ATTACHMENT 1 - APPLICABLE PUBLICATIONS.pdf

ATTACHMENT 1

APPLICABLE PUBLICATIONS

The Contractor must abide by all applicable regulations, publications, manuals, and local policies and procedures. A brief summary of relevant regulations and federal requirements follows below. This summary is not exhaustive.

Occupational medical examinations based on 5 USC Part 339- Medical Qualification Determinations, ARS 414.0, Occupational Medical Examinations and Surveillance Manual, satisfy the basic medical surveillance requirements in OSHA 29 CRF 1910, General Industry.

Occupational medical examinations are conducted to determine if: workers are medically and physically able to perform the assigned duties without substantial risk of harm to themselves, others, or the mission (fitness for duty examinations) and whether the workplace is causing workers injury or illness due to an occupational exposure (medical surveillance examinations).

The following Tables identify the ARS requirements for the specific types of occupational examinations or medical treatment that are required.

Table 1: Requirement for Preplacement/Initial/New Hire Examinations

OSHA 29 CFR 1910; 5 USC

Part 339

These exams are performed before placement in a specific job to medically assess if the worker will be able to perform the job safely. They may be combined with occupational medical surveillance to record a baseline of values for future comparison. These medical examinations should be done before the worker commences work. However, if the individual has already started work, these examinations shall be completed within 60 days of assignment, unless more stringent requirements exist.

Table 2: Requirements for Personnel Policy Enforcement Examinations

OSHA 29 CFR 1910; 5 USC

Part 339; 20 CFR Part 10

These exams medically assess workers to determine if they meet established standards and conditions of employment.

Examples of these types of examinations are drug use screening and fitness for duty examinations. Other types of personnel policy examinations may include work related injury/illness evaluations, return to work examinations, and impairment evaluations.

20 CFR Part 10 In support of injury compensation claims administration, qualified SOH personnel must provide claims administrators with an assessment of the work-relatedness of reported injuries and illnesses. In support of return-to-work programs, qualified SOH personnel must provide the personnel office with a professional opinion on workplace conditions and worker practices appropriate for light-duty assignments.

ARS did not include a table for Ergonomics as there is currently no Occupational Health and Safety Agency regulations establishing ergonomic requirements or standards. In 2001, Congress passed Joint Regulation 6 disapproving rules relating to ergonomics, which was approved by the President. Subsequent revisions of ARS regulations and policies have not contained ergonomic requirements.

Table 3: Requirement for Medical Certification Examinations OSHA 29 CFR 1910; 5 USC Part

These determine if an individual meets specific medical fitness standards, such as those promulgated by the Federal Aviation Administration and Department of Transportation for aviators and commercial drivers, respectively.

Additionally, the examination should determine if the individual can perform the essential duties of the position without endangering self or others. The individual is either within all standards and thus medically qualified or fails to meet one or more standards and thus is not medically qualified.

Table 4: Requirements for Medic OSHA 29 CFR 1910; 5 USC Part

Provide appropriate, periodic occupational health assessments for those potentially exposed to chemical, biological, and physical hazards in the course of their duties in accordance with 5 USC Part 339, OSHA laws and regulations, ARS 414.0, ARS OMSP, Employee Animal Exposure Surveillance Program (EAESP), NIH/CDC Biosafety in Microbiological and Biomedical Laboratories

(BMBL).

OSHA 29 CFR 1910; 5 USC Part

Medical Surveillance Examinations or occupational health examinations, provide baseline and periodic assessments or measurements to detect abnormalities in workers exposed to work-related health hazards. These examinations are effective for the individual if useful screening techniques (history questionnaires, medical exams, or lab tests) are available to identify abnormalities in the target organ system at a stage when modifying exposure or providing medical treatment can arrest progression or prevent recurrence. These exams include Baseline Surveillance exams and Periodic Surveillance Exams.

OSHA 29 CFR 1910; 5 USC Part

Several occupational groups require special consideration because of their unique exposures, specific health risk considerations, or otherwise regulated medical surveillance requirements. This includes medical surveillance of surety (chemical/biological/nuclear) workers, firefighters, police officers and security guards, workers in their reproductive years, pregnant workers, breastfeeding workers, laser workers, and workers who require DOT examinations.

These examinations are for fitness for duty and/or medical related surveillance and may be conducted annually, every five years, at certain ages, and if required by circumstances.

They could include audiogram, health history, height, weight, body mass index, vital signs, spirometry, vision screening, mapping, physical exam, blood and urine tests, electrocardiogram, UA and chest x-rays, cardiac risk evaluations, hearing, evaluation for psychiatric disorders and neurological problems, and the administration of vaccines.

OSHA 29 CFR 1910; 5 USC Part

Ancillary tests conducted during fitness for duty and/or medical surveillance examinations include hearing testing;

cadmium medical surveillance and biomedical monitoring;

testing for carboxyhemoglobin; chest x-rays;

cholinesterase biomonitoring; complete blood count and other hematologic tests for benzene, lead, and methemoglobin; lipid panel tests; liver function tests;

mercury biomonitoring; renal function tests; respirator clearance; spirometry/pulmonary function tests; urine and vision tests.

