[Federal Register Volume 59, Number 1 (Monday, January 3, 1994)]
[Unknown Section]
[Page 0]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 93-31820]
[[Page Unknown]]
[Federal Register: January 3, 1994]
_______________________________________________________________________
Part III
Department of Labor
_______________________________________________________________________
Occupational Safety and Health Administration
_______________________________________________________________________
29 CFR Parts 1915 and 1926
Standard for Cadmium in Shipyard Employment and in Construction Work;
Reprint With Corrections and Technical Amendments; Final Rule
DEPARTMENT OF LABOR
Occupational Safety and Health Administration
29 CFR Parts 1915 and 1926
Occupational Safety and Health Standards for Cadmium in Shipyard
Employment and Construction
AGENCY: Occupational Safety and Health Administration, Department of
Labor.
ACTION: Final rule; miscellaneous corrections, technical amendments,
and redesignation.
-----------------------------------------------------------------------
SUMMARY: The Occupational Safety and Health Administration (OSHA) is
correcting an error stemming from the wording of the amendatory
language of the final rule that incorporated applicable General
Industry standards for toxic substances into the Occupational Safety
and Health Standards for Shipyard Employment. The final rule, which
appeared in the Federal Register on July 1, 1993, had the effect of
mistakenly inferring that the cadmium standard for shipyard employment
from the Code of Federal Regulations was being deleted though the
preamble made it clear it was retained. This correction reprints the
full text of the cadmium standard as published on September 14, 1992,
and incorporates changes from an April 23, 1993, document that made
corrections and amendments to the original publication. In addition,
several cross-references regarding employee records are being amended
to reflect the designation of a new section in the shipyard employment
standards, and a number of effective dates are being converted to dates
certain.
In addition, OSHA is redesignating the cadmium standard for
construction employment, also published in the same September 14
document, into a different subpart. The redesignation merges it in with
the newly created subpart that contains specific toxic substance
standards for construction.
EFFECTIVE DATE: July 1, 1993.
FOR FURTHER INFORMATION CONTACT: Mr. James F. Foster, OSHA Office of
Public Affairs, Room N-3647, U.S. Department of Labor, 200 Constitution
Avenue NW., Washington, DC 20210, telephone (202) 219-8151.
SUPPLEMENTARY INFORMATION:
Background
The final regulations which are the subject of this action was
published in the Federal Register on June 30 and July 1, 1993 (58 FR
35076 and 35512, respectively). Up until then, most health standards
applicable to shipyard employment and construction were not codified in
the parts of title 29 of the Code of Federal Regulations that contained
the bulk of the standards applicable to shipyards (part 1915) and
construction (part 1926). These toxic substance standards were made
applicable by cross-reference to subpart Z of the general industry
standards (part 1910) and other parts and documents.
The Shipyard Employment Standard Advisory Committee (SESAC)
recommended that OSHA incorporate all toxic substance standards
covering shipyards into 29 CFR part 1915. As a first step to carry out
this recommendation, when OSHA issued the cadmium standard on September
14, 1992 (57 FR 42102), it created a subpart Z in part 1915 to include
health standards applicable to shipyards and included the cadmium
standard in subpart Z as Sec. 1915.1027. On April 23, 1993 (58 FR
21780), OSHA published a document that made corrections and amendments
to the September 14 document. As a second step, OSHA published a
technical amendment in the July 1, 1993, issue of the Federal Register,
which incorporated a comprehensive subpart Z into 29 CFR part 1915. The
July 1 document included the other toxic substance standards besides
cadmium, and added certain related standards applicable to shipyards.
In similar fashion to what SESAC sought, the Advisory Committee for
Construction Safety and Health also asked that OSHA incorporate the
general industry standards deemed applicable to construction into
OSHA's construction standards. This incorporation of the pertinent 1910
standards into part 1926 was accomplished on June 30, 1993 (58 FR
35076), and in doing so, OSHA created a subpart Z in part 1926, for the
applicable specific toxic substance standards.
Need for Correction
As published, the July 1 final regulation contained amendatory
language that had the effect of removing the regulatory text and
appendixes of Sec. 1915.1027--Cadmium, by mistake. The preamble of that
document made it clear that the Cadmium standard remained applicable to
shipyard employment (58 FR 35513). This document reinserts the
regulatory text and appendices of Sec. 1915.1027 into subpart Z--Toxic
and Hazardous Substances of part 1915 along with the corrections and
amendments made on April 23, 1993.
In addition, in the July 1 document, the text of existing
Sec. 1910.20, entitled ``Access to employee exposure and medical
records,'' was reprinted as an additional standard in part 1915, to add
it to the shipyard employment standards as new Sec. 1915.1120. OSHA is
changing cross-references in paragraphs (m) and (n) of the cadmium
standard to reflect the designation for the new section regarding
employee records within part 1915. These changes are to
Sec. 1915.1027(m)(4)(iii)(H), where the reference to ``Sec. 1910.20(g)
(1) and (2)'' is changed to read ``Sec. 1915.1120(g) (1) and (2)''; in
Sec. 1915.1027(n) (1)(iii), (3)(iii), and (5)(i), the reference to ``29
CFR 1910.20'' is changed to read ``Sec. 1915.1120 of this part''; and
in Sec. 1915.1027(n)(6), the reference to ``29 CFR 1910.20(h)'' is
changed to read ``Sec. 1915.1120(h) of this part.''
In this document, OSHA is also converting a number of effective
dates that were not computed to dates certain. As published on
September 14, 1992, the standard included over a dozen effective dates
that were based on the effective dates of the cadmium document, such as
for 60 and 90 days after the section or standard became effective.
These dates, set out in paragraphs (p)(2)(i)-(viii) (57 FR 42399) are
being computed in this document. The following list details the
specific instances where these changes are made:
In Sec. 1915.1027(p)(2)(i), the words ``60 days after the
effective date of this standard'' are changed to read ``February 12,
1993'';
In Sec. 1915.1027(p)(2)(vi)(A), the words ``60 days after
the effective date of this section'' are changed to read ``February 12,
1993'';
In Sec. 1915.1027(p)(2) (ii) and (iii), the words ``90
days after the effective date of this section'' are changed to read
``March 15, 1993'';
In Sec. 1915.1027(p)(2) (vii) and (viii), the words ``90
days after the effective date of this standard'' are changed to read
``March 15, 1993'';
In Sec. 1915.1027(p)(2)(i), the words ``120 days after the
effective date of this standard'' are changed to read ``April 14,
1993'';
In Sec. 1915.1027(p)(2) (ii) and (iii), the words ``150
days after the effective date of this section'' are changed to read
``May 14, 1993'';
In Sec. 1915.1027(p)(2) (vii) and (viii), the words ``180
days after the effective date of this standard'' are changed to read
``June 14, 1993'';
In Sec. 1915.1027(p)(2) (iv) and (iv)(B), the words ``1
year after the effective date of this section'' are changed to read
``December 14, 1993''; and
In Sec. 1915.1027(p)(2)(v), the words ``two (2) years
after the effective date of this section'' are changed to read
``December 14, 1994.''
When it was published in the same September 14, 1992, document, at
57 FR 42452, the cadmium standard for construction was codified as
Sec. 1926.63 in subpart D, which covers occupational health and
environmental controls. With the publication of the June 30, 1993,
document that created a separate subpart Z for specific toxic
substances within OSHA's construction standards, it follows that the
cadmium standard belongs with the new subpart. Therefore, this document
is redesignating Sec. 1926.63 as Sec. 1926.1127, to place it in the
appropriate place subpart Z of the construction standards.
In addition, in the June 30 document, the text of existing
Sec. 1910.20, entitled ``Access to employee exposure and medical
records,'' was reprinted as an additional standard in part 1926, to add
it to the construction standards as new Sec. 1926.33. OSHA is amending
cross-references in paragraphs (m) and (n) of the cadmium standard
(redesignated as Sec. 1926.1127) to reflect the designation for the new
section regarding employee records within part 1926. These changes are
to paragraph (m)(4)(iii)(H), where the reference to ``Sec. 1910.20(g)
(1) and (2)'' is changed to read ``Sec. 1926.33(g) (1) and (2)''; in
paragraphs (n) (1)(iii), (3)(iii), and (5)(i), where the reference to
``29 CFR 1910.20'' is changed to read ``Sec. 1926.33 of this part'';
and in paragraph (n)(6), the reference to ``29 CFR 1910.20(h)'' is
changed to read ``Sec. 1926.33(h) of this part.''
The corrections and technical amendments in this document are not
substantive regulatory actions, and therefore are not required to have
notice, comment, or an advance effective date. They are being made
retroactively effective, as of July 1, 1993, to make it clear that the
cadmium standard has been in effect covering shipyard employment since
December 14, 1992. The cadmium standard remained in effect subsequent
to the July 1, 1993, Federal Register document, as was OSHA's clearly
expressed intent.
List of Subjects
29 CFR Part 1915
Air contaminants, Hazardous materials, Hazard communication,
Laboratories, Medical records, Occupational safety and health,
Recordkeeping, Shipyards, Shipbuilding, Ship repairing, Shipbreaking,
Toxic chemicals.
29 CFR Part 1926
Construction industry, Hazardous materials, Occupational safety and
health, Protective equipment.
Authority and Signature
This document was prepared under the direction of Joseph A. Dear,
Assistant Secretary of Labor for Occupational Safety and Health, U.S.
Department of Labor, 200 Constitution Avenue, NW., Washington, DC
20210.
Accordingly, pursuant to sections 4, 6, and 8 of the Occupational
Safety and Health Act (29 U.S.C. 653, 655, and 657); section 107 of the
Contract Work Hours and Safety Standards Act (Construction Safety Act)
(40 U.S.C. 333); section 41 Longshore and Harbor Workers Compensation
Act (33 U.S.C. 941); section 4 of the Administrative Procedure Act (5
U.S.C. 553); and Secretary of Labor's Order No. 1-90 (55 FR 9033); OSHA
is issuing these corrections and technical amendments.
Signed at Washington, DC, 17th day of December, 1993.
Joseph A. Dear,
Assistant Secretary of Labor.
