Ashley Clay, MSPAS
PA-C Medcor Provider
Medical surveillance is the systematic approach your employer takes to ensure a safe workplace that is free of occupational (job-related) hazards. This approach evaluates the effectiveness of safety measures that are in place to keep employees from adverse health effects related to potential hazards at work. Medical surveillance programs focus on prevention. Prevention is a critical component of effective worksite health and safety programs and training. Medical surveillance helps employers and employees see that the safety measures that have been put in place are effective; it also alerts businesses if there is a problem so that corrective actions can be taken.
What kinds of exposures does medical surveillance monitor?
The Occupational Safety and Health Administration (OSHA) has established numerous standards that govern medical surveillance of potential physical or chemical hazards in general industry, construction, and maritime. Surveillance programs may monitor exposure to hazards like occupational noise levels, crystalline silica dust, cotton dust, blood borne pathogens, hazardous waste, and toxic substances (arsenic, asbestos, coke oven emissions, hexavalent chromium, lead, etc.).
Some employers may have site-specific surveillance programs unique to their organizations that monitor other potential hazards or unregulated chemicals.
What types of screenings occur during medical surveillance?
Medical screening is the clinical aspect of medical surveillance. Medical screenings may consist of interviews, a physical exam, blood or other lab tests, lung function tests, vision screening, hearing tests, or diagnostic testing such as EKGs or x-rays. The employer’s health and safety team, along with the help of an industrial hygienist, help determine what kind of screenings are needed.
Medical surveillance screenings may take place before someone is placed in a position at work (to determine fitness for duty and ability to wear PPE), at specified intervals throughout their employment (to benchmark health status and check for any adverse changes), after a known exposure, and/or upon leaving the position.
Proper recordkeeping by your employer is essential for consistent, readily accessible information surrounding medical examination results, employee medical clearance status, training certifications, and exposure trend data.
Is my personal health information protected?
A medical surveillance program may include specific guidelines for long-term recordkeeping, but it is important to note that health records at work must meet confidentiality and regulatory compliance of both OSHA and the Health Insurance Portability and Accountability Act (HIPAA). Employers are not notified of specific test results and other personal medical or non-work-related conditions, but employers are made aware of the recommendations and/or accommodations that may be required based on results and if the results are satisfactory for employment and/or job duties. The employee has the right to review and discuss any test results with the individual performing the exam.
As an employee—remember, you have federally regulated rights to a safe workplace free of known hazards. Learn about your worker rights and protections. Make sure you report any workplace concern or safety issue to your supervisor and follow all hazard control plans and safety measures to stay safe at work!
Occupational Safety and Health Administration, “Clinicians,” https://www.osha.gov/dts/oom/clinicians/
Occupational Safety and Health Administration, “Employer Responsibilities,” https://www.osha.gov/as/opa/worker/employer-responsibility.html
Occupational Safety and Health Administration, “Medical Screening and Surveillance,” https://www.osha.gov/SLTC/medicalsurveillance/surveillance.html
Occupational Safety and Health Administration, “Medical Screening and Surveillance Requirements in OSHA Standards: A Guide,” https://www.osha.gov/Publications/osha3162.pdf
Occupational Safety and Health Administration, “Medical Screening and Surveillance Overview,” https://www.osha.gov/SLTC/medicalsurveillance/index.html
Occupational Safety and Health Administration, “Medical Screening and Surveillance OSHA Standards,” https://www.osha.gov/SLTC/medicalsurveillance/standards.html
Occupational Safety and Health Administration, “OSHA Worker Rights and Protections,” https://www.osha.gov/workers
The National Institute for Occupational Safety and Health, “Worker Health Surveillance,” https://www.cdc.gov/niosh/topics/surveillance/default.html