Medical Surveillance Programs

Medical Surveillance

  • Bloodborne Pathogens Program

    Employees with potential for exposure to human blood or other potentially infectious materials must be offered the hepatitis B vaccination in accordance with the Federal Occupational Safety Health Administration standard. Employees with potential for exposure must either accept or decline the 3-dose vaccination series. Upon acceptance of the vaccination series EH&S will provide a referral form to the employee. The employee is responsible for scheduling the vaccination with Specialty Health Clinic. The employees’ department is responsible for the payment of the 3-dose vaccination series.

    29 CFR 1910.1030

  • BSL-3 Laboratory Workers (Select Agents)

    Employees who have access to select agents or who work in a biosafety level 3 (BSL-3) laboratory must participate in a medical surveillance program. Specific medical monitoring requirements are not specified and depend on the agent(s) that are used, as determined by the attending physician.

    The Occupational Health Surveillance System UNR-OHSS will be used for BSL-3 Laboratory worker medical surveillance.

    • PI/Supervisors will complete electronic risk assessments for related staff.
    • Upon completion of the risk assessment the program participant will review and complete the required confidential health questionnaire.
    • The designated medical provider will review the risk assessment, participant questionnaire, and complete a medical assessment.
    • Program will review participant status, risk assessments, and add participants to IACUC or IBC Protocols as indicated.

    Frequency: On initial assignment, continual employment questionnaire every three years, when physical evaluation is warranted, consultation as needed, and response to suspected or known exposure incidents.

    The participants’ department will be responsible for payment of associated costs.

    CDC/NIH Biosafety in Microbiological and Biomedical Laboratories, NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules

    Personnel who work with biological agents must be informed that certain medical conditions may increase the risk of infection. Individuals who are immunocompromised, pregnant, or who have other conditions that may predispose them to infection, must be encouraged to self-identify to the occupational healthcare provider for medical counseling and guidance.

    The participants’ department will be responsible for payment of associated costs.

    42 CFR 73, 7 CFR 331, 9 CFR 121

  • Animal Handlers

    Personnel who work with vertebrate animals must participate in a medical surveillance program. This program is designed to protect faculty, students, and staff. It is required for compliance with the Standards set forth by AAALAC International, the Public Health Service, and the National Science Foundation and in some cases the Occupational Health and Safety Administration. This program is designed to comply with the provisions of the Guide for the Care and Use of Laboratory Animals, 8th edition (NRC, 2011), the Guide for the Care and Use of Agricultural Animals in Research and Teaching, 3rd edition (FASS, 2010) and the associated core reference text Occupational Health and Safety in the Care and Use of Research and Animals (NRC, 1997). Some animal workers will perform activities which are also subject to the provisions of the Respiratory Protection program.

    The Occupational Health Surveillance System UNR-OHSS will be used for Animal Handler medical surveillance.

    • PI/Supervisors will complete electronic risk assessments for identified staff.
    • Upon completion of the risk assessment the program participant will review and complete the required confidential health questionnaire.
    • The designated medical provider will review the risk assessment, participant questionnaire, and complete a medical assessment.
    • Program reviewer will review participant status, risk assessments, and add participants to IACUC as indicated.

    Frequency

    On initial assignment, continual employment questionnaire typically every three years, when physical evaluation is warranted, consultation as needed, and response to suspected or known exposure incidents.

    The participants’ department will be responsible for payment of associated costs. If additional vaccinations are recommended, but not required, participant should look to their own insurance for coverage.

  • Respiratory Protection

    Individuals who wear respiratory protective devices must be medically evaluated prior to wearing a respirator in accordance with the Federal Occupational Safety Health Administration standard.   Workers that want to voluntarily wear a respirator for comfort or personal reasons should consult Environmental Health and Safety for further guidance.

    Screening

    • BSL-3 Laboratory Workers and Animal Handlers who are required to wear respiratory protection will have a medical questionnaire completed through UNR-OHSS. Medical assessment will be completed through Specialty Health Clinic.
    • Other employees who are required to wear respiratory protection will complete a medical questionnaire through 3M Online Screening Program. Medical assessment will be completed by 3M physicians.
    • EH&S Industrial Hygienist will perform a fit test for each employee prior to them being permitted to wear a respirator.

    Medical Evaluation

    • Medical evaluation will be required and conducted by a Specialty Health Physician for any positive answer on the medical questionnaire, or when deemed necessary. The medical evaluation will consist of the following:
      • Physical Exam with an emphasis on respiratory and cardiovascular
      • Pulmonary Function Test (PFT)
      • Any other test deemed necessary by the physician
      • Physician statement to employer indicating medical clearance for the use of respirator.

    Frequency

    Upon initial assignment, annually, when work conditions change, health of the employee changes or other frequency determined by healthcare provider.

    The participants’ department will be responsible for payment of associated costs.

    29 CFR 1910.134

  • Asbestos

    Employees who have exposure that exceeds 0.1 fibers per cubic centimeter (f/cc) in air (8-hour time weighted limit) or 1 f/cc (30 minutes excursion limit), and those who perform asbestos abatement activities are required to participate in medical surveillance per the Occupational Health and Safety Administration.

    Medical Evaluation

    • Review of occupational and medical history
    • Inclusion in Respiratory Protection Program
    • Physical Exam with emphasis on respiratory, cardiovascular and digestive
    • 3 view chest x-ray (CXR) read by radiologist (ideally NIOSH Certified B-Reader radiologist)
    • Pulmonary Function Test (PFT)
    • Any other test deemed necessary by physician

    Frequency

    CXR every 5 years for exposures within last 10 years. CXR every 2 years if exposure was greater than 10 years ago. If the employee is over 45 year of age, CXR annually. CXR upon employee separation.

    The participants’ department will be responsible for payment of associated costs.

    29 CFR 1910.1001

  • Regulated Waste

    Employees who perform waste bulking operations in the Regulated Waste Program are required to participate in medical surveillance.

    Medical Evaluation

    • Participants medical and work history
    • Physical exam with emphasis on symptoms related to the handling of hazardous substances and health hazards
    • Fitness for duty including the ability to wear required PPE under extreme conditions (i.e., temperature extremes) that may be anticipated at the work site.

    Frequency

    • Once every 12 months unless treating physician believes a shorter or longer interval (not greater than biennially) is appropriate.
    • Upon termination or reassignment to an area where the employee will not be covered if the employee has not had an examination with the previous six months.
    • As soon as possible upon notification that the employee has developed signs or symptoms indicating possible overexposure to hazardous substances or health hazards.
    • Upon notification that the employee has been injured or exposed above permissible exposure limits or published exposure levels.

    Note: UNR does not have a HAZMAT team. An analysis of the regulations and operations were conducted and the result is that the spills that EH&S cleans up are small incidents not requiring use of respiratory protection. All large incidents are handled by Reno Fire and/or a hazardous waste contractor. This analysis was completed and documented through a Memo on File, dated January 10, 2017.

  • Respirable Crystalline Silica

    Employees who have exposure that exceeds airborne respirable crystalline silica of 25 μg/m3, (calculated as an 8-hour TWA) are required to use respiratory protection. If the employee is required to use a respirator for 30 days or more per year they will be required to participate in medical surveillance per the Occupational Health and Safety Administration.

    Medical Examination

    • Medical and work history with emphasis on: past, present, and anticipated exposure to respirable crystalline silica, dust, and other agents affecting the respiratory system.
    • Any dysfunction including signs and symptoms of respiratory disease, history of tuberculosis, and smoking status.
    • A physical examination with special emphasis on the respiratory system.
    • A chest X-ray interpreted and classified according to the International Labour Office (ILO) International Classification of Radiographs of Pneumoconiosis by a NIOSH-certified B Reader.
    • A pulmonary function test to include forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and FEV1/FVC ratio administered by a spirometry technician with a current certificate from a NIOSH-approved spirometry course.
    • Testing for latent tuberculosis infection.
    • Any other tests deemed appropriate by the PLHCP.

    Frequency: Initial exam is required within 30 days of initial assignment, unless the employee has received a medical examination that meets the requirement of this section within the previous three years. Periodic exams every three years or more frequently if recommended by the PLHCP.

    The participants’ department will be responsible for payment of associated costs.

    29 CFR 1910.1053