Accordingly, 29 CFR part 1915, subpart Z is corrected by the
following amendment:
PART 1915--OCCUPATIONAL SAFETY AND HEALTH STANDARDS FOR SHIPYARD
EMPLOYMENT
1. The authority citation for subpart Z of part 1915 continues to
read as follows:
Authority: Sections 4, 6, 8 Occupational Safety and Health Act,
29 U.S.C. 653, 655, 657; Sec. 4 of the Administrative Procedure Act,
5 U.S.C. 553; Secretary of Labor's Orders 12-71 (36 FR 8754), 8-76
(41 FR 25059), 9-83 (48 FR 35736), or 1-90 (55 FR 9033), as
applicable; and 29 CFR part 1911.
Subpart Z--Toxic and Hazardous Substances [Amended]
2. Subpart Z of part 1915 is corrected by adding the text and
appendices of Sec. 1915.1027 as follows:
Sec. 1915.1027 Cadmium.
(a) Scope. This standard applies to all occupational exposures to
cadmium and cadmium compounds, in all forms, and in all industries
covered by the Occupational Safety and Health Act, except the
construction-related industries, which are covered under 29 CFR
1926.63.
(b) Definitions.
Action level (AL) is defined as an airborne concentration of
cadmium of 2.5 micrograms per cubic meter of air (2.5 g/m\3\),
calculated as an 8-hour time-weighted average (TWA).
Assistant Secretary means the Assistant Secretary of Labor for
Occupational Safety and Health, U.S. Department of Labor, or designee.
Authorized person means any person authorized by the employer and
required by work duties to be present in regulated areas or any person
authorized by the OSH Act or regulations issued under it to be in
regulated areas.
Director means the Director of the National Institute for
Occupational Safety and Health (NIOSH), U.S. Department of Health and
Human Services, or designee.
Employee exposure and similar language referring to the air cadmium
level to which an employee is exposed means the exposure to airborne
cadmium that would occur if the employee were not using respiratory
protective equipment.
Final medical determination is the written medical opinion of the
employee's health status by the examining physician under paragraphs
(l)(3)-(12) of this section or, if multiple physician review under
paragraph (l)(13) of this section or the alternative physician
determination under paragraph (l)(14) of this section is invoked, it is
the final, written medical finding, recommendation or determination
that emerges from that process.
High-efficiency particulate air (HEPA) filter means a filter
capable of trapping and retaining at least 99.97 percent of mono-
dispersed particles of 0.3 micrometers in diameter.
Regulated area means an area demarcated by the employer where an
employee's exposure to airborne concentrations of cadmium exceeds, or
can reasonably be expected to exceed the permissible exposure limit
(PEL).
This section means this cadmium standard.
(c) Permissible Exposure Limit (PEL). The employer shall assure
that no employee is exposed to an airborne concentration of cadmium in
excess of five micrograms per cubic meter of air (5 g/m\3\),
calculated as an eight-hour time-weighted average exposure (TWA).
(d) Exposure monitoring--(1) General. (i) Each employer who has a
workplace or work operation covered by this section shall determine if
any employee may be exposed to cadmium at or above the action level.
(ii) Determinations of employee exposure shall be made from
breathing zone air samples that reflect the monitored employee's
regular, daily 8-hour TWA exposure to cadmium.
(iii) Eight-hour TWA exposures shall be determined for each
employee on the basis of one or more personal breathing zone air
samples reflecting full shift exposure on each shift, for each job
classification, in each work area. Where several employees perform the
same job tasks, in the same job classification, on the same shift, in
the same work area, and the length, duration, and level of cadmium
exposures are similar, an employer may sample a representative fraction
of the employees instead of all employees in order to meet this
requirement. In representative sampling, the employer shall sample the
employee(s) expected to have the highest cadmium exposures.
(2) Specific. (i) Initial monitoring. Except as provided for in
paragraphs (d)(2)(ii) and (d)(2)(iii) of this section, the employer
shall monitor employee exposures and shall base initial determinations
on the monitoring results.
(ii) Where the employer has monitored after September 14, 1991,
under conditions that in all important aspects closely resemble those
currently prevailing and where that monitoring satisfies all other
requirements of this section, including the accuracy and confidence
levels of paragraph (d)(6) of this section, the employer may rely on
such earlier monitoring results to satisfy the requirements of
paragraph (d)(2)(i) of this section.
(iii) Where the employer has objective data, as defined in
paragraph (n)(2) of this section, demonstrating that employee exposure
to cadmium will not exceed the action level under the expected
conditions of processing, use, or handling, the employer may rely upon
such data instead of implementing initial monitoring.
(3) Monitoring Frequency (periodic monitoring). (i) If the initial
monitoring or periodic monitoring reveals employee exposures to be at
or above the action level, the employer shall monitor at a frequency
and pattern needed to represent the levels of exposure of employees and
where exposures are above the PEL to assure the adequacy of respiratory
selection and the effectiveness of engineering and work practice
controls. However, such exposure monitoring shall be performed at least
every six months. The employer, at a minimum, shall continue these
semi-annual measurements unless and until the conditions set out in
paragraph (d)(3)(ii) of this section are met.
(ii) If the initial monitoring or the periodic monitoring indicates
that employee exposures are below the action level and that result is
confirmed by the results of another monitoring taken at least seven
days later, the employer may discontinue the monitoring for those
employees whose exposures are represented by such monitoring.
(4) Additional monitoring. The employer also shall institute the
exposure monitoring required under paragraphs (d)(2)(i) and (d)(3) of
this section whenever there has been a change in the raw materials,
equipment, personnel, work practices, or finished products that may
result in additional employees being exposed to cadmium at or above the
action level or in employees already exposed to cadmium at or above the
action level being exposed above the PEL, or whenever the employer has
any reason to suspect that any other change might result in such
further exposure.
(5) Employee notification of monitoring results. (i) Within 15
working days after the receipt of the results of any monitoring
performed under this section, the employer shall notify each affected
employee individually in writing of the results. In addition, within
the same time period the employer shall post the results of the
exposure monitoring in an appropriate location that is accessible to
all affected employees.
(ii) Wherever monitoring results indicate that employee exposure
exceeds the PEL, the employer shall include in the written notice a
statement that the PEL has been exceeded and a description of the
corrective action being taken by the employer to reduce employee
exposure to or below the PEL.
(6) Accuracy of measurement. The employer shall use a method of
monitoring and analysis that has an accuracy of not less than plus or
minus 25 percent ( 25%), with a confidence level of 95
percent, for airborne concentrations of cadmium at or above the action
level, the permissible exposure limit (PEL), and the separate
engineering control air limit (SECAL).
(e) Regulated areas--(1) Establishment. The employer shall
establish a regulated area wherever an employee's exposure to airborne
concentrations of cadmium is, or can reasonably be expected to be in
excess of the permissible exposure limit (PEL).
(2) Demarcation. Regulated areas shall be demarcated from the rest
of the workplace in any manner that adequately establishes and alerts
employees of the boundaries of the regulated area.
(3) Access. Access to regulated areas shall be limited to
authorized persons.
(4) Provision of respirators. Each person entering a regulated area
shall be supplied with and required to use a respirator, selected in
accordance with paragraph (g)(2) of this section.
(5) Prohibited activities. The employer shall assure that employees
do not eat, drink, smoke, chew tobacco or gum, or apply cosmetics in
regulated areas, carry the products associated with these activities
into regulated areas, or store such products in those areas.
(f) Methods of compliance--(1) Compliance hierarchy. (i) Except as
specified in paragraphs (f)(1) (ii), (iii) and (iv) of this section the
employer shall implement engineering and work practice controls to
reduce and maintain employee exposure to cadmium at or below the PEL,
except to the extent that the employer can demonstrate that such
controls are not feasible.
(ii) Except as specified in paragraphs (f)(1) (iii) and (iv) of
this section, in industries where a separate engineering control air
limit (SECAL) has been specified for particular processes (See Table 1
in this paragraph (f)(1)(ii)), the employer shall implement engineering
and work practice controls to reduce and maintain employee exposure at
or below the SECAL, except to the extent that the employer can
demonstrate that such controls are not feasible.
Table 1.--Separate Engineering Control Airborne Limits (SECALs) for
Processes in Selected Industries
------------------------------------------------------------------------
SECAL
Industry Process (g/
m3)
------------------------------------------------------------------------
Nickel cadmium battery.... Plate making, plate 50
preparation.
All other processes........... 15
Zinc/Cadmium refining*.... Cadmium refining, casting, 50
melting, oxide production,
sinter plant.
Pigment manufacture....... Calcine, crushing, milling, 50
blending.
All other processes........... 15
Stabilizers*.............. Cadmium oxide charging, 50
crushing, drying, blending.
Lead smelting*............ Sinter plant, blast furnace, 50
baghouse, yard area.
Plating*.................. Mechanical plating............ 15
------------------------------------------------------------------------
*Processes in these industries that are not specified in this table must
achieve the PEL using engineering controls and work practices as
required in f(1)(i).
(iii) The requirement to implement engineering and work practice
controls to achieve the PEL or, where applicable, the SECAL does not
apply where the employer demonstrates the following:
(A) The employee is only intermittently exposed; and
(B) The employee is not exposed above the PEL on 30 or more days
per year (12 consecutive months).
(iv) Wherever engineering and work practice controls are required
and are not sufficient to reduce employee exposure to or below the PEL
or, where applicable, the SECAL, the employer nonetheless shall
implement such controls to reduce exposures to the lowest levels
achievable. The employer shall supplement such controls with
respiratory protection that complies with the requirements of paragraph
(g) of this section and the PEL.
(v) The employer shall not use employee rotation as a method of
compliance.
(2) Compliance program. (i) Where the PEL is exceeded, the employer
shall establish and implement a written compliance program to reduce
employee exposure to or below the PEL by means of engineering and work
practice controls, as required by paragraph (f)(1) of this section. To
the extent that engineering and work practice controls cannot reduce
exposures to or below the PEL, the employer shall include in the
written compliance program the use of appropriate respiratory
protection to achieve compliance with the PEL.
