of lead exposureexposure

Only a few lead compounds can be Only a few lead compounds can be absorbed through the skinabsorbed through the skin

When scattered through the air as When scattered through the air as a dust, fume, or mist, lead can be a dust, fume, or mist, lead can be inhaled and absorbed through the inhaled and absorbed through the lungs and upper respiratory tractlungs and upper respiratory tract

1b

Health hazards of lead Health hazards of lead exposureexposure

Inhalation of airborne lead is Inhalation of airborne lead is generally the most important generally the most important source of occupational lead source of occupational lead absorptionabsorption

Lead also can be absorbed through Lead also can be absorbed through the digestive system if it enters the digestive system if it enters the mouth and is ingestedthe mouth and is ingested

1c

Health hazards of lead Health hazards of lead exposureexposure

The lead stored in the tissues can The lead stored in the tissues can slowly cause irreversible damage slowly cause irreversible damage to:to:• individual cellsindividual cells• organsorgans• whole body systemswhole body systems

1d

Health hazards of lead Health hazards of lead exposureexposure

Lead causes health problems and Lead causes health problems and disease after exposure periods:disease after exposure periods:• as short as days (acute exposure)as short as days (acute exposure)• as long as several years (chronic as long as several years (chronic

overexposure). overexposure).

1e

Health hazards of lead Health hazards of lead exposureexposure

A short-term dose of lead exposure A short-term dose of lead exposure can lead to acute encephalopathy, can lead to acute encephalopathy, a condition affecting the brain that a condition affecting the brain that develops quickly into:develops quickly into:• seizuresseizures• comacoma• death from cardiorespiratory arrestdeath from cardiorespiratory arrest

1f

Health hazards of lead Health hazards of lead exposureexposure

Central nervous system damage is Central nervous system damage is one of the most severe forms of one of the most severe forms of lead poisoninglead poisoning

Long-term (chronic) overexposure Long-term (chronic) overexposure to lead may damage the blood-to lead may damage the blood-forming, nervous, urinary, and forming, nervous, urinary, and reproductive systemsreproductive systems

1g

Health hazards of lead Health hazards of lead exposureexposure

Read the MSDS and the container’s Read the MSDS and the container’s label when you use any product label when you use any product that contains leadthat contains lead

1h

Potential for exposurePotential for exposure

You may be exposed to lead if You may be exposed to lead if you perform activities like:you perform activities like:• abrasive blastingabrasive blasting• sandingsanding• scrapingscraping• cuttingcutting• burningburning• weldingwelding• paintingpainting

2a

Potential for exposurePotential for exposure

Operations that generate lead dust Operations that generate lead dust and fumes include:and fumes include:• flame-torch cutting, welding, the use flame-torch cutting, welding, the use

of heat guns, sanding, scraping and of heat guns, sanding, scraping and grinding of grinding of lead painted lead painted surfacessurfaces

2b

Potential for exposurePotential for exposure

Operations that generate lead dust Operations that generate lead dust and fumes include:and fumes include:• abrasive blasting of bridges and other abrasive blasting of bridges and other

structures containing lead-based structures containing lead-based paintspaints

• maintaining process equipment or maintaining process equipment or exhaust duct workexhaust duct work

2c

OSHA’s standard on leadOSHA’s standard on lead

Lead includes metallic lead, all Lead includes metallic lead, all inorganic lead compounds, and inorganic lead compounds, and organic lead soapsorganic lead soaps

Applies to all construction work Applies to all construction work where an employee may be where an employee may be exposed to lead on the jobexposed to lead on the job

3a

OSHA’s standard on leadOSHA’s standard on lead

Under the standard, construction Under the standard, construction includes the following:includes the following:

Demolition or salvage of structures Demolition or salvage of structures where lead or materials containing where lead or materials containing lead are presentlead are present

Removal or encapsulation of Removal or encapsulation of materials containing leadmaterials containing lead

3b

OSHA’s standard on leadOSHA’s standard on lead

New construction, alteration, New construction, alteration, repair, or renovation where lead is repair, or renovation where lead is presentpresent