OSHA 29 CFR 1910; 5 USC Part

Medical surveillance exams are required for all employees reasonably anticipated to be at risk for exposure to contaminated blood/body fluids via: - Eyes – Skin – Mucus membranes – Parenteral routes. Required examination includes as a baseline blood borne pathogen education.

Special procedures initially required are verification of Hepatitis B immunity (antibody testing or documentation of vaccination).

Table 5: Requirement for Termination Examinations OSHA 29 CFR 1910; 5 USC Part

Termination Examinations are either for termination of employment such as for asbestos exposure and termination of exposure exams that take place when exposure to a specific hazard has ceased.

Table 7: Requirements for Vaccinations/Immunizations

Hearing conservation testing is performed as part of medical surveillance examinations.

Additional details regarding the requirements for these exams appear in the table 8 below.

Although ARS BL has not specifically identified them as required for evaluating contracting options, Ionizing Radiation examinations and Hazardous Duty & Environmental Differential Evaluations are included in Table 9 and 10 below, as these may be required as part of BL SOH

Program.

Table 8: Requirements for Hearing Conservation Examinations OSHA 29 CFR 1910; 5 USC Part

Personnel exposed to hazardous noise levels shall be placed in a hearing testing surveillance program. That program shall include pre-placement, periodic (at least annually), and termination audiograms. Individual medical readiness is also a key factor in identifying civilian populations for audiometric testing.

OSHA 29 CFR 1910; 5 USC Part

Workers enrolled in the Hearing Conservation Program should undergo initial and annual audiometric evaluation.

These tests should be conducted using audiometers (manual or microprocessor) calibrated to American National Standards Institute S3.6 according to Reference (j). Pure-tone, unaided, air conduction hearing threshold levels should be determined.

OSHA 29 CFR 1910; 5 USC Part

All hearing conservation audiometric surveillance testing shall: (2) Be conducted in a testing environment with background octave band SPLs not greater than: (a) 500 Hz, 27 dB. (b) 1000 Hz, 29 dB. (c) 2000 Hz, 34 dB. (d) 4000 Hz, 39 dB. (e) 8000 Hz, 41 dB. For the test environment, be resurveyed annually using equipment conforming at least to the Type 1 requirements of ANSI Standard S1.4 through S1.4a and the order 3 extended range requirements of ANSI Standard S1.11. Include pure tone, air conduction, hearing thresholds for each ear at the test frequencies of 500, 1000, 2000, 3000, 4000, and 6000 Hz. This Instruction does not preclude testing at 8000 Hz. Be performed on audiometers calibrated to the specifications of ANSI Standard S3.6. Occur on audiometers that have received a functional operation check before each day’s use for specifications in 29 CFR §§1910.95 and 1910.145.

Table 9: Requirement for Ionizing Radiation Examinations Legal or Regulatory Source Ionizing Radiation Program

OSHA 29 CFR 1910; 5 USC

Part 339

Individuals who, in the course of their duties, may be occupationally exposed to ionizing radiation shall be provided, as necessary, bioassays when it is determined that by a qualified radiation protection expert or professional that there is a significant potential to exceed 10 percent of the limits identified in 10 CFR Part 20; it benefits the Heads of ARS BL to document doses below the limits of 10 CFR Part 20; or the Heads of ARS BL have reason to believe exposure to ionizing radiation or radioactive material is probable in a wartime or emergency environment, and monitoring will be beneficial in preventive measures, medical treatment, or future inquiries; or it is required by NRC license.

Table 10: Requirements for Hazardous Duty & Environmental Differential Evaluations 5 USC §5343(c)(4) For proper [wage] differentials, as determined by the Office of Personnel Management, for duty involving unusually severe working conditions or unusually severe hazards, and for any hardship or hazard related to asbestos, such differentials shall be determined by applying occupational safety and hazard standards consistent with the permissible exposure limit set by the Secretary of Labor.

5 CFR §532.511 Entitlements to environmental differential pay. (1) In accordance with 5 USC §5343(c)(4) an employee shall be paid an environmental differential when exposed to a working condition or hazard that falls within one of the categories approved by the Office of Personnel Management (OPM). (2) Each installation or activity must evaluate its situations against the guidelines issued by the OPM to determine whether the local situation is covered by one or more of the defined categories.

OSHA 29 CFR 1910; 5 CFR

§532.511

Hazardous Duty and Environmental Differential Pay Evaluations. Qualified SOH personnel must evaluate operations and workplaces in support of assessments for hazardous duty and environmental differential pay in accordance with 5 CFR §532.511. SOH personnel must provide the personnel office with a professional opinion on workplace conditions and worker practices and make recommendations for reducing risks to acceptable levels. ARS BL must eliminate or reduce hazards identified

Privacy Act, 5 United States Code (U.S.C.) §552a;

Federal Information Security Management Act of 2002 (P.L. 107-347)(FISMA) National Institute of Standards and Technology (NIST) Special Publications 800-53 Rev. 4 Health Insurance Portability and Accountability Act (HIPAA); 45 Code of Federal Regulations (CFR) Part 160, 162, and 164; Health Insurance Reform: Security Standards; Final Rule dated February 20, 2003;

An Introductory Resource Guide for Implementing the HIPAA Security Rule, March 2005; and Title IV - Health Information Technology for Economic and Clinical Health

(HITECH) Act, January 16, 2009

ATTACHMENT 1