(ii) Written compliance programs shall include at least the
following:
(A) A description of each operation in which cadmium is emitted;
e.g., machinery used, material processed, controls in place, crew size,
employee job responsibilities, operating procedures, and maintenance
practices;
(B) A description of the specific means that will be employed to
achieve compliance, including engineering plans and studies used to
determine methods selected for controlling exposure to cadmium, as well
as, where necessary, the use of appropriate respiratory protection to
achieve the PEL;
(C) A report of the technology considered in meeting the PEL;
(D) Air monitoring data that document the sources of cadmium
emissions;
(E) A detailed schedule for implementation of the program,
including documentation such as copies of purchase orders for
equipment, construction contracts, etc.;
(F) A work practice program that includes items required under
paragraphs (h), (i), and (j) of this section;
(G) A written plan for emergency situations, as specified in
paragraph (h) of this section; and
(H) Other relevant information.
(iii) The written compliance programs shall be reviewed and updated
at least annually, or more often if necessary, to reflect significant
changes in the employer's compliance status.
(iv) Written compliance programs shall be provided upon request for
examination and copying to affected employees, designated employee
representatives as well as to the Assistant Secretary, and the
Director.
(3) Mechanical ventilation. (i) When ventilation is used to control
exposure, measurements that demonstrate the effectiveness of the system
in controlling exposure, such as capture velocity, duct velocity, or
static pressure shall be made as necessary to maintain its
effectiveness.
(ii) Measurements of the system's effectiveness in controlling
exposure shall be made as necessary within five working days of any
change in production, process, or control that might result in a
significant increase in employee exposure to cadmium.
(iii) Recirculation of air. If air from exhaust ventilation is
recirculated into the workplace, the system shall have a high
efficiency filter and be monitored to assure effectiveness.
(iv) Procedures shall be developed and implemented to minimize
employee exposure to cadmium when maintenance of ventilation systems
and changing of filters is being conducted.
(g) Respirator protection--(1) General. Where respirators are
required by this section, the employer shall provide them at no cost to
the employee and shall assure that they are used in compliance with the
requirements of this section. Respirators shall be used in the
following circumstances:
(i) Where exposure levels exceed the PEL, during the time period
necessary to install or implement feasible engineering and work
practice controls;
(ii) In those maintenance and repair activities and during those
brief or intermittent operations where exposures exceed the PEL and
engineering and work practice controls are not feasible or are not
required;
(iii) In regulated areas, as prescribed in paragraph (e) of this
section;
(iv) Where the employer has implemented all feasible engineering
and work practice controls and such controls are not sufficient to
reduce exposures to or below the PEL;
(v) In emergencies;
(vi) Wherever an employee who is exposed to cadmium at or above the
action level requests a respirator;
(vii) Wherever an employee is exposed above the PEL in an industry
to which a SECAL is applicable; and
(viii) Wherever an employee is exposed to cadmium above the PEL and
engineering controls are not required under paragraph (f)(1)(iii) of
this section.
(2) Respirator selection. (i) Where respirators are required under
this section, the employer shall select and provide the appropriate
respirator as specified in Table 2 in this paragraph (g)(2)(i). The
employer shall select respirators from among those jointly approved as
acceptable protection against cadmium dust, fume, and mist by the Mine
Safety and Health Administration (MSHA) and by the National Institute
for Occupational Safety and Health (NIOSH) under the provisions of 30
CFR part 11.
Table 2.--Respiratory Protection for Cadmium
----------------------------------------------------------------------------------------------------------------
Airborne concentration or condition of usea Required respirator typeb
----------------------------------------------------------------------------------------------------------------
10 x or less............................. A half mask, air-purifying respirator equipped with a HEPAc
filter.d
25 x or less............................. A powered air-purifying respirator (``PAPR'') with a loose-fitting
hood or helmet equipped with a HEPA filter, or a supplied-air
respirator with a loose-fitting hood or helmet facepiece operated
in the continuous flow mode.
50 x or less............................. A full facepiece air-purifying respirator equipped with a HEPA
filter, or a powered air-purifying respirator with a tight-fitting
half mask equipped with a HEPA filter, or a supplied air
respirator with a tight-fitting half mask operated in the
continuous flow mode.
250 x or less............................ A powered air-purifying respirator with a tight-fitting full
facepiece equipped with a HEPA filter, or a supplied-air
respirator with a tight-fitting full facepiece operated in the
continuous flow mode.
1000 x or less........................... A supplied-air respirator with half mask or full facepiece operated
in the pressure demand or other positive pressure mode.
>1000 x or unknown concentrations........ A self-contained breathing apparatus with a full facepiece operated
in the pressure demand or other positive pressure mode, or a
supplied-air respirator with a full facepiece operated in the
pressure demand or other positive pressure mode and equipped with
an auxiliary escape type self-contained breathing apparatus
operated in the pressure demand mode.
Fire fighting.............................. A self-contained breathing apparatus with full facepiece operated
in the pressure demand or other positive pressure mode.
----------------------------------------------------------------------------------------------------------------
aConcentrations expressed as multiple of the PEL.
bRespirators assigned for higher environmental concentrations may be used at lower exposure levels. Quantitative
fit testing is required for all tight-fitting air purifying respirators where airborne concentration of
cadmium exceeds 10 times the TWA PEL (10 x 5 g/m3=50 g/m3). A full facepiece respirator is
required when eye irritation is experienced.
cHEPA means High Efficiency Particulate Air.
dFit testing, qualitative or quantitative, is required.
SOURCE: Respiratory Decision Logic, NIOSH, 1987.
(ii) The employer shall provide a powered, air-purifying respirator
(PAPR) in lieu of a negative pressure respirator wherever:
(A) An employee entitled to a respirator chooses to use this type
of respirator; and
(B) This respirator will provide adequate protection to the
employee.
(3) Respirator program. (i) Where respiratory protection is
required, the employer shall institute a respirator protection program
in accordance with 29 CFR 1910.134.
(ii) The employer shall permit each employee who is required to use
an air purifying respirator to leave the regulated area to change the
filter elements or replace the respirator whenever an increase in
breathing resistance is detected and shall maintain an adequate supply
of filter elements for this purpose.
(iii) The employer shall also permit each employee who is required
to wear a respirator to leave the regulated area to wash his or her
face and the respirator facepiece whenever necessary to prevent skin
irritation associated with respirator use.
(iv) If an employee exhibits difficulty in breathing while wearing
a respirator during a fit test or during use, the employer shall make
available to the employee a medical examination in accordance with
paragraph (l)(6)(ii) of this section to determine if the employee can
wear a respirator while performing the required duties.
(v) No employee shall be assigned a task requiring the use of a
respirator if, based upon his or her most recent examination, an
examining physician determines that the employee will be unable to
continue to function normally while wearing a respirator. If the
physician determines the employee must be limited in, or removed from
his or her current job because of the employee's inability to wear a
respirator, the limitation or removal shall be in accordance with
paragraphs (l) (11) and (12) of this section.
(4) Respirator fit testing. (i) The employer shall assure that the
respirator issued to the employee is fitted properly and exhibits the
least possible facepiece leakage.
(ii) For each employee wearing a tight-fitting, air purifying
respirator (either negative or positive pressure) who is exposed to
airborne concentrations of cadmium that do not exceed 10 times the PEL
(10 x 5 g/m\3\ = 50 g/m\3\), the employer shall
perform either quantitative or qualitative fit testing at the time of
initial fitting and at least annually thereafter. If quantitative fit
testing is used for a negative pressure respirator, a fit factor that
is at least 10 times the protection factor for that class of
respirators (Table 2 in paragraph (g)(2)(i) of this section) shall be
achieved at testing.
(iii) For each employee wearing a tight-fitting air purifying
respirator (either negative or positive pressure) who is exposed to
airborne concentrations of cadmium that exceed 10 times the PEL (10 x
5 g/m\3\ = 50 g/m\3\), the employer shall perform
quantitative fit testing at the time of initial fitting and at least
annually thereafter. For negative-pressure respirators, a fit factor
that is at least 10 times the protection factor for that class of
respirators (Table 2 in paragraph (g)(2)(i) of this section) shall be
achieved during quantitative fit testing.
(iv) For each employee wearing a tight-fitting, supplied-air
respirator or self-contained breathing apparatus, the employer shall
perform quantitative fit testing at the time of initial fitting and at
least annually thereafter. This shall be accomplished by fit testing an
air purifying respirator of identical type facepiece, make, model, and
size as the supplied air respirator or self-contained breathing
apparatus that is equipped with HEPA filters and tested as a surrogate
(substitute) in the negative pressure mode. A fit factor that is at
least 10 times the protection factor for that class of respirators
(Table 2 in paragraph (g)(2)(i) of this section) shall be achieved
during quantitative fit testing. A supplied-air respirator or self-
contained breathing apparatus with the same type facepiece, make,
model, and size as the air purifying respirator with which the employee
passed the quantitative fit test may then be used by that employee up
to the protection factor listed in Table 2 for that class of
respirators.
(v) Fit testing shall be conducted in accordance with appendix C of
this section.
(h) Emergency situations. The employer shall develop and implement
a written plan for dealing with emergency situations involving
substantial releases of airborne cadmium. The plan shall include
provisions for the use of appropriate respirators and personal
protective equipment. In addition, employees not essential to
correcting the emergency situation shall be restricted from the area
and normal operations halted in that area until the emergency is
abated.
(i) Protective work clothing and equipment--(1) Provision and use.
If an employee is exposed to airborne cadmium above the PEL or where
skin or eye irritation is associated with cadmium exposure at any
level, the employer shall provide at no cost to the employee, and
assure that the employee uses, appropriate protective work clothing and
equipment that prevents contamination of the employee and the
employee's garments. Protective work clothing and equipment includes,
but is not limited to:
(i) Coveralls or similar full-body work clothing;
(ii) Gloves, head coverings, and boots or foot coverings; and
(iii) Face shields, vented goggles, or other appropriate protective
equipment that complies with 29 CFR 1910.133.
