ES&H Manual



6800 Appendix T5

Subcontract Employee Medical Monitoring



1.0            Purpose


Medical monitoring is required for subcontract employees who perform certain work; or are exposed to certain hazard issues (e.g.: high noise, radiation, welding, oxygen deficiency).  This monitoring is offered on-site by Jefferson Lab’s Occupational Medicine Department at no cost to subcontract employee or their subcontracted company.  Those who decline on-site services are responsible for providing Jefferson Lab’s Occupational Medicine Department with comparable medical examination documentation from an outside medical facility.  Independent examinations must align with Jefferson Lab protocols.  Forms and other requirements are obtained from Occupational Medicine (x7539).


2.0            Scope


This document outlines the responsibilities and process steps use to obtain medical monitoring for subcontract employees.


NOTE:  Subcontract employees under the age of 18 are not allowed to work with hazard issues and are not offered medical monitoring.


Jefferson Lab notifies subcontract employees of work areas with hazard issues that require medical monitoring.  When applicable, Occupational Medicine ensures that subcontract employees receive appropriate medical monitoring.


The process steps in this appendix are performed in coordination with ES&H Manual Chapter 6800 Occupational Medicine.


3.0            Responsibilities

NOTE:     Management authority may be delegated at the discretion of the responsible manager.


3.1              Subcontracting Officer’s Technical Representative (SOTR)

·         Recognize activities and hazard issues that require medical monitoring in work areas.

·         Inform subcontract employees that:

o   They are to report any suspected hazard issue, so it can be determined whether medical monitoring is required.

o   Initial and/or routine medical monitoring is required if they perform certain work; or are exposed to certain hazard issues (e.g.: high noise, radiation, welding, oxygen deficiency). 

·         Ensure that subcontract employees who perform activities or work in areas that require medical monitoring have current medical certifications prior to authorizing work.

·         Inform Occupational Medicine of new subcontract employees; any changes in health status; or altered job activity that might require occupational medicine assistance, work restrictions, and/or medical monitoring.

·         Schedule appointments for medical monitoring with Occupational Medicine (when required) and prior to expiration of any current certification.


3.2              Occupational Medicine

·         Schedule and conduct medical monitoring for subcontract employees who require it.

·         Provide the necessary information and certification forms to subcontract employees receiving off-site consultations.

·         When applicable update subcontract employees’ Skills Requirements List (SRL) based on medical monitoring.

·         Maintain medical records in accordance with 10 CFR 851 Worker Safety and Health Program, 36 CFR 1223 Managing Vital Records, and DOE O 243.2 Vital Records. 

·         Provide subcontract employees with their medical records upon request.


4.0            Process Steps


4.1              Medical Monitoring for New, Loaned, or Transferred Subcontract Employees


The SOTR is responsible for the following process steps.


Step 1:             Evaluate the subcontract employees’ assigned work area and note any activities or hazard issues that require medical monitoring.


Step 2:             Inform the subcontract employee of hazard issues and medical monitoring requirements.


Step 3:             Schedule appointments with Occupational Medicine and ensure that medical monitoring is received.


Step 4:             Ensure that the subcontract employees’ required medical monitoring certification(s) remains current for the duration of the work.


5.0            Reference


Jefferson Lab provides medical monitoring for the below stated hazard issues at specific intervals. 


Table 1.  Activities/Hazard Issues Requiring Medical Monitoring

Activity/Hazard Issue

Typical Frequency of Monitoring

ES&H Manual Chapter

Aerial Lift Operators

3 years

6147 Aerial Work Platforms

Beryllium Associated Work

3 years

6682 Beryllium Handling and Exposure

Crane Operators

3 years

6141 Cranes and Hoists

Forklift Operators

3 years

6145 Forklift Safety

Ionizing Radiation

3 years

6310 Protection from Ionizing Radiation

Lasers – Class 3b and 4

Initially and after any suspected injury

6410 Laser Safety Program

Lead Associated Work

3 years

6680 Lead Handling

Nanoparticle Technology (Engineered)

3 years

6650 Engineered Nanoparticle Policy

Noise Exposure


6640 Hearing Conservation

Oxygen Deficiency

3 years

6540 ODH Control Program


3 years

6630 Respiratory Protection Program

Static Magnetic Field Exposure

Condition Specific

6420 Non-Ionizing Radiant Energy (i.e.: Radio Frequency (RF), Microwave, and Static Magnetic Fields)


3 years

6122 Hot Work (i.e. Welding, Cutting, Brazing, and Grinding) Safety Program


6.0            Revision Summary


Revision 1 - Periodic Review – 05/20/2013 – Reconciled Table 1 with Appendix T1 Table; no substantive changes required.

Revision 0 – 05/10/2010 - This is new content.











ESH&Q Division

Smitty Chandler





This document is controlled as an on line file.  It may be printed but the print copy is not a controlled document.  It is the user’s responsibility to ensure that the document is the same revision as the current on line file.  This copy was printed on 6/3/2013.