Lead Paint Removal >> Lead Paint Is A Dangerous Health Risk

If the two physicians are unable to resolve their disagreement quickly, the employer and employee through their respective physicians shall designate a third physician to review any findings, determinations, or recommendations of the prior physicians and to conduct such examinations, consultations, laboratory tests, and discussions with the prior physicians which the third physician deems necessary to resolve the disagreement of the Lead Paint Is A Dangerous Health Risk prior physicians. 

5. The Lead Paint Is A Dangerous Health Risk employer shall act consistent with the findings, determinations and recommendations of the third physician, unless the employer and the employee reach an agreement which is otherwise consistent with the recommendations of at least one of the three physicians. (D) Alternate Physician Determination Mechanisms. 

The Lead Paint Is A Dangerous Health Risk employer and an employee or authorized employee representative may agree upon the use of any expeditious alternate physician determination mechanism in lieu of the multiple physician review mechanism provided by this section so long as the alternate mechanism otherwise satisfies the requirements contained in this section. 

(4) Information Provided to Examining and Consulting Physicians. (A) The Lead Paint Is A Dangerous Health Risk employer shall provide the following information to and initial physician conducting a medical examination or consultation under the provisions of this section: 1. A copy of this regulation and its appendices; 2. A description of the affected employee's duties as they relate to the employee's exposure; 

3. The Lead Paint Is A Dangerous Health Risk employee's exposure level or anticipated exposure level to lead and to any other toxic substance (if applicable); 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 concerning the employee in the employer's possession or control. 

(B) The Lead Paint Is A Dangerous Health Risk employer shall provide the foregoing information to a second or third physician conducting a medical examination or consultation under this section upon request either by the second or third physician, or by the employee. (5) Written Medical Opinions. (A) The employer shall obtain and furnish the employee with a copy of a written medical report from each examining or consulting physician which contains the following information: 

1. The physician's opinion as to whether the employee has any detected medical condition which would place the employee at increased risk of material impairment of the Lead Paint Is A Dangerous Health Risk employee's health from exposure to lead. 2. Any recommended special protective measures to be provided to the employee, or limitations to be placed upon the employee's exposure to lead. 

3. Any recommended limitation upon the employee's use of respirators, including a determination of whether the employee can wear a powered air-purifying respirator if the physician determines that the employee cannot wear a negative pressure respirator; and 4. The results of the blood lead determinations. (B) The Lead Paint Is A Dangerous Health Risk employer shall instruct the examining physician to: 

1. Not reveal either in the written opinion, or in any other means of communication with the employer, findings, including laboratory results, or diagnoses unrelated to the Lead Paint Is A Dangerous Health Risk employee's occupational exposure to lead; and 2. Advise the employee of any medical condition, occupational or non-occupational, which dictates further medical examination or treatment. 

(6) Chelation. (A) The employer shall assure that any person whom he retains, employs, supervises, or controls does not engage in prophylactic chelation of any employee at any time. (B) If therapeutic or diagnostic chelation is to be performed by any person in Section 5198(j)(6)(A), the employer shall assure that it be done under the supervision of a licensed physician in a clinical setting with thorough and appropriate medical monitoring and that the Lead Paint Is A Dangerous Health Risk employee is notified in writing prior to its occurrence. 

(k) Medical Removal Protection. (1) Temporary Removal Due to Elevated Blood Lead Levels. (A) First Year of the Standard. During the first year following the effective date of this section, the Lead Paint Is A Dangerous Health Risk employer shall remove an employee from work having a daily 8-hour TWA exposure to lead at or above 100 µg/m3 on each occasion that a periodic and 

A follow-up blood sampling test conducted pursuant to this section indicate that the employee's blood lead level is at or above 80 µg/100 g of whole blood; (B) Second Year of the Standard. During the second year following the effective date of this section, the Lead Paint Is A Dangerous Health Risk employer shall remove an employee from work having, and

A daily 8-hour TWA exposure to lead at or above 50 µg/m3 on each occasion that a periodic and a follow-up blood sampling test conducted pursuant to this section indicate that the Lead Paint Is A Dangerous Health Risk employee's blood lead level is at or above 70 µg/100 g of whole blood; (C) Third Year of the Standard, and Thereafter. 

Beginning with the third year following the effective date of this section, the Lead Paint Is A Dangerous Health Risk employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that a periodic and a followup blood sampling test conducted pursuant to this section indicate that the employee's blood lead level is at or above 60 µg/100 g of whole blood; and (D) Fifth Year of the Standard, and Thereafter. 

Beginning with the fifth year following the effective date of this section, the Lead Paint Is A Dangerous Health Risk employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that the average of the last three blood sampling tests conducted pursuant to this section (or the average of all blood sampling tests conducted over the previous six (6) months, 

Whichever is longer) indicates that the Lead Paint Is A Dangerous Health Risk employee's blood lead level is at or above 50 µg/100 g of whole blood; provided, however, that an employee need not be removed if the last blood sampling test indicates a blood lead level at or below 40 µg/100 g of whole blood. (2) Temporary Removal Due to a Final Medical Determination. 

(A) The Lead Paint Is A Dangerous Health Risk employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that a final medical determination results in a medical finding, determination, or opinion that the employee has a detected medical condition which places the employee at increased risk of material impairment to health from exposure to lead. 

NOTE: For the Lead Paint Is A Dangerous Health Risk purposes of this section, the phrase "final medical determination” shall mean the outcome of the multiple physician review mechanism or alternate physician determination mechanism used pursuant to the medical surveillance provisions of this section. 

(B) Where a final medical determination results in any recommended special protective measures for an employee, or limitations on an employee's exposure to lead, the Lead Paint Is A Dangerous Health Risk employer shall implement and act consistent with the recommendation.

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