(2) Removal and storage. (i) The employer shall assure that
employees remove all protective clothing and equipment contaminated
with cadmium at the completion of the work shift and do so only in
change rooms provided in accordance with paragraph (j)(1) of this
section.
(ii) The employer shall assure that no employee takes cadmium-
contaminated protective clothing or equipment from the workplace,
except for employees authorized to do so for purposes of laundering,
cleaning, maintaining, or disposing of cadmium contaminated protective
clothing and equipment at an appropriate location or facility away from
the workplace.
(iii) The employer shall assure that contaminated protective
clothing and equipment, when removed for laundering, cleaning,
maintenance, or disposal, is placed and stored in sealed, impermeable
bags or other closed, impermeable containers that are designed to
prevent dispersion of cadmium dust.
(iv) The employer shall assure that bags or containers of
contaminated protective clothing and equipment that are to be taken out
of the change rooms or the workplace for laundering, cleaning,
maintenance or disposal shall bear labels in accordance with paragraph
(m)(3) of this section.
(3) Cleaning, replacement, and disposal. (i) The employer shall
provide the protective clothing and equipment required by paragraph
(i)(1) of this section in a clean and dry condition as often as
necessary to maintain its effectiveness, but in any event at least
weekly. The employer is responsible for cleaning and laundering the
protective clothing and equipment required by this paragraph to
maintain its effectiveness and is also responsible for disposing of
such clothing and equipment.
(ii) The employer also is responsible for repairing or replacing
required protective clothing and equipment as needed to maintain its
effectiveness. When rips or tears are detected while an employee is
working they shall be immediately mended, or the worksuit shall be
immediately replaced.
(iii) The employer shall prohibit the removal of cadmium from
protective clothing and equipment by blowing, shaking, or any other
means that disperses cadmium into the air.
(iv) The employer shall assure that any laundering of contaminated
clothing or cleaning of contaminated equipment in the workplace is done
in a manner that prevents the release of airborne cadmium in excess of
the permissible exposure limit prescribed in paragraph (c) of this
section.
(v) The employer shall inform any person who launders or cleans
protective clothing or equipment contaminated with cadmium of the
potentially harmful effects of exposure to cadmium and that the
clothing and equipment should be laundered or cleaned in a manner to
effectively prevent the release of airborne cadmium in excess of the
PEL.
(j) Hygiene areas and practices--(1) General. For employees whose
airborne exposure to cadmium is above the PEL, the employer shall
provide clean change rooms, handwashing facilities, showers, and
lunchroom facilities that comply with 29 CFR 1910.141.
(2) Change rooms. The employer shall assure that change rooms are
equipped with separate storage facilities for street clothes and for
protective clothing and equipment, which are designed to prevent
dispersion of cadmium and contamination of the employee's street
clothes.
(3) Showers and handwashing facilities. (i) The employer shall
assure that employees who are exposed to cadmium above the PEL shower
during the end of the work shift.
(ii) The employer shall assure that employees whose airborne
exposure to cadmium is above the PEL wash their hands and faces prior
to eating, drinking, smoking, chewing tobacco or gum, or applying
cosmetics.
(4) Lunchroom facilities. (i) The employer shall assure that the
lunchroom facilities are readily accessible to employees, that tables
for eating are maintained free of cadmium, and that no employee in a
lunchroom facility is exposed at any time to cadmium at or above a
concentration of 2.5 g/m\3\.
(ii) The employer shall assure that employees do not enter
lunchroom facilities with protective work clothing or equipment unless
surface cadmium has been removed from the clothing and equipment by
HEPA vacuuming or some other method that removes cadmium dust without
dispersing it.
(k) Housekeeping. (1) All surfaces shall be maintained as free as
practicable of accumulations of cadmium.
(2) All spills and sudden releases of material containing cadmium
shall be cleaned up as soon as possible.
(3) Surfaces contaminated with cadmium shall, wherever possible, be
cleaned by vacuuming or other methods that minimize the likelihood of
cadmium becoming airborne.
(4) HEPA-filtered vacuuming equipment or equally effective
filtration methods shall be used for vacuuming. The equipment shall be
used and emptied in a manner that minimizes the reentry of cadmium into
the workplace.
(5) Shoveling, dry or wet sweeping, and brushing may be used only
where vacuuming or other methods that minimize the likelihood of
cadmium becoming airborne have been tried and found not to be
effective.
(6) Compressed air shall not be used to remove cadmium from any
surface unless the compressed air is used in conjunction with a
ventilation system designed to capture the dust cloud created by the
compressed air.
(7) Waste, scrap, debris, bags, containers, personal protective
equipment, and clothing contaminated with cadmium and consigned for
disposal shall be collected and disposed of in sealed impermeable bags
or other closed, impermeable containers. These bags and containers
shall be labeled in accordance with paragraph (m)(2) of this section.
(l) Medical surveillance--(1) General--(i) Scope. (A) Currently
exposed--The employer shall institute a medical surveillance program
for all employees who are or may be exposed to cadmium at or above the
action level unless the employer demonstrates that the employee is not,
and will not be, exposed at or above the action level on 30 or more
days per year (twelve consecutive months); and,
(B) Previously exposed--The employer shall also institute a medical
surveillance program for all employees who prior to the effective date
of this section might previously have been exposed to cadmium at or
above the action level by the employer, unless the employer
demonstrates that the employee did not prior to the effective date of
this section work for the employer in jobs with exposure to cadmium for
an aggregated total of more than 60 months.
(ii) To determine an employee's fitness for using a respirator, the
employer shall provide the limited medical examination specified in
paragraph (l)(6) of this section.
(iii) The employer shall assure that all medical examinations and
procedures required by this standard are performed by or under the
supervision of a licensed physician, who has read and is familiar with
the health effects section of appendix A to this section, the
regulatory text of this section, the protocol for sample handling and
laboratory selection in appendix F to this section, and the
questionnaire of appendix D to this section. These examinations and
procedures shall be provided without cost to the employee and at a time
and place that is reasonable and convenient to employees.
(iv) The employer shall assure that the collecting and handling of
biological samples of cadmium in urine (CdU), cadmium in blood (CdB),
and beta-2 microglobulin in urine (2-M) taken from
employees under this section is done in a manner that assures their
reliability and that analysis of biological samples of cadmium in urine
(CdU), cadmium in blood (CdB), and beta-2 microglobulin in urine
(2-M) taken from employees under this section is
performed in laboratories with demonstrated proficiency for that
particular analyte. (See appendix F to this section.)
(2) Initial examination. (i) The employer shall provide an initial
(preplacement) examination to all employees covered by the medical
surveillance program required in paragraph (l)(1)(i) of this section.
The examination shall be provided to those employees within 30 days
after initial assignment to a job with exposure to cadmium or no later
than 90 days after the effective date of this section, whichever date
is later.
(ii) The initial (preplacement) medical examination shall include:
(A) A detailed medical and work history, with emphasis on: Past,
present, and anticipated future exposure to cadmium; any history of
renal, cardiovascular, respiratory, hematopoietic, reproductive, and/or
musculo-skeletal system dysfunction; current usage of medication with
potential nephrotoxic side-effects; and smoking history and current
status; and
(B) Biological monitoring that includes the following tests:
(1) Cadmium in urine (CdU), standardized to grams of creatinine (g/
Cr);
(2) Beta-2 microglobulin in urine (2-M), standardized
to grams of creatinine (g/Cr), with pH specified, as described in
appendix F to this section; and
(3) Cadmium in blood (CdB), standardized to liters of whole blood
(lwb).
(iii) Recent Examination: An initial examination is not required to
be provided if adequate records show that the employee has been
examined in accordance with the requirements of paragraph (l)(2)(ii) of
this section within the past 12 months. In that case, such records
shall be maintained as part of the employee's medical record and the
prior exam shall be treated as if it were an initial examination for
the purposes of paragraphs (l)(3) and (4) of this section.
(3) Actions triggered by initial biological monitoring. (i) If the
results of the initial biological monitoring tests show the employee's
CdU level to be at or below 3 g/g Cr, 2-M level
to be at or below 300 g/g Cr and CdB level to be at or below 5
g/lwb, then:
(A) For currently exposed employees, who are subject to medical
surveillance under paragraph (l)(1)(i)(A) of this section, the employer
shall provide the minimum level of periodic medical surveillance in
accordance with the requirements in paragraph (l)(4)(i) of this
section; and
(B) For previously exposed employees, who are subject to medical
surveillance under paragraph (l)(1)(i)(B) of this section, the employer
shall provide biological monitoring for CdU, 2-M, and CdB
one year after the initial biological monitoring and then the employer
shall comply with the requirements of paragraph (l)(4)(v) of this
section.
(ii) For all employees who are subject to medical surveillance
under paragraph (l)(1)(i) of this section, if the results of the
initial biological monitoring tests show the level of CdU to exceed 3
g/g Cr, the level of 2-M to exceed 300
g/g Cr, or the level of CdB to exceed 5 g/lwb, the
employer shall:
(A) Within two weeks after receipt of biological monitoring
results, reassess the employee's occupational exposure to cadmium as
follows:
(1) Reassess the employee's work practices and personal hygiene;
(2) Reevaluate the employee's respirator use, if any, and the
respirator program;
(3) Review the hygiene facilities;
(4) Reevaluate the maintenance and effectiveness of the relevant
engineering controls;
(5) Assess the employee's smoking history and status;
(B) Within 30 days after the exposure reassessment, specified in
paragraph (l)(3)(ii)(A) of this section, take reasonable steps to
correct any deficiencies found in the reassessment that may be
responsible for the employee's excess exposure to cadmium; and,
(C) Within 90 days after receipt of biological monitoring results,
provide a full medical examination to the employee in accordance with
the requirements of paragraph (l)(4)(ii) of this section. After
completing the medical examination, the examining physician shall
determine in a written medical opinion whether to medically remove the
employee. If the physician determines that medical removal is not
necessary, then until the employee's CdU level falls to or below 3
g/g Cr, 2-M level falls to or below 300
g/g Cr and CdB level falls to or below 5 g/lwb, the
employer shall:
(1) Provide biological monitoring in accordance with paragraph
(l)(2)(ii)(B) of this section on a semiannual basis; and
(2) Provide annual medical examinations in accordance with
paragraph (l)(4)(ii) of this section.