Installation of products containing Installation of products containing leadlead

Lead contamination from Lead contamination from emergency cleanupemergency cleanup

3c

OSHA’s standard on leadOSHA’s standard on lead

Transportation, disposal, storage, Transportation, disposal, storage, or containment of lead or materials or containment of lead or materials containing leadcontaining lead

Maintenance operations associated Maintenance operations associated with construction activities with construction activities described abovedescribed above

3d

OSHA’s standard on leadOSHA’s standard on lead

The standard includes The standard includes requirements for:requirements for:

3e

OSHA’s standard on leadOSHA’s standard on lead

Exposure limitsExposure limits Exposure assessmentExposure assessment Methods of complianceMethods of compliance Respiratory protectionRespiratory protection Protective work clothing and Protective work clothing and

equipmentequipment HousekeepingHousekeeping

3f

Hygiene facilities and practicesHygiene facilities and practices Medical surveillanceMedical surveillance Medical removal protectionMedical removal protection Employee Information and trainingEmployee Information and training SignsSigns RecordkeepingRecordkeeping Observation of monitoringObservation of monitoring

OSHA’s standard on leadOSHA’s standard on lead

3g

OSHA’s standard on leadOSHA’s standard on lead

Appendices that contain helpful Appendices that contain helpful information about lead’s hazards information about lead’s hazards include:include:• Appendix A - Substance Data Sheet for Appendix A - Substance Data Sheet for

Occupational Exposure to LeadOccupational Exposure to Lead• Appendix B - Employee Standard Appendix B - Employee Standard

SummarySummary• Appendix C - Medical Surveillance Appendix C - Medical Surveillance

GuidelinesGuidelines

3h

Permissible exposure limit Permissible exposure limit (PEL)(PEL)

The PEL is the limit of airborne The PEL is the limit of airborne lead to which you can be exposedlead to which you can be exposed

The PEL is 50 micrograms of lead The PEL is 50 micrograms of lead per cubic meter of air averaged per cubic meter of air averaged over an 8-hour workdayover an 8-hour workday

4a

Permissible exposure limit Permissible exposure limit (PEL)(PEL)

Short exposures above 50 Short exposures above 50 micrograms per cubic meter are micrograms per cubic meter are permitted if each 8-hour work day permitted if each 8-hour work day your average exposure does not your average exposure does not exceed this levelexceed this level

4b

Permissible exposure limit Permissible exposure limit (PEL)(PEL)

Daily exposure to lead can extend Daily exposure to lead can extend beyond a typical 8-hour workday if:beyond a typical 8-hour workday if:• you work overtimeyou work overtime• have other alterations in your work have other alterations in your work

scheduleschedule

4c

Permissible exposure limit Permissible exposure limit (PEL)(PEL)

The standard contains a formula The standard contains a formula that calculates how much your that calculates how much your exposure needs to be reduced exposure needs to be reduced when you are exposed more than when you are exposed more than 8 hours8 hours

4d

Assessing the exposure Assessing the exposure levellevel

Employers must make an initial Employers must make an initial determination of whether any determination of whether any employee’s exposure to lead employee’s exposure to lead exceeds the standard’s action levelexceeds the standard’s action level

An action level is the level at which An action level is the level at which an employer must begin certain an employer must begin certain compliance activitiescompliance activities

5a

Assessing the exposure Assessing the exposure levellevel

The action level is an airborne The action level is an airborne concentration of 30 micrograms concentration of 30 micrograms per cubic meter calculated as an per cubic meter calculated as an eight-hour TWAeight-hour TWA

Respirators are not considered Respirators are not considered when the action level is being when the action level is being assessedassessed

5b

Assessing the exposure Assessing the exposure levellevel

Initial determination and results Initial determination and results must be made available based on must be made available based on the following:the following:• Any information, observation, or Any information, observation, or

calculation that indicates employee calculation that indicates employee exposure to leadexposure to lead

• Any previous measurements of Any previous measurements of airborne leadairborne lead

