When exposures exceed the PEL, an employer must provide dedicated changing rooms, a lunchroom under positive pressure, and shower facilities. Food, beverages, and tobacco products cannot be present, consumed, or used, and cosmetics cannot be applied anywhere in the facility, except in the changing room, lunchroom, or shower areas. Changing rooms must separate street clothes from contaminated work clothing in a way that prevents cross-contamination. Employees are not permitted to enter the lunchroom without removing lead from their protective work clothing. Employees must wash their hands and face before eating, drinking, smoking, or applying cosmetics, and they must shower at the end of each work shift (29 CFR 1910.1025(i)).

Medical Monitoring

The following are the key points of the OSHA lead standard for general industry regarding medical surveillance (29 CFR 1910.1025(j)):

•  The employer institutes a medical surveillance program for all employees who are or may be exposed at or above the air action level of 30 μg/m3.

•  Monitoring is performed by or under the supervision of a licensed physician.

•  A full medical examination and consultation shall be made available to an employee

         image  Before the first assignment to an area that has lead at or above the action level.

         image  At least once a year for an employee who had a BLL of 40 μg/dL or over at any time during the preceding 12 months.

         image  As soon as possible on notification by an employee that he or she has developed signs or symptoms of lead intoxication, desires medical advice concerning the effects of lead (past or current) and the ability to procreate a healthy child, or who has difficulty in breathing during respirator fit test or use.

•  A full medical examination will include

         image  A detailed work and medical history.

         image  A thorough physical examination.

         image  Measurement of blood pressure.

         image  Analysis of BLL, hemoglobin and hematocrit, erythrocyte indexes, peripheral smear morphology, zinc protophorphyrin (ZPP), blood urea nitrogen and creatinine, urinalysis with microscopic examination, and any other tests that a physician thinks are appropriate, including a pregnancy test or laboratory evaluation of male fertility if requested by the employee.

•  Biologic monitoring (for all employees who are working at or above the action level) and medical removal protection:

         image  BLL and ZPP levels evaluated every 6 months.

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