(iii) For all employees who are subject to medical surveillance
under paragraph (l)(1)(i) of this section, if the results of the
initial biological monitoring tests show the level of CdU to be in
excess of 15 g/g Cr, or the level of CdB to be in excess of 15
g/lwb, or the level of 2-M to be in excess of
1,500 g/g Cr, the employer shall comply with the requirements
of paragraphs (l)(3)(ii)(A)-(B) of this section. Within 90 days after
receipt of biological monitoring results, the employer shall provide a
full medical examination to the employee in accordance with the
requirements of paragraph (l)(4)(ii) of this section. After completing
the medical examination, the examining physician shall determine in a
written medical opinion whether to medically remove the employee.
However, if the initial biological monitoring results and the
biological monitoring results obtained during the medical examination
both show that: CdU exceeds 15 g/g Cr; or CdB exceeds 15
g/lwb; or 2-M exceeds 1500 g/g Cr, and
in addition CdU exceeds 3 g/g Cr or CdB exceeds 5 g/
liter of whole blood, then the physician shall medically remove the
employee from exposure to cadmium at or above the action level. If the
second set of biological monitoring results obtained during the medical
examination does not show that a mandatory removal trigger level has
been exceeded, then the employee is not required to be removed by the
mandatory provisions of this paragraph. If the employee is not required
to be removed by the mandatory provisions of this paragraph or by the
physician's determination, then until the employee's CdU level falls to
or below 3 g/g Cr, 2-M level falls to or below
300 g/g Cr and CdB level falls to or below 5 g/lwb,
the employer shall:
(A) Periodically reassess the employee's occupational exposure to
cadmium;
(B) Provide biological monitoring in accordance with paragraph
(l)(2)(ii)(B) of this section on a quarterly basis; and
(C) Provide semiannual medical examinations in accordance with
paragraph (l)(4)(ii) of this section.
(iv) For all employees to whom medical surveillance is provided,
beginning on January 1, 1999, and in lieu of paragraphs (l)(3)(i)-(iii)
of this section:
(A) If the results of the initial biological monitoring tests show
the employee's CdU level to be at or below 3 g/g Cr,
2-M level to be at or below 300 g/g Cr and CdB
level to be at or below 5 g/lwb, then for currently exposed
employees, the employer shall comply with the requirements of paragraph
(l)(3)(i)(A) of this section, and for previously exposed employees, the
employer shall comply with the requirements of paragraph (l)(3)(i)(B)
of this section;
(B) If the results of the initial biological monitoring tests show
the level of CdU to exceed 3 g/g Cr, the level of
2-M to exceed 300 g/g Cr, or the level of CdB to
exceed 5 g/lwb, the employer shall comply with the
requirements of paragraphs (l)(3)(ii)(A)-(C) of this section; and,
(C) If the results of the initial biological monitoring tests show
the level of CdU to be in excess of 7 g/g Cr, or the level of
CdB to be in excess of 10 g/lwb, or the level of
2-M to be in excess of 750 g/g Cr, the employer
shall: Comply with the requirements of paragraphs (l)(3)(ii)(A)-(B) of
this section; and, within 90 days after receipt of biological
monitoring results, provide a full medical examination to the employee
in accordance with the requirements of paragraph (l)(4)(ii) of this
section. After completing the medical examination, the examining
physician shall determine in a written medical opinion whether to
medically remove the employee. However, if the initial biological
monitoring results and the biological monitoring results obtained
during the medical examination both show that: CdU exceeds 7
g/g Cr; or CdB exceeds 10 g/lwb; or 2-M
exceeds 750 g/g Cr, and in addition CdU exceeds 3 g/g
Cr or CdB exceeds 5 g/liter of whole blood, then the physician
shall medically remove the employee from exposure to cadmium at or
above the action level. If the second set of biological monitoring
results obtained during the medical examination does not show that a
mandatory removal trigger level has been exceeded, then the employee is
not required to be removed by the mandatory provisions of this
paragraph. If the employee is not required to be removed by the
mandatory provisions of this paragraph or by the physician's
determination, then until the employee's CdU level falls to or below 3
g/g Cr, 2-M level falls to or below 300
g/g Cr and CdB level falls to or below 5 g/lwb, the
employer shall: periodically reassess the employee's occupational
exposure to cadmium; provide biological monitoring in accordance with
paragraph (l)(2)(ii)(B) of this section on a quarterly basis; and
provide semiannual medical examinations in accordance with paragraph
(l)(4)(ii) of this section.
(4) Periodic medical surveillance. (i) For each employee who is
covered under paragraph (l)(1)(i)(A) of this section, the employer
shall provide at least the minimum level of periodic medical
surveillance, which consists of periodic medical examinations and
periodic biological monitoring. A periodic medical examination shall be
provided within one year after the initial examination required by
paragraph (l)(2) of this section and thereafter at least biennially.
Biological sampling shall be provided at least annually, either as part
of a periodic medical examination or separately as periodic biological
monitoring.
(ii) The periodic medical examination shall include:
(A) A detailed medical and work history, or update thereof, with
emphasis on: Past, present and anticipated future exposure to cadmium;
smoking history and current status; reproductive history; current use
of medications with potential nephrotoxic side-effects; any history of
renal, cardiovascular, respiratory, hematopoietic, and/or musculo-
skeletal system dysfunction; and as part of the medical and work
history, for employees who wear respirators, questions 3-11 and 25-32
in Appendix D to this section;
(B) A complete physical examination with emphasis on: Blood
pressure, the respiratory system, and the urinary system;
(C) A 14 inch by 17 inch, or a reasonably standard sized posterior-
anterior chest X-ray (after the initial X-ray, the frequency of chest
X-rays is to be determined by the examining physician);
(D) Pulmonary function tests, including forced vital capacity (FVC)
and forced expiratory volume at 1 second (FEV1);
(E) Biological monitoring, as required in paragraph (l)(2)(ii)(B)
of this section;
(F) Blood analysis, in addition to the analysis required under
paragraph (l)(2)(ii)(B) of this section, including blood urea nitrogen,
complete blood count, and serum creatinine;
(G) Urinalysis, in addition to the analysis required under
paragraph (l)(2)(ii)(B) of this section, including the determination of
albumin, glucose, and total and low molecular weight proteins;
(H) For males over 40 years old, prostate palpation, or other at
least as effective diagnostic test(s); and
(I) Any additional tests deemed appropriate by the examining
physician.
(iii) Periodic biological monitoring shall be provided in
accordance with paragraph (l)(2)(ii)(B) of this section.
(iv) If the results of periodic biological monitoring or the
results of biological monitoring performed as part of the periodic
medical examination show the level of the employee's CdU,
2-M, or CdB to be in excess of the levels specified in
paragraphs (l)(3) (ii) or (iii); or, beginning on January 1, 1999, in
excess of the levels specified in paragraphs (l)(3) (ii) or (iv) of
this section, the employer shall take the appropriate actions specified
in paragraphs (l)(3)(ii)-(iv) of this section.
(v) For previously exposed employees under paragraph (l)(1)(i)(B)
of this section:
(A) If the employee's levels of CdU did not exceed 3 g/g
Cr, CdB did not exceed 5 g/lwb, and 2-M did not
exceed 300 g/g Cr in the initial biological monitoring tests,
and if the results of the followup biological monitoring required by
paragraph (l)(3)(i)(B) of this section one year after the initial
examination confirm the previous results, the employer may discontinue
all periodic medical surveillance for that employee.
(B) If the initial biological monitoring results for CdU, CdB, or
2-M were in excess of the levels specified in paragraph
(l)(3)(i) of this section, but subsequent biological monitoring results
required by paragraph (l)(3)(ii)-(iv) of this section show that the
employee's CdU levels no longer exceed 3 g/g Cr, CdB levels no
longer exceed 5 g/lwb, and 2-M levels no longer
exceed 300 g/g Cr, the employer shall provide biological
monitoring for CdU, CdB, and 2-M one year after these
most recent biological monitoring results. If the results of the
followup biological monitoring, specified in this paragraph, confirm
the previous results, the employer may discontinue all periodic medical
surveillance for that employee.
(C) However, if the results of the follow-up tests specified in
paragraph (l)(4)(v)(A) or (B) of this section indicate that the level
of the employee's CdU, 2-M, or CdB exceeds these same
levels, the employer is required to provide annual medical examinations
in accordance with the provisions of paragraph (l)(4)(ii) of this
section until the results of biological monitoring are consistently
below these levels or the examining physician determines in a written
medical opinion that further medical surveillance is not required to
protect the employee's health.
(vi) A routine, biennial medical examination is not required to be
provided in accordance with paragraphs (l)(3)(i) and (l)(4) of this
section if adequate medical records show that the employee has been
examined in accordance with the requirements of paragraph (l)(4)(ii) of
this section within the past 12 months. In that case, such records
shall be maintained by the employer as part of the employee's medical
record, and the next routine, periodic medical examination shall be
made available to the employee within two years of the previous
examination.
(5) Actions triggered by medical examinations. (i) If the results
of a medical examination carried out in accordance with this section
indicate any laboratory or clinical finding consistent with cadmium
toxicity that does not require employer action under paragraph (l)(2),
(3) or (4) of this section, the employer, within 30 days, shall
reassess the employee's occupational exposure to cadmium and take the
following corrective action until the physician determines they are no
longer necessary:
(A) Periodically reassess: The employee's work practices and
personal hygiene; the employee's respirator use, if any; the employee's
smoking history and status; the respiratory protection program; the
hygiene facilities; and the maintenance and effectiveness of the
relevant engineering controls;
(B) Within 30 days after the reassessment, take all reasonable
steps to correct the deficiencies found in the reassessment that may be
responsible for the employee's excess exposure to cadmium;
(C) Provide semiannual medical reexaminations to evaluate the
abnormal clinical sign(s) of cadmium toxicity until the results are
normal or the employee is medically removed; and
(D) Where the results of tests for total proteins in urine are
abnormal, provide a more detailed medical evaluation of the toxic
effects of cadmium on the employee's renal system.