5c

Assessing the exposure Assessing the exposure levellevel

Initial determination and results Initial determination and results must be made available based on must be made available based on the following:the following:• Any employee complaints of Any employee complaints of

symptoms attributable to lead symptoms attributable to lead exposureexposure

• Objective data regarding materials, Objective data regarding materials, processes, or operationsprocesses, or operations

5d

Assessing the exposure Assessing the exposure levellevel

For the initial determination, a For the initial determination, a representative number of representative number of employees may be monitoredemployees may be monitored

5e

When exposure results are When exposure results are not yet availablenot yet available

Employers must provide protection Employers must provide protection if you are performing certain tasks if you are performing certain tasks before the results of the exposure before the results of the exposure assessment are knownassessment are known

6a

When exposure results are When exposure results are not yet availablenot yet available

During certain tasks, until tests During certain tasks, until tests show that your exposure level is show that your exposure level is not above the PEL, you will need:not above the PEL, you will need:• respiratory protectionrespiratory protection• protective clothing and equipmentprotective clothing and equipment• change areaschange areas

6b

When exposure results are When exposure results are not yet availablenot yet available

During certain tasks, until tests During certain tasks, until tests show that your exposure level is show that your exposure level is not above the PEL, you will need:not above the PEL, you will need:• hand washing facilitieshand washing facilities• biological monitoringbiological monitoring• trainingtraining

6c

Monitoring requirementsMonitoring requirements

If the initial determination proves If the initial determination proves that exposure is below the action that exposure is below the action level:level:• testing does not need to be repeated testing does not need to be repeated

unless there is a change in processes unless there is a change in processes or controlsor controls

7a

Monitoring requirementsMonitoring requirements

If employee exposure is at or If employee exposure is at or above the action level, but at or above the action level, but at or below the PEL:below the PEL:• air monitoring tests must be air monitoring tests must be

performed at least every six months performed at least every six months until at least two consecutive until at least two consecutive measurements (taken at least seven measurements (taken at least seven days apart) are below the action leveldays apart) are below the action level

7b

Monitoring requirementsMonitoring requirements

If employee exposure is above the If employee exposure is above the PEL, monitoring must:PEL, monitoring must:• be performed quarterlybe performed quarterly• continue until at least two continue until at least two

consecutive measurements (taken at consecutive measurements (taken at least seven days apart) are at or least seven days apart) are at or below the PELbelow the PEL

7c

Monitoring requirementsMonitoring requirements

Additional monitoring is needed if Additional monitoring is needed if there are changes to:there are changes to:• equipmentequipment• processesprocesses• controlscontrols• personnelpersonnel• tasks that could increase exposuretasks that could increase exposure

7d

Monitoring requirementsMonitoring requirements

Affected employees can observe Affected employees can observe monitoringmonitoring

Employers must notify you in Employers must notify you in writing within 5 working days of writing within 5 working days of the air monitoring resultsthe air monitoring results

7e

Monitoring requirementsMonitoring requirements

If the results indicate that your If the results indicate that your exposure exceeds the PEL, exposure exceeds the PEL, information regarding corrective information regarding corrective actions must be providedactions must be provided

7f

Written compliance Written compliance programsprograms

Compliance programs are required Compliance programs are required before starting any job where before starting any job where employee exposures may reach employee exposures may reach the PEL as an 8-hour TWAthe PEL as an 8-hour TWA

8a

Written compliance Written compliance program includes:program includes:

A description of each activity in A description of each activity in which lead is emittedwhich lead is emitted

Specific plans to achieve Specific plans to achieve compliancecompliance

8b

Written compliance Written compliance program includes:program includes:

Information on the technology Information on the technology considered to meet the PELconsidered to meet the PEL

Air monitoring data that Air monitoring data that documents the documents the source of lead source of lead emissionsemissions

8c

Written compliance Written compliance program includes:program includes:

A detailed schedule for A detailed schedule for implementing the programimplementing the program

A work practice programA work practice program

An administrative An administrative control schedule control schedule for job rotationfor job rotation

8d

Written compliance Written compliance program includes:program includes:

A description of arrangements A description of arrangements made among contractors on multi-made among contractors on multi-contractor sites to inform affected contractor sites to inform affected employees of potential lead employees of potential lead exposureexposure

Any other relevant Any other relevant informationinformation

8e

Written compliance Written compliance programsprograms

The compliance program must The compliance program must provide for frequent and regular provide for frequent and regular inspections of:inspections of:• job sitesjob sites• materialsmaterials• equipmentequipment

8f

Control measures to Control measures to reduce exposuresreduce exposures

Employees must not be exposed to Employees must not be exposed to lead in excess of the PEL as an 8-lead in excess of the PEL as an 8-hour TWAhour TWA

Minimize exposure through the use Minimize exposure through the use of engineering controls and work of engineering controls and work practicespractices

9a

Control measures to Control measures to reduce exposuresreduce exposures

Respirators are not to be used in Respirators are not to be used in lieu of engineering and work lieu of engineering and work practices to reduce employee practices to reduce employee exposuresexposures

Respirators can only be used in Respirators can only be used in combination with engineering combination with engineering controls and work practices to controls and work practices to control employee exposurescontrol employee exposures

9b

Control measures to Control measures to reduce exposuresreduce exposures

All feasible engineering controls All feasible engineering controls and work practices must be in and work practices must be in place if they are not place if they are not sufficient to reduce sufficient to reduce exposure to or below exposure to or below the PELthe PEL

9c

Control measures to Control measures to reduce exposuresreduce exposures

Engineering controls reduce Engineering controls reduce employee exposure in the employee exposure in the workplace either by:workplace either by:• removing or isolating the hazardremoving or isolating the hazard• isolating the worker from exposure isolating the worker from exposure

through the use of technologythrough the use of technology

9d

Control measures to Control measures to reduce exposuresreduce exposures

Work practice controls reduce the Work practice controls reduce the likelihood of exposure by altering likelihood of exposure by altering the manner in the manner in which a task is which a task is performedperformed

9e

Engineering controlsEngineering controls

Exhaust VentilationExhaust Ventilation

Enclosure/EncapsulationEnclosure/Encapsulation

SubstitutionSubstitution

10a

Engineering controlsEngineering controls

Component ReplacementComponent Replacement

Process/Equipment ModificationProcess/Equipment Modification

IsolationIsolation

10b

Housekeeping as a Housekeeping as a work practice controlwork practice control

Housekeeping is an important work Housekeeping is an important work practice controlpractice control

Accumulations of lead dust and Accumulations of lead dust and lead-containing debris must be lead-containing debris must be removed at least dailyremoved at least daily

11a

Housekeeping as a Housekeeping as a work practice controlwork practice control

Vacuuming lead dust with filtered Vacuuming lead dust with filtered equipment (HEPA) or wetting it equipment (HEPA) or wetting it with water before sweeping are with water before sweeping are effective control measureseffective control measures

Conduct cleaning operations at the Conduct cleaning operations at the end of the dayend of the day

11b

Housekeeping as a Housekeeping as a work practice controlwork practice control

Use suitable respiratory protection Use suitable respiratory protection and personal protective clothing and personal protective clothing during cleanupduring cleanup

11c

Housekeeping as a Housekeeping as a work practice controlwork practice control

Place lead-containing debris and Place lead-containing debris and contaminated items into:contaminated items into:• sealed impermeable bagssealed impermeable bags• other closed impermeable containersother closed impermeable containers

11d

Housekeeping as a Housekeeping as a work practice controlwork practice control

Bags and containers should be Bags and containers should be appropriately labeled as lead-appropriately labeled as lead-containing wastecontaining waste

11e

Personal hygiene as work Personal hygiene as work practice controlspractice controls

Hand washing facilities must be Hand washing facilities must be provided where occupational provided where occupational exposure to lead occursexposure to lead occurs

12a

Change areas, showers, and Change areas, showers, and lunchrooms are to be made lunchrooms are to be made available to workers exposed to available to workers exposed to lead above lead above the PELthe PEL

Personal hygiene as work Personal hygiene as work practice controlspractice controls

12b

Personal hygiene as work Personal hygiene as work practice controlspractice controls

