(1)
Applicability.
The requirements of
29 CFR
1926.62, and other applicable OSHA standards
shall apply to the personal protection and medical monitoring of employees
except that:
(a) In accordance with
454 CMR
22.13(1), Deleading
Contractors shall maintain as records the results of all personal exposure
monitoring, respirator fit testing, medical examinations and blood lead testing
conducted pursuant to the requirements of
29 CFR
1926.62(d), (f) and (j) or
pursuant to the requirements of 454 CMR 22.09; and
(b) The frequency of blood monitoring of
employees licensed as Deleader-supervisors and Deleader-workers shall be
governed by 454 CMR 22.09(5)(a).
(c) The personal protection and medical
monitoring of employees and other employees exempted from coverage by OSHA
standards shall be governed by the provisions of 454 CMR 22.09.
(2)
General
Respiratory Protection Requirements. The Deleading Contractor,
Lead-safe Renovation Contractor, or employer conducting Class I Deleading,
Moderate-risk Deleading or Renovation Work shall ensure that employees,
inspectors and other persons involved in said work are provided with
respiratory protection which meets the requirements of relevant OSHA
regulations, including
29 CFR
1910.134 and 29 CFR 1926.62(f). Employers
shall provide respirators and all necessary maintenance materials at no cost to
employees and shall provide proper respirator fit testing prior to initial use
and at least annually thereafter.
(3)
Requirements for the Use of
Protective Clothing and Equipment. The Deleading Contractor,
Lead-safe Renovation Contractor, or employer conducting Class I Deleading,
Moderate-risk Deleading or Renovation Work shall ensure that employees,
inspectors and other persons involved in said work are provided with protective
clothing and other personal protective equipment in accordance with relevant
OSHA regulations, including
29 CFR
1926.62(g). In addition, the
following specific requirements must be met:
(a) Employers shall provide employees with
protective clothing and equipment without cost.
(b) Protective clothing shall provide
sufficient coverage and be sufficiently impermeable to lead dust, caustic
paste, chemical solvents and other contaminants to prevent contamination of
underlying garments or body surfaces.
(c) Where dust generating methods are used,
the employer shall provide a minimum of two changes of protective clothing
during an eight-hour day.
(d) Where
caustic paste is used to remove paint, the employer shall provide and ensure
the use of: full-body overalls impervious to caustic substances; gloves
impervious to caustic substances; glove extenders; appropriate boot or shoe
covers; and face shields, where caustic paste is to be applied or removed at or
above face level.
(4)
Medical Examinations and Consultations. The Deleading
Contractor, Lead-safe Renovator Contractor, or other employer conducting Class
I Deleading Work, Moderate-risk Deleading Work or Renovation Work shall ensure
that employees are provided with medical examinations and consultations in
accordance with
29 CFR
1926.62(j)(1) and (3) and
454 CMR 22.09(4)(a) through (g).
(a)
Frequency of Medical Examinations. The medical
examinations specified by 454 CMR 22.09(4) shall be provided:
1. As soon as possible, upon notification by
an employee either that he or she has developed signs or symptoms commonly
associated with lead intoxication, that the employee desires medical advice
concerning the effects of current or past exposure to lead on the employee's
ability to procreate a healthy child, that the employee is pregnant, or that
the employee has demonstrated difficulty in breathing during a respirator
fitting test or during use; or
2.
Immediately following medical removal specified by 454 CMR 22.09(5)(b) or as
medically appropriate, as determined by a physician.
(b)
Requirement for Physician's
Involvement or Oversight. All medical examinations and
consultations conducted pursuant to 454 CMR 22.09(4) shall be performed by or
under the direction of a physician.
(c)
Information Provided to
Examining and Consulting Physicians. The Deleading Contractor,
Lead-safe Renovation Contractor or other employer shall provide to the
physician conducting a medical examination or consultation under 454 CMR 22.09
the following information:
1. A copy of the
following sections of the Department's regulations:
a.454 CMR 22.09: Worker Protection
and Medical Monitoring Requirements;
b.
454 CMR
22.11: Work Practices and Other
Requirements for Renovation Work; and
c.
454
CMR 22.12: Work Practices and Other
Requirements for Deleading Projects.
2. A description of the employee's duties as
they relate to exposure to lead or other harmful substances;
3. The employee's exposure level or
anticipated exposure level to lead and, where applicable, to any other toxic
substance;
4. A description of any
personal protective equipment used or to be used;
5. Prior blood lead determinations;
and
6. All prior written medical
opinions in the employer's possession or control.
(d)
Employer's Instructions to
Physicians. The Deleading Contractor, Lead-safe Renovation
Contractor, or other employer shall instruct any examining or consulting
physician to:
1. Not reveal to the employer,
either in a written statement of medical findings or in any other means of
communication, any findings, including laboratory results or diagnoses
unrelated to an applicant's occupational exposure to lead or ability to engage
in Deleading or Renovation Work;
2.
Advise the applicant or employee of any medical condition, occupational or
non-occupational, which dictates further medical examination or
treatment;
3. Provide the applicant
or employee with a clear warning of the reproductive hazards caused by exposure
to lead; and
4. Provide to the
employer a copy of the Reporting Physician's Statement for provision to the
applicant or employee as required under 454 CMR 22.09(4)(f).
(e)
Elements of
Medical Examination. Medical examinations made pursuant to 454 CMR
22.09 shall include the following elements:
1.
A detailed work history and a medical history, with particular attention to
past lead exposure, personal habits and hygiene, and past or present
gastrointestinal, hematologic, renal, cardiovascular, reproductive and
neurological problems;
2. A
thorough physical examination, with particular attention to teeth, gums,
hematologic, gastrointestinal, renal, cardiovascular, neurological, and
pulmonary systems;
3. A blood
pressure measurement;
4. A blood
sample which determines:
a. Blood lead
level;
b. Hemoglobin and hematocrit
determinations, red cell indices, and examination of peripheral smear
morphology;
c. Zpp;
d. Blood urea nitrogen;
e. Serum creatinine;
5. A routine urinalysis with microscopic
examination; and
6. Any laboratory
or other test relevant to lead exposure which the examining physician deems
necessary by sound medical practice.
(f)
Reporting Physician's
Statement. Within two working days after receipt of the Reporting
Physician's Statement, the Deleading Contractor, Lead Safe Renovation
Contractor, or other employer, shall furnish a copy of the same to the
applicant or employee.
(g)
Reporting of Blood Lead Levels. Within two working
days after the receipt of the report of the applicant's or employee's blood
lead level, the Deleading Contractor, Lead-safe Renovation Contractor, or other
employer shall furnish the applicant or employee with a copy thereof.
(5)
Blood Lead and Zpp
Level Monitoring.
(a)
Frequency of Testing.
1. Deleader-supervisors and Deleader-workers
shall receive blood lead and zpp monitoring every two months during the first
six months following licensure or certification and at least quarterly
thereafter.
2. Except as specified
by 454 CMR 22.09(5)(a)3., Lead-safe Renovator-supervisors and Workers on
Renovation Projects shall receive blood lead and zpp monitoring according to
the schedule set forth at
29 CFR
1926.62(j).
3. Persons tested pursuant to 454 CMR
22.09(5)(a)1. or 2. whose last blood lead analysis indicates a lead level at or
above 25 ug/dl of whole blood shall be tested at least every two months until
two consecutive blood lead analyses indicate blood lead levels below 25 ug/dl
of whole blood.
4. Where a person
is removed from Deleading or Renovation Work pursuant to 454 CMR 22.09(5)(b),
said person shall receive blood lead and zpp testing at least monthly during
the period of medical removal.
5.
Upon being hired to perform Deleading Work for a new employer, and before
engaging in such work, Deleader-supervisors and Deleader-workers shall receive
blood lead and zpp monitoring in accordance with the schedule set forth at 454
CMR 22.09(5)(a) unless more frequent testing is indicated by 454 CMR
22.09(5)(a)3. or 4.
(b)
Medical Removal. No person whose blood lead level is
above 50 ug/dl shall be permitted to engage in Deleading or Renovation Work
that further exposes the individual to lead hazards. Said person shall
immediately be removed from any lead exposure when the result of any single
test of his or her blood lead level is at or above 50 ug/dl of whole blood. In
order to confirm the accuracy of the laboratory test result, a second blood
test shall be taken within two weeks.
(c)
Return to Work Following
Medical Removal. A person medically removed from Deleading or
Renovation Work pursuant to 454 CMR 22.09(5)(b) may return to his or her former
job status when two consecutive blood sampling tests indicate that the blood
lead level is below 40 ug/dl of whole blood, in accordance with the standard
set forth at 29 OSHA 1926.62(K)(1)(iii)(A)(1).
(d)
Blood Lead Testing
Laboratories. Blood lead samples collected in accordance with
454 CMR 22.00 shall be
analyzed by the Department of Labor Standards, Industrial Hygiene Laboratory,
or by laboratories approved by OSHA-CDC for blood lead analysis.