(6) Examination for respirator use. (i) To determine an employee's
fitness for respirator use, the employer shall provide a medical
examination that includes the elements specified in paragraph (l)(6)(i)
(A)-(D) of this section. This examination shall be provided prior to
the employee's being assigned to a job that requires the use of a
respirator or no later than 90 days after this section goes into
effect, whichever date is later, to any employee without a medical
examination within the preceding 12 months that satisfies the
requirements of this paragraph.
(A) A detailed medical and work history, or update thereof, with
emphasis on: Past exposure to cadmium; smoking history and current
status; any history of renal, cardiovascular, respiratory,
hematopoietic, and/or musculoskeletal system dysfunction; a description
of the job for which the respirator is required; and questions 3-11 and
25-32 in appendix D to this section;
(B) A blood pressure test;
(C) Biological monitoring of the employee's levels of CdU, CdB and
2-M in accordance with the requirements of paragraph
(l)(2)(ii)(B) of this section, unless such results already have been
obtained within the previous 12 months; and
(D) Any other test or procedure that the examining physician deems
appropriate.
(ii) After reviewing all the information obtained from the medical
examination required in paragraph (l)(6)(i) of this section, the
physician shall determine whether the employee is fit to wear a
respirator.
(iii) Whenever an employee has exhibited difficulty in breathing
during a respirator fit test or during use of a respirator, the
employer, as soon as possible, shall provide the employee with a
periodic medical examination in accordance with paragraph (l)(4)(ii) of
this section to determine the employee's fitness to wear a respirator.
(iv) Where the results of the examination required under paragraph
(l)(6)(i), (ii), or (iii) of this section are abnormal, medical
limitation or prohibition of respirator use shall be considered. If the
employee is allowed to wear a respirator, the employee's ability to
continue to do so shall be periodically evaluated by a physician.
(7) Emergency examinations. (i) In addition to the medical
surveillance required in paragraphs (l)(2)-(6) of this section, the
employer shall provide a medical examination as soon as possible to any
employee who may have been acutely exposed to cadmium because of an
emergency.
(ii) The examination shall include the requirements of paragraph
(l)(4)(ii) of this section, with emphasis on the respiratory system,
other organ systems considered appropriate by the examining physician,
and symptoms of acute overexposure, as identified in paragraphs II
(B)(1)-(2) and IV of appendix A to this section.
(8) Termination of employment examination. (i) At termination of
employment, the employer shall provide a medical examination in
accordance with paragraph (l)(4)(ii) of this section, including a chest
X-ray, to any employee to whom at any prior time the employer was
required to provide medical surveillance under paragraphs (l)(1)(i) or
(l)(7) of this section. However, if the last examination satisfied the
requirements of paragraph (l)(4)(ii) of this section and was less than
six months prior to the date of termination, no further examination is
required unless otherwise specified in paragraphs (l)(3) or (l)(5) of
this section;
(ii) However, for employees covered by paragraph (l)(1)(i)(B) of
this section, if the employer has discontinued all periodic medical
surveillance under paragraph (l)(4)(v) of this section, no termination
of employment medical examination is required.
(9) Information provided to the physician. The employer shall
provide the following information to the examining physician:
(i) A copy of this standard and appendices;
(ii) A description of the affected employee's former, current, and
anticipated duties as they relate to the employee's occupational
exposure to cadmium;
(iii) The employee's former, current, and anticipated future levels
of occupational exposure to cadmium;
(iv) A description of any personal protective equipment, including
respirators, used or to be used by the employee, including when and for
how long the employee has used that equipment; and
(v) relevant results of previous biological monitoring and medical
examinations.
(10) Physician's written medical opinion. (i) The employer shall
promptly obtain a written, signed medical opinion from the examining
physician for each medical examination performed on each employee. This
written opinion shall contain:
(A) The physician's diagnosis for the employee;
(B) The physician's opinion as to whether the employee has any
detected medical condition(s) that would place the employee at
increased risk of material impairment to health from further exposure
to cadmium, including any indications of potential cadmium toxicity;
(C) The results of any biological or other testing or related
evaluations that directly assess the employee's absorption of cadmium;
(D) Any recommended removal from, or limitation on the activities
or duties of the employee or on the employee's use of personal
protective equipment, such as respirators;
(E) A statement that the physician has clearly and carefully
explained to the employee the results of the medical examination,
including all biological monitoring results and any medical conditions
related to cadmium exposure that require further evaluation or
treatment, and any limitation on the employee's diet or use of
medications.
(ii) The employer promptly shall obtain a copy of the results of
any biological monitoring provided by an employer to an employee
independently of a medical examination under paragraphs (l)(2) and
(l)(4) of this section, and, in lieu of a written medical opinion, an
explanation sheet explaining those results.
(iii) The employer shall instruct the physician not to reveal
orally or in the written medical opinion given to the employer specific
findings or diagnoses unrelated to occupational exposure to cadmium.
(11) Medical Removal Protection (MRP)--(i) General. (A) The
employer shall temporarily remove an employee from work where there is
excess exposure to cadmium on each occasion that medical removal is
required under paragraph (l)(3), (l)(4), or (l)(6) of this section and
on each occasion that a physician determines in a written medical
opinion that the employee should be removed from such exposure. The
physician's determination may be based on biological monitoring
results, inability to wear a respirator, evidence of illness, other
signs or symptoms of cadmium-related dysfunction or disease, or any
other reason deemed medically sufficient by the physician.
(B) The employer shall medically remove an employee in accordance
with paragraph (l)(11) of this section regardless of whether at the
time of removal a job is available into which the removed employee may
be transferred.
(C) Whenever an employee is medically removed under paragraph
(l)(11) of this section, the employer shall transfer the removed
employee to a job where the exposure to cadmium is within the
permissible levels specified in that paragraph as soon as one becomes
available.
(D) For any employee who is medically removed under the provisions
of paragraph (l)(11)(i) of this section, the employer shall provide
follow-up biological monitoring in accordance with (l)(2)(ii)(B) of
this section at least every three months and follow-up medical
examinations semi-annually at least every six months until in a written
medical opinion the examining physician determines that either the
employee may be returned to his/her former job status as specified
under paragraph (l)(11)(iv)-(v) of this section or the employee must be
permanently removed from excess cadmium exposure.
(E) The employer may not return an employee who has been medically
removed for any reason to his/her former job status until a physician
determines in a written medical opinion that continued medical removal
is no longer necessary to protect the employee's health.
(ii) Where an employee is found unfit to wear a respirator under
paragraph (l)(6)(ii) of this section, the employer shall remove the
employee from work where exposure to cadmium is above the PEL.
(iii) Where removal is based on any reason other than the
employee's inability to wear a respirator, the employer shall remove
the employee from work where exposure to cadmium is at or above the
action level.
(iv) Except as specified in paragraph (l)(11)(v) of this section,
no employee who was removed because his/her level of CdU, CdB and/or
2-M exceeded the medical removal trigger levels in
paragraph (l)(3) or (l)(4) of this section may be returned to work with
exposure to cadmium at or above the action level until the employee's
levels of CdU fall to or below 3 g/g Cr, CdB falls to or below
5 g/lwb, and 2-M falls to or below 300
g/g Cr.
(v) However, when in the examining physician's opinion continued
exposure to cadmium will not pose an increased risk to the employee's
health and there are special circumstances that make continued medical
removal an inappropriate remedy, the physician shall fully discuss
these matters with the employee, and then in a written determination
may return a worker to his/her former job status despite what would
otherwise be unacceptably high biological monitoring results.
Thereafter, the returned employee shall continue to be provided with
medical surveillance as if he/she were still on medical removal until
the employee's levels of CdU fall to or below 3 g/g Cr, CdB
falls to or below 5 g/lwb, and 2-M falls to or
below 300 g/g Cr.
(vi) Where an employer, although not required by paragraph
(l)(11)(i)-(iii) of this section to do so, removes an employee from
exposure to cadmium or otherwise places limitations on an employee due
to the effects of cadmium exposure on the employee's medical condition,
the employer shall provide the same medical removal protection benefits
to that employee under paragraph (l)(12) of this section as would have
been provided had the removal been required under paragraph (l)(11)(i)-
(iii) of this section.
(12) Medical Removal Protection Benefits (MRPB). (i) The employer
shall provide MRPB for up to a maximum of 18 months to an employee each
time and while the employee is temporarily medically removed under
paragraph (l)(11) of this section.
(ii) For purposes of this section, the requirement that the
employer provide MRPB means that the employer shall maintain the total
normal earnings, seniority, and all other employee rights and benefits
of the removed employee, including the employee's right to his/her
former job status, as if the employee had not been removed from the
employee's job or otherwise medically limited.
(iii) Where, after 18 months on medical removal because of elevated
biological monitoring results, the employee's monitoring results have
not declined to a low enough level to permit the employee to be
returned to his/her former job status:
(A) The employer shall make available to the employee a medical
examination pursuant to this section in order to obtain a final medical
determination as to whether the employee may be returned to his/her
former job status or must be permanently removed from excess cadmium
exposure; and
(B) The employer shall assure that the final medical determination
indicates whether the employee may be returned to his/her former job
status and what steps, if any, should be taken to protect the
employee's health.
(iv) The employer may condition the provision of MRPB upon the
employee's participation in medical surveillance provided in accordance
with this section.
(13) Multiple physician review. (i) If the employer selects the
initial physician to conduct any medical examination or consultation
provided to an employee under this section, the employee may designate
a second physician to:
(A) Review any findings, determinations, or recommendations of the
initial physician; and
(B) Conduct such examinations, consultations, and laboratory tests
as the second physician deems necessary to facilitate this review.
(ii) The employer shall promptly notify an employee of the right to
seek a second medical opinion after each occasion that an initial
physician provided by the employer conducts a medical examination or
consultation pursuant to this section. The employer may condition its
participation in, and payment for, multiple physician review upon the
employee doing the following within fifteen (15) days after receipt of
this notice, or receipt of the initial physician's written opinion,
whichever is later:
(A) Informing the employer that he or she intends to seek a medical
opinion; and
(B) Initiating steps to make an appointment with a second
physician.