Lunchrooms or eating areas may Lunchrooms or eating areas may not be entered unless you have not be entered unless you have removed any surface dust from removed any surface dust from your protective clothing or your protective clothing or equipmentequipment

12c

Personal hygiene as work Personal hygiene as work practice controlspractice controls

Change rooms must have separate Change rooms must have separate storage facilities for your storage facilities for your protective clothing and equipment protective clothing and equipment and street clothesand street clothes

12d

Personal hygiene as work Personal hygiene as work practice controlspractice controls

Work clothing and protective Work clothing and protective equipment must not be worn away equipment must not be worn away from the job sitefrom the job site

Where showers are not provided, Where showers are not provided, employees exposed to lead above employees exposed to lead above the PEL must wash their hands and the PEL must wash their hands and face at the end of the workshiftface at the end of the workshift

12e

Administrative controlsAdministrative controls

Administrative controls reduce Administrative controls reduce employee exposure by removing employee exposure by removing the employee from the hazardthe employee from the hazard

If administrative controls are being If administrative controls are being used, the employer must establish used, the employer must establish and implement a job rotation and implement a job rotation scheduleschedule

13a

Administrative controlsAdministrative controls

The program must:The program must:• identify each affected employeeidentify each affected employee• specify the duration and exposure specify the duration and exposure

level at each job or work stationlevel at each job or work station• include other useful informationinclude other useful information

The job rotation schedule must be The job rotation schedule must be included in the written compliance included in the written compliance planplan

13b

Respirator requirementsRespirator requirements

Employers must provide respiratory Employers must provide respiratory protection, at no cost to protection, at no cost to employees, and must ensure its employees, and must ensure its use when:use when:

14a

employee exposure to lead employee exposure to lead exceeds the PELexceeds the PEL

engineering and work practice engineering and work practice controls are not controls are not sufficient to reduce sufficient to reduce exposure levels to or exposure levels to or below the PELbelow the PEL

14b

Respirator requirementsRespirator requirements

Respirator requirementsRespirator requirements

an employee requests a respiratoran employee requests a respirator

interim protection is interim protection is needed for employees performing needed for employees performing some some tasks before tasks before exposure results exposure results are availableare available

14c

Respirator requirementsRespirator requirements

Respiratory protection program Respiratory protection program must be in accordance with 29 CFR must be in accordance with 29 CFR 1910.1341910.134

Respirators must be Respirators must be selected according to selected according to the standard’s the standard’s Table 1Table 1

14d

Respirator requirementsRespirator requirements

Employer must provide a powered-Employer must provide a powered-air purifying respirator when an air purifying respirator when an employee chooses to use oneemployee chooses to use one

If an employee has breathing If an employee has breathing difficulty during fit testing or difficulty during fit testing or respirator use, a medical respirator use, a medical examination must be performedexamination must be performed

14e

Protective clothing and Protective clothing and equipmentequipment

Employers must provide protective Employers must provide protective work clothing and equipment at no work clothing and equipment at no cost if you are exposed to lead:cost if you are exposed to lead:• above the PEL as an above the PEL as an

8-hour TWA8-hour TWA• compounds that can compounds that can

cause skin and eye cause skin and eye irritationirritation

15a

Protective clothing and Protective clothing and equipmentequipment

Appropriate protective work Appropriate protective work clothing and equipment can clothing and equipment can include:include:• coveralls or similar full-body work coveralls or similar full-body work

clothingclothing• glovesgloves• hatshats

15b

Protective clothing and Protective clothing and equipmentequipment

Appropriate protective work Appropriate protective work clothing and equipment can clothing and equipment can include:include:• shoes or disposable shoes or disposable

shoe coverletsshoe coverlets• face shields or vented face shields or vented

gogglesgoggles

15c

Protective clothing and Protective clothing and equipmentequipment

Clean protective clothing must be Clean protective clothing must be provided at least weeklyprovided at least weekly

Clothing must be provided daily if Clothing must be provided daily if your airborne exposure to lead is your airborne exposure to lead is greater than 200 micrograms per greater than 200 micrograms per cubic metercubic meter

15d

Protective clothing and Protective clothing and equipmentequipment

Employers are responsible for Employers are responsible for repairs, replacement, cleaning, repairs, replacement, cleaning, laundering, and disposallaundering, and disposal

15e

Protective clothing and Protective clothing and equipment – enteringequipment – entering

Change into work clothing and Change into work clothing and shoe covers in the clean section of shoe covers in the clean section of the designated changing areasthe designated changing areas

Use work garments and protective Use work garments and protective gear before entering the lead work gear before entering the lead work areaarea

15f

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

HEPA vacuum heavily HEPA vacuum heavily contaminated protective work contaminated protective work clothing while it is still being wornclothing while it is still being worn

Remove shoe covers and Remove shoe covers and disposable garmentsdisposable garments

15g

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

Leave shoe covers in the lead work Leave shoe covers in the lead work area where they will be collected area where they will be collected for disposalfor disposal

Remove protective clothing and Remove protective clothing and gear in the dirty area of the gear in the dirty area of the designated changing areadesignated changing area

15h

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

Remove reusable protective Remove reusable protective coveralls by carefully rolling down coveralls by carefully rolling down the garment to reduce your the garment to reduce your exposure to dustexposure to dust

Remove respirators lastRemove respirators last

Wash hands and faceWash hands and face

15i

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

Where applicable, place disposable Where applicable, place disposable coveralls and shoe covers with the coveralls and shoe covers with the abatement wasteabatement waste

Contaminated clothing which is to Contaminated clothing which is to be cleaned, laundered or disposed be cleaned, laundered or disposed of must be placed in closed of must be placed in closed containers in the change roomcontainers in the change room

15j

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

Clean protective gear, including Clean protective gear, including respirators, according to standard respirators, according to standard proceduresprocedures

Wash hands and face again.Wash hands and face again.

15k

Protective clothing and Protective clothing and equipment - leavingequipment - leaving

If showers are available, take a If showers are available, take a shower and wash your hairshower and wash your hair

If shower facilities are not available If shower facilities are not available at the work site, shower at the work site, shower immediately at homeimmediately at home

15l

Protective clothing and Protective clothing and equipmentequipment

Containers of contaminated clothing must Containers of contaminated clothing must be labeled with the following warning:be labeled with the following warning:

15m

Protective clothing and Protective clothing and equipmentequipment

Inform the people who are Inform the people who are responsible for handling or responsible for handling or laundering contaminated clothing laundering contaminated clothing in writing about the potential in writing about the potential hazardshazards

15n

Warning signsWarning signs

Post the following warning sign in Post the following warning sign in work areas where the exposure to work areas where the exposure to lead exceeds the PEL:lead exceeds the PEL:

16a

Warning signsWarning signs

All signs must be well lit and kept All signs must be well lit and kept clean so that they are easily visibleclean so that they are easily visible

16b

Medical surveillanceMedical surveillance

Medical surveillance program Medical surveillance program supplements the procedures that supplements the procedures that minimize exposure to leadminimize exposure to lead

Medical surveillance determines if Medical surveillance determines if the other provisions of the the other provisions of the standard have protected the standard have protected the workersworkers

17a

Medical surveillanceMedical surveillance

Medical surveillance involves Medical surveillance involves having periodic blood tests and having periodic blood tests and may also include medical may also include medical examinationsexaminations

The frequency of the testing The frequency of the testing depends on your exposure, and depends on your exposure, and previous blood test resultsprevious blood test results

17b

Medical surveillanceMedical surveillance

The provision for having medical The provision for having medical examinations depends on:examinations depends on:• your exposureyour exposure• blood test resultsblood test results• the development of symptoms of the development of symptoms of

overexposureoverexposure

17c

Medical surveillanceMedical surveillance

Blood samplingBlood sampling

Medical examsMedical exams

Multiple physician reviewMultiple physician review

ChelationChelation

17d

Medical removal Medical removal protection benefitsprotection benefits

Medical removal protects worker Medical removal protects worker health by:health by:• stopping further occupational stopping further occupational

exposureexposure• enabling the worker to excrete the enabling the worker to excrete the

absorbed lead naturallyabsorbed lead naturally

18a

Medical removal Medical removal protection benefitsprotection benefits

Employers must remove Employers must remove employees with lead exposure at employees with lead exposure at or above the action level each or above the action level each time:time:

18b

Medical removal Medical removal protection benefitsprotection benefits

a periodic and follow-up blood a periodic and follow-up blood sampling test indicates a blood sampling test indicates a blood lead level at or above 50 lead level at or above 50 micrograms per decilitermicrograms per deciliter

a final medical determination a final medical determination indicates a detected medical indicates a detected medical condition that increases health condition that increases health risks from lead exposurerisks from lead exposure

18c

Medical removal Medical removal protection benefitsprotection benefits

Employers must provide up to 18 Employers must provide up to 18 months of medical removal months of medical removal protection benefits each time an protection benefits each time an employee is removed from lead employee is removed from lead exposureexposure

18d

Medical removal Medical removal protection benefitsprotection benefits

As long as the position/job exists, As long as the position/job exists, the employer must maintain the:the employer must maintain the:• earningsearnings• seniorityseniority• other employment rights and benefitsother employment rights and benefits

18e

Medical removal Medical removal protection benefitsprotection benefits

Employers must return employees Employers must return employees to their former job status when:to their former job status when:• two consecutive blood sampling tests two consecutive blood sampling tests

indicate a blood lead level is at or indicate a blood lead level is at or below 40 micrograms per deciliter for below 40 micrograms per deciliter for employees removed due to a blood employees removed due to a blood lead level at or above 50 micrograms lead level at or above 50 micrograms per deciliterper deciliter

18f

Medical removal Medical removal protection benefitsprotection benefits

Employers must return employees Employers must return employees to their former job status when:to their former job status when:• a subsequent final medical a subsequent final medical

determination indicates there is no determination indicates there is no longer a detected medical condition longer a detected medical condition that increases health risks from lead that increases health risks from lead exposureexposure

18g

Medical removal Medical removal protection benefitsprotection benefits

If a removed employee files a If a removed employee files a worker’s compensation claim for a worker’s compensation claim for a lead-related disability, employers lead-related disability, employers must continue medical removal must continue medical removal protection benefits pending the protection benefits pending the disposition of the claimdisposition of the claim

18h

Medical removal Medical removal protection benefitsprotection benefits

When the multiple physicians’ When the multiple physicians’ review has not yet resulted in a review has not yet resulted in a final medical determination, the final medical determination, the employer must:employer must:

18i

Medical removal Medical removal protection benefitsprotection benefits

remove employees from lead remove employees from lead exposureexposure

provide special protective provide special protective measuresmeasures

place limitations on employeesplace limitations on employees

18j

Medical removal Medical removal protection benefitsprotection benefits

return employees to their former return employees to their former job statusjob status

end special protective measuresend special protective measures

remove limitationsremove limitations

18k

RecordkeepingRecordkeeping

Employers must establish and Employers must establish and maintain an accurate record of:maintain an accurate record of:• all required monitoring and other data all required monitoring and other data

used to conduct employee exposure used to conduct employee exposure assessmentsassessments

19a

RecordkeepingRecordkeeping

Employers must establish and Employers must establish and maintain an accurate record of:maintain an accurate record of:• any objective data relied on to any objective data relied on to

determine initial exposure if it was determine initial exposure if it was used in lieu of exposure monitoring used in lieu of exposure monitoring for exposure assessment purposesfor exposure assessment purposes

19b

RecordkeepingRecordkeeping

Employers must establish and Employers must establish and maintain an accurate record of:maintain an accurate record of:• information and medical records for information and medical records for

each employee subject to medical each employee subject to medical surveillancesurveillance

• each employee subject to medical each employee subject to medical removalremoval

19c

RecordkeepingRecordkeeping

Employer must make all records Employer must make all records available upon request to:available upon request to:• affected employeesaffected employees• former employees designated former employees designated

representativesrepresentatives

19d