It is currently being proposed that this requirement be deleted from the medical surveillance requirements. There is a requirement for a semi-annual sputum cytology examination for employees 45 years of age or older or with ten or more years of exposure over the action level. If you have any questions please contact the Office of Health Compliance Assistance or the Office of Occupational Medicine at (202) 219-8036 or 219-5003, respectively.ĭirector Directorate of Compliance Programs The Agency does not believe it is appropriate to require sputum cytology in the surveillance of these workers, although it may be useful on a case by case basis for clinical management.īased upon the above information, CSHOs encountering inspection situations where semiannual chest X-rays and/or sputum cytology tests were not conducted in accordance with the requirements of the respective standards shall not issue citations for these elements provided:ġ) All other elements of the required medical examinations were provided, andĢ) at least annual chest X-rays were being provided to affected workers in lieu of semiannual chest X-rays. The Agency believes that the role of chest X-rays in the surveillance of high risk populations would be appropriately served if conducted annually instead of every six-months.Ī review of the literature on recommended medical practice does not support the use of sputum cytology as an effective means of enhancing the early detection of lung cancer in workers exposed to arsenic or coke oven emissions. Regarding the frequency of chest X-rays, the literature does not support the current provisions in the arsenic and coke oven emission standards with respect to semiannual X-ray tests. The following interim guidance is provided pending completion of the rulemaking on this matter.
Based upon the review the Agency has proposed to modify those two elements as discussed above. OSHA has conducted a review and evaluation of the literature and current medical practices concerning the two elements. 1018(n)(2)(ii)(C) calls for annual sputum cytology, and sputum cytology every six months if the exposed employee is over the age of 45, and has been exposed over the action level for more than 10 years (5 or more years if employed in a regulated area under the.
1018(n)(3)(ii) calls for annual chest X-rays, and X-rays every six months if the exposed employee is over the age of 45, and has been exposed over the action level for more than 10 years (5 or more years if employed in a regulated area under the. Specifically, those standards currently call for medical examinations which contain elements that may not be the best recommended medical practice.ġ. These concerns are addressed in a July 22nd, 1996 Federal Register Notice (Volume 61 page 37849) in which the Agency has proposed to eliminate required sputum cytology testing and reduce required X-ray examinations from every six months to annually for both standards. These same problems are also applicable to our Coke Oven Standard found in. Your concerns involved the chest X-ray and sputum cytology requirements under the medical surveillance section of the Arsenic standard (.1018). This letter is in response to your letter dated April 22, 1996, originally sent to the OSHA Boston Regional Office.
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