(iii) If the findings, determinations, or recommendations of the
second physician differ from those of the initial physician, then the
employer and the employee shall assure that efforts are made for the
two physicians to resolve any disagreement.
(iv) If the two physicians have been unable to quickly resolve
their disagreement, then the employer and the employee, through their
respective physicians, shall designate a third physician to:
(A) Review any findings, determinations, or recommendations of the
other two physicians; and
(B) Conduct such examinations, consultations, laboratory tests, and
discussions with the other two physicians as the third physician deems
necessary to resolve the disagreement among them.
(v) The employer shall act consistently with the findings,
determinations, and recommendations of the third physician, unless the
employer and the employee reach an agreement that is consistent with
the recommendations of at least one of the other two physicians.
(14) Alternate physician determination. The employer and an
employee or designated employee representative may agree upon the use
of any alternate form of physician determination in lieu of the
multiple physician review provided by paragraph (l)(13) of this
section, so long as the alternative is expeditious and at least as
protective of the employee.
(15) Information the employer must provide the employee. (i) The
employer shall provide a copy of the physician's written medical
opinion to the examined employee within two weeks after receipt
thereof.
(ii) The employer shall provide the employee with a copy of the
employee's biological monitoring results and an explanation sheet
explaining the results within two weeks after receipt thereof.
(iii) Within 30 days after a request by an employee, the employer
shall provide the employee with the information the employer is
required to provide the examining physician under paragraph (l)(9) of
this section.
(16) Reporting. In addition to other medical events that are
required to be reported on the OSHA Form No. 200, the employer shall
report any abnormal condition or disorder caused by occupational
exposure to cadmium associated with employment as specified in Chapter
(V)(E) of the Reporting Guidelines for Occupational Injuries and
Illnesses.
(m) Communication of cadmium hazards to employees--(1) General. In
communications concerning cadmium hazards, employers shall comply with
the requirements of OSHA's Hazard Communication Standard, 29 CFR
1910.1200, including but not limited to the requirements concerning
warning signs and labels, material safety data sheets (MSDS), and
employee information and training. In addition, employers shall comply
with the following requirements:
(2) Warning signs. (i) Warning signs shall be provided and
displayed in regulated areas. In addition, warning signs shall be
posted at all approaches to regulated areas so that an employee may
read the signs and take necessary protective steps before entering the
area.
(ii) Warning signs required by paragraph (m)(2)(i) of this section
shall bear the following information:
DANGER
CADMIUM
CANCER HAZARD
CAN CAUSE LUNG AND KIDNEY DISEASE
AUTHORIZED PERSONNEL ONLY
RESPIRATORS REQUIRED IN THIS AREA
(iii) The employer shall assure that signs required by this
paragraph are illuminated, cleaned, and maintained as necessary so that
the legend is readily visible.
(3) Warning labels. (i) Shipping and storage containers containing
cadmium, cadmium compounds, or cadmium contaminated clothing,
equipment, waste, scrap, or debris shall bear appropriate warning
labels, as specified in paragraph (m)(3)(ii) of this section.
(ii) The warning labels shall include at least the following
information:
DANGER
CONTAINS CADMIUM
CANCER HAZARD
AVOID CREATING DUST
CAN CAUSE LUNG AND KIDNEY DISEASE
(iii) Where feasible, installed cadmium products shall have a
visible label or other indication that cadmium is present.
(4) Employee information and training. (i) The employer shall
institute a training program for all employees who are potentially
exposed to cadmium, assure employee participation in the program, and
maintain a record of the contents of such program.
(ii) Training shall be provided prior to or at the time of initial
assignment to a job involving potential exposure to cadmium and at
least annually thereafter.
(iii) The employer shall make the training program understandable
to the employee and shall assure that each employee is informed of the
following:
(A) The health hazards associated with cadmium exposure, with
special attention to the information incorporated in appendix A to this
section;
(B) The quantity, location, manner of use, release, and storage of
cadmium in the workplace and the specific nature of operations that
could result in exposure to cadmium, especially exposures above the
PEL;
(C) The engineering controls and work practices associated with the
employee's job assignment;
(D) The measures employees can take to protect themselves from
exposure to cadmium, including modification of such habits as smoking
and personal hygiene, and specific procedures the employer has
implemented to protect employees from exposure to cadmium such as
appropriate work practices, emergency procedures, and the provision of
personal protective equipment;
(E) The purpose, proper selection, fitting, proper use, and
limitations of respirators and protective clothing;
(F) The purpose and a description of the medical surveillance
program required by paragraph (l) of this section;
(G) The contents of this section and its appendices; and
(H) The employee's rights of access to records under Sec. 1915.1120
(e) and (g).
(iv) Additional access to information and training program and
materials.
(A) The employer shall make a copy of this section and its
appendices readily available without cost to all affected employees and
shall provide a copy if requested.
(B) The employer shall provide to the Assistant Secretary or the
Director, upon request, all materials relating to the employee
information and the training program.
(n) Recordkeeping--(1) Exposure monitoring. (i) The employer shall
establish and keep an accurate record of all air monitoring for cadmium
in the workplace.
(ii) This record shall include at least the following information:
(A) The monitoring date, duration, and results in terms of an 8-
hour TWA of each sample taken;
(B) The name, social security number, and job classification of the
employees monitored and of all other employees whose exposures the
monitoring is intended to represent;
(C) A description of the sampling and analytical methods used and
evidence of their accuracy;
(D) The type of respiratory protective device, if any, worn by the
monitored employee;
(E) A notation of any other conditions that might have affected the
monitoring results.
(iii) The employer shall maintain this record for at least thirty
(30) years, in accordance with Sec. 1915.1120 of this part.
(2) Objective data for exemption from requirement for initial
monitoring. (i) For purposes of this section, objective data are
information demonstrating that a particular product or material
containing cadmium or a specific process, operation, or activity
involving cadmium cannot release dust or fumes in concentrations at or
above the action level even under the worst-case release conditions.
Objective data can be obtained from an industry-wide study or from
laboratory product test results from manufacturers of cadmium-
containing products or materials. The data the employer uses from an
industry-wide survey must be obtained under workplace conditions
closely resembling the processes, types of material, control methods,
work practices and environmental conditions in the employer's current
operations.
(ii) The employer shall establish and maintain a record of the
objective data for at least 30 years.
(3) Medical surveillance. (i) The employer shall establish and
maintain an accurate record for each employee covered by medical
surveillance under paragraph (l)(1)(i) of this section.
(ii) The record shall include at least the following information
about the employee:
(A) Name, social security number, and description of the duties;
(B) A copy of the physician's written opinions and an explanation
sheet for biological monitoring results;
(C) A copy of the medical history, and the results of any physical
examination and all test results that are required to be provided by
this section, including biological tests, X-rays, pulmonary function
tests, etc., or that have been obtained to further evaluate any
condition that might be related to cadmium exposure;
(D) The employee's medical symptoms that might be related to
exposure to cadmium; and
(E) A copy of the information provided to the physician as required
by paragraph (l)(9)(ii)-(v) of this section.
(iii) The employer shall assure that this record is maintained for
the duration of employment plus thirty (30) years, in accordance with
Sec. 1915.1120 of this part.
(4) Training. The employer shall certify that employees have been
trained by preparing a certification record which includes the identity
of the person trained, the signature of the employer or the person who
conducted the training, and the date the training was completed. The
certification records shall be prepared at the completion of training
and shall be maintained on file for one (1) year beyond the date of
training of that employee.
(5) Availability. (i) Except as otherwise provided for in this
section, access to all records required to be maintained by paragraphs
(n)(1)-(4) of this section shall be in accordance with the provisions
of Sec. 1915.1120 of this part.
(ii) Within 15 days after a request, the employer shall make an
employee's medical records required to be kept by paragraph (n)(3) of
this section available for examination and copying to the subject
employee, to designated representatives, to anyone having the specific
written consent of the subject employee, and after the employee's death
or incapacitation, to the employee's family members.
(6) Transfer of records. Whenever an employer ceases to do business
and there is no successor employer to receive and retain records for
the prescribed period or the employer intends to dispose of any records
required to be preserved for at least 30 years, the employer shall
comply with the requirements concerning transfer of records set forth
in Sec. 1915.1120(h) of this part.
(o) Observation of monitoring--(1) Employee observation. The
employer shall provide affected employees or their designated
representatives an opportunity to observe any monitoring of employee
exposure to cadmium.
(2) Observation procedures. When observation of monitoring requires
entry into an area where the use of protective clothing or equipment is
required, the employer shall provide the observer with that clothing
and equipment and shall assure that the observer uses such clothing and
equipment and complies with all other applicable safety and health
procedures.
(p) Dates--(1) Effective date. This section shall become effective
December 14, 1992.
(2) Start-up dates. All obligations of this section commence on the
effective date except as follows:
(i) Exposure monitoring. Except for small businesses (nineteen (19)
or fewer employees), initial monitoring required by paragraph (d)(2) of
this section shall be completed as soon as possible and in any event no
later than February 12, 1993. For small businesses, initial monitoring
required by paragraph (d)(2) of this section shall be completed as soon
as possible and in any event no later than April 14, 1993.
(ii) Regulated areas. Except for small business, defined under
paragraph (p)(2)(i) of this section, regulated areas required to be
established by paragraph (e) of this section shall be set up as soon as
possible after the results of exposure monitoring are known and in any
event no later than March 15, 1993. For small businesses, regulated
areas required to be established by paragraph (e) of this section shall
be set up as soon as possible after the results of exposure monitoring
are known and in any event no later than May 14, 1993.
(iii) Respiratory protection. Except for small businesses, defined
under paragraph (p)(2)(i) of this section, respiratory protection
required by paragraph (g) of this section shall be provided as soon as
possible and in any event no later than 90 days after the effective
date of this section. For small businesses, respiratory protection
required by paragraph (g) of this section shall be provided as soon as
possible and in any event no later than March 15, 1993.
(iv) Compliance program. Written compliance programs required by
paragraph (f)(2) of this section shall be completed and available for
inspection and copying as soon as possible and in any event no later
than December 14, 1993.
(v) Methods of compliance. The engineering controls required by
paragraph (f)(1) of this section shall be implemented as soon as
possible and in any event no later than December 14, 1994. Work
practice controls shall be implemented as soon as possible. Work
practice controls that are directly related to engineering controls to
be implemented in accordance with the compliance plan shall be
implemented as soon as possible after such engineering controls are
implemented.
(vi) Hygiene and lunchroom facilities. (A) Handwashing facilities,
permanent or temporary, shall be provided in accordance with 29 CFR
1910.141 (d)(1) and (2) as soon as possible and in any event no later
than February 12, 1993.
(B) Change rooms, showers, and lunchroom facilities shall be
completed as soon as possible and in any event no later than December
14, 1993.
(vii) Employee information and training. Except for small
businesses, defined under paragraph (p)(2)(i) of this section, employee
information and training required by paragraph (m)(4) of this section
shall be provided as soon as possible and in any event no later than
March 15, 1993. For small businesses, employee information and training
required by paragraph (m)(4) of this standard shall be provided as soon
as possible and in any event no later than June 14, 1993.
(viii) Medical surveillance. Except for small businesses, defined
under paragraph (p)(2)(i) of this section, initial medical examinations
required by paragraph (l) of this section shall be provided as soon as
possible and in any event no later than March 15, 1993. For small
businesses, initial medical examinations required by paragraph (l) of
this section shall be provided as soon as possible and in any event no
later than June 14, 1993.
(q) Appendices. (1) Appendix C to this section is incorporated as
part of this section, and compliance with its contents is mandatory.
(2) Except where portions of appendices A, B, D, E, and F to this
section are expressly incorporated in requirements of this section,
these appendices are purely informational and are not intended to
create any additional obligations not otherwise imposed or to detract
from any existing obligations.
Appendix A to Sec. 1915.1027--Substance Safety Data Sheet
Cadmium
I. Substance Identification
A. Substance: Cadmium.
B. 8-Hour, Time-weighted-average, Permissible Exposure Limit
(TWA PEL):
1. TWA PEL: Five micrograms of cadmium per cubic meter of air 5
g/m3, time-weighted average (TWA) for an 8-hour
workday.
C. Appearance: Cadmium metal--soft, blue-white, malleable,
lustrous metal or grayish-white powder. Some cadmium compounds may
also appear as a brown, yellow, or red powdery substance.
II. Health Hazard Data
A. Routes of Exposure. Cadmium can cause local skin or eye
irritation. Cadmium can affect your health if you inhale it or if
you swallow it.
B. Effects of Overexposure.
1. Short-term (acute) exposure: Cadmium is much more dangerous
by inhalation than by ingestion. High exposures to cadmium that may
be immediately dangerous to life or health occur in jobs where
workers handle large quantities of cadmium dust or fume; heat
cadmium-containing compounds or cadmium-coated surfaces; weld with
cadmium solders or cut cadmium-containing materials such as bolts.
2. Severe exposure may occur before symptoms appear. Early
symptoms may include mild irritation of the upper respiratory tract,
a sensation of constriction of the throat, a metallic taste and/or a
cough. A period of 1-10 hours may precede the onset of rapidly
progressing shortness of breath, chest pain, and flu-like symptoms
with weakness, fever, headache, chills, sweating and muscular pain.
Acute pulmonary edema usually develops within 24 hours and reaches a
maximum by three days. If death from asphyxia does not occur,
symptoms may resolve within a week.
3. Long-term (chronic) exposure. Repeated or long-term exposure
to cadmium, even at relatively low concentrations, may result in
kidney damage and an increased risk of cancer of the lung and of the
prostate.
C. Emergency First Aid Procedures.
1. Eye exposure: Direct contact may cause redness or pain. Wash
eyes immediately with large amounts of water, lifting the upper and
lower eyelids. Get medical attention immediately.
2. Skin exposure: Direct contact may result in irritation.
Remove contaminated clothing and shoes immediately. Wash affected
area with soap or mild detergent and large amounts of water. Get
medical attention immediately.
3. Ingestion: Ingestion may result in vomiting, abdominal pain,
nausea, diarrhea, headache and sore throat. Treatment for symptoms
must be administered by medical personnel. Under no circumstances
should the employer allow any person whom he retains, employs,
supervises or controls to engage in therapeutic chelation. Such
treatment is likely to translocate cadmium from pulmonary or other
tissue to renal tissue. Get medical attention immediately.
4. Inhalation: If large amounts of cadmium are inhaled, the
exposed person must be moved to fresh air at once. If breathing has
stopped, perform cardiopulmonary resuscitation. Administer oxygen if
available. Keep the affected person warm and at rest. Get medical
attention immediately.
5. Rescue: Move the affected person from the hazardous exposure.
If the exposed person has been overcome, attempt rescue only after
notifying at least one other person of the emergency and putting
into effect established emergency procedures. Do not become a
casualty yourself. Understand your emergency rescue procedures and
know the location of the emergency equipment before the need arises.
III. Employee Information
A. Protective Clothing and Equipment.
1. Respirators: You may be required to wear a respirator for
non-routine activities; in emergencies; while your employer is in
the process of reducing cadmium exposures through engineering
controls; and where engineering controls are not feasible. If
respirators are worn in the future, they must have a joint Mine
Safety and Health Administration (MSHA) and National Institute for
Occupational Safety and Health (NIOSH) label of approval. Cadmium
does not have a detectable odor except at levels well above the
permissible exposure limits. If you can smell cadmium while wearing
a respirator, proceed immediately to fresh air. If you experience
difficulty breathing while wearing a respirator, tell your employer.
2. Protective Clothing: You may be required to wear impermeable
clothing, gloves, foot gear, a face shield, or other appropriate
protective clothing to prevent skin contact with cadmium. Where
protective clothing is required, your employer must provide clean
garments to you as necessary to assure that the clothing protects
you adequately. The employer must replace or repair protective
clothing that has become torn or otherwise damaged.
3. Eye Protection: You may be required to wear splash-proof or
dust resistant goggles to prevent eye contact with cadmium.
B. Employer Requirements.
1. Medical: If you are exposed to cadmium at or above the action
level, your employer is required to provide a medical examination,
laboratory tests and a medical history according to the medical
surveillance provisions under paragraph (1) of this standard. (See
summary chart and tables in this appendix A.) These tests shall be
provided without cost to you. In addition, if you are accidentally
exposed to cadmium under conditions known or suspected to constitute
toxic exposure to cadmium, your employer is required to make special
tests available to you.
2. Access to Records: All medical records are kept strictly
confidential. You or your representative are entitled to see the
records of measurements of your exposure to cadmium. Your medical
examination records can be furnished to your personal physician or
designated representative upon request by you to your employer.
3. Observation of Monitoring: Your employer is required to
perform measurements that are representative of your exposure to
cadmium and you or your designated representative are entitled to
observe the monitoring procedure. You are entitled to observe the
steps taken in the measurement procedure, and to record the results
obtained. When the monitoring procedure is taking place in an area
where respirators or personal protective clothing and equipment are
required to be worn, you or your representative must also be
provided with, and must wear the protective clothing and equipment.
C. Employee Requirements.--You will not be able to smoke, eat,
drink, chew gum or tobacco, or apply cosmetics while working with
cadmium in regulated areas. You will also not be able to carry or
store tobacco products, gum, food, drinks or cosmetics in regulated
areas because these products easily become contaminated with cadmium
from the workplace and can therefore create another source of
unnecessary cadmium exposure.
Some workers will have to change out of work clothes and shower
at the end of the day, as part of their workday, in order to wash
cadmium from skin and hair. Handwashing and cadmium-free eating
facilities shall be provided by the employer and proper hygiene
should always be performed before eating. It is also recommended
that you do not smoke or use tobacco products, because among other
things, they naturally contain cadmium. For further information,
read the labeling on such products.
IV. Physician Information
A. Introduction.--The medical surveillance provisions of
paragraph (1) generally are aimed at accomplishing three main
interrelated purposes: First, identifying employees at higher risk
of adverse health effects from excess, chronic exposure to cadmium;
second, preventing cadmium-induced disease; and third, detecting and
minimizing existing cadmium-induced disease. The core of medical
surveillance in this standard is the early and periodic monitoring
of the employee's biological indicators of: (a) Recent exposure to
cadmium; (b) cadmium body burden; and (c) potential and actual
kidney damage associated with exposure to cadmium.
The main adverse health effects associated with cadmium
overexposure are lung cancer and kidney dysfunction. It is not yet
known how to adequately biologically monitor human beings to
specifically prevent cadmium-induced lung cancer. By contrast, the
kidney can be monitored to provide prevention and early detection of
cadmium-induced kidney damage. Since, for non-carcinogenic effects,
the kidney is considered the primary target organ of chronic
exposure to cadmium, the medical surveillance provisions of this
standard effectively focus on cadmium-induced kidney disease. Within
that focus, the aim, where possible, is to prevent the onset of such
disease and, where necessary, to minimize such disease as may
already exist. The by-products of successful prevention of kidney
disease are anticipated to be the reduction and prevention of other
cadmium-induced diseases.
B. Health Effects.--The major health effects associated with
cadmium overexposure are described below.
1. Kidney: The most prevalent non-malignant disease observed
among workers chronically exposed to cadmium is kidney dysfunction.
Initially, such dysfunction is manifested as proteinuria. The
proteinuria associated with cadmium exposure is most commonly
characterized by excretion of low-molecular weight proteins (15,000
to 40,000 MW) accompanied by loss of electrolytes, uric acid,
calcium, amino acids, and phosphate. The compounds commonly excreted
include: beta-2-microglobulin (2-M), retinol binding
protein (RBP), immunoglobulin light chains, and lysozyme. Excretion
of low molecular weight proteins are characteristic of damage to the
proximal tubules of the kidney (Iwao et al., 1980).
It has also been observed that exposure to cadmium may lead to
urinary excretion of high-molecular weight proteins such as albumin,
immunoglobulin G, and glycoproