Medical Surveillance

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It’s vital that employers focus on maintaining the health and safety of both on and off-site workers. We can achieve this by following the Occupational Safety and Health Administration’s (OSHA) guidelines for a procedure known as Medical Surveillance. Taken directly from the OSHA website, “Medical surveillance is the analysis of health information to look for problems that may be occur ring in the workplace that require targeted prevention. Thus, surveillance serves as a feedback loop to the employer. Surveillance may be based on a single case or sentinel event, but more typically uses screening results from the group of employees being evaluated to look for abnormal trends in health status. Surveillance can also be conducted on a single employee over time. Review of group results helps to identify potential problem areas and the effectiveness of existing worksite preventive strategies”.  By strategically considering all potential medical impacts a job can have on the human body, employers can prepare to avoid these problems down the road.

Medical Surveillance vs. Medical Screening

The concepts of medical surveillance and medical screening are frequently confused and used interchangeably, however these are two different processes:

Medical Surveillance is “the process of identifying, quantifying, and removing causative factors that increase the risk of occupational diseases or injuries”. OSHA requires that employers do their due diligence to determine these potential dangers on a jobsite prior to the work being carried out. These hazards can range from lead and asbestos poisoning to ticks and sake bites. 

Medical Screening is “the process of early detection and treatment of diseases associated with particular occupations”. As workers are performing in conditions where there were detected risks during the medical surveillance stage, either individuals or entire groups of workers need to be monitored and put through routine tests to monitor their health. Screenings can be performed by several different assessments including mental, physiological, biological, and toxicological.

Developing a Program

  1. Identify what hazardous substances/risks that your worker(s) could encounter
    1. You will want to perform a hazard analysis of the substances may be used during the job as part of the process as well as byproduct/result of your task being completed.
  2. Familiarize yourself with State, Federal, and OSHA regulation(s) 
    1. The OSHA regulations will outline several areas of importance for completing the surveillance of the jobsite and screening of workers:
      1. Permissible Exposure Limit (PEL) – The legal limit for employee exposure to a regulated chemical substance.
      2. Actions Levels (ALs) – The level OSHA uses to determine whether the employer must offer employees medical surveillance and increased exposure monitoring.
  • Excursion Limit (EL) – The limit on the time an employee’s exposure during a single workday may exceed the PEL or time-weighted average
  1. Determine the necessary components of your medical screening practice, including examinations and tests. 
    1. As mentioned above, medical screenings can include a variation of assessments. Every substance that a worker may come in contact with will have different properties and need to be tested for in various ways.
  2. Identify which of your employees that will need medical surveillance/screenings and communicate details of this program that you’re developing to them
    1. Retain all employee current medical and exposure records
    2. Advise employees where these records can be located in the event of an emergency and provide documentation to OSHA or any other organization requiring these records
    3. Inform employees any pertinent information provided by OSHA, NIOSH, or any other governing agency

Common Medical Surveillance Areas of Concern

OSHA has more in-depth safety information regarding the following more common areas of concern to be mindful of during your medical surveillance investigation:

Stay Organized!

As you prepare to complete your next medical surveillance, consider using JSABuilder to organize all of your site and/or job specific step-by-step procedures to conduct your review! Job Safety Analysis (JSA) or Activity Hazard Analysis (AHA) worksheets are essential for creating consistency within the workplace and keeps employers and employees safe when on the job. Go to to start your free 30-day trial and test out building your own custom Job Safety Analysis worksheet today! You can also follow us on Twitter and LinkedIn , where we talk about Health and Safety, provide Safety tips, and updates on current Health and Safety topics.

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