Workplace Medical Exams, Tests and Immunizations

To determine if the vision, hearing, cardiovascular (including blood pressure and heart rate), respiratory, neurologic, and musculoskeletal systems allow the employee to perform the essential job functions safely. 

To determine if there is evidence of anemia, infection, blood cancer, or clotting problems, and to monitor for evidence of toxicity from heavy metals, benzene, or other chemicals that can be toxic to bone marrow. 

To determine if kidney and liver function has been affected by workplace exposures to heavy metals, or chemical exposures. Liver and kidney function, if abnormal due to non-work-related causes, might require some special precautions at work to limit further damage to these organs. 

To assess kidney function, infection, diabetes, and occult blood. Some heavy metals and chemicals are nephrotoxic or can cause bladder cancer.

This special CXR interpretation can only be done by NIOSH certified B-readers. It is an OSHA requirement for Silica, Asbestos, Coal miners, and Beryllium workers. OSHA provides the schedule for performing this test.

This is typically done at baseline to document the status of the lungs prior to commencing employment. It is then done at exit to document the lung status when the employee leaves the company. For periodic exams, the CXR is typically only performed if something in the medical history or physical exam suggests lung pathology, such as chronic cough or coughing up blood. 

To determine if there is prior cardiac muscle damage, arrythmias, or electrical conduction problems. It is typically done if something in the medical history or physical exam suggests a cardiac problem, such as irregular or rapid heartbeat, a loud murmur, or history of a prior heart attack

To determine baseline lung function and to monitor lung function periodically to determine if the employee has adequate lung function to do the essential job functions, and if a respirator restriction is necessary. It is also used to monitor any changes to lung function over time, that could be due to work exposures or non-work exposures such as smoking. 

To determine if hearing is adequate to safely perform the essential job functions, or if hearing aids might be necessary at work.  

Also used to monitor noise exposed employees as part of an OSHA hearing conservation program. Audiograms are required annually under this OSHA standard.

Performed to satisfy federal drug-free workplace regulations (e.g. DOT exams) or as part of a drug-free workplace program. Testing is helpful for monitoring illicit drug use, but also to identify employees who may have a legitimate prescription for a drug, that may require safety sensitive work restrictions. Drug testing is usually a urine test, but saliva testing is also available. Alcohol testing utilizes breath alcohol technology.

Required to be offered to employees who fall under the OSHA Bloodborne Pathogens Standard.

Offered to employees who are at risk for wounds of the skin (e.g punctures, lacerations, abrasions) that could be tetanus prone.

To monitor employees who will be exposed to PCBs in the field. Baseline PCB levels are established and then monitored annually to ensure that PCB levels are not rising.

To monitor employees who may be exposed to pesticides in the field. Baseline RBC cholinesterase levels are obtained and the levels are checked annually to ensure that they have not decreased due to pesticide exposure.

Must include all required exam elements including vision and a whisper test. If the driver does not pass the whisper test, then an audiogram must be performed.

To monitor workers who are exposed to Beryllium to determine if they have become sensitized to Beryllium. This is an annual test. 

The following tests are for periodic monitoring of heavy metal exposures as required by OSHA regulations:  

• Urine Arsenic (speciated) 
• Urine and blood mercury 
• Urine and blood cadmium 
• Blood lead level (BLL) and Zinc Protoporphyrin (ZPP) 
• Urine Beta-2 microglobulin (an early marker of kidney toxicity) 

An enhanced musculoskeletal exam to determine if the employee has any musculoskeletal issues that would prevent him or her from performing the essential job functions, or that might need accommodation. 

This can be a skin test (PPD) or a blood test (Quantiferon Gold or T-Spot). This test is required under the Silica standard, but would also be required for entering certain healthcare facilities, or if an employee has a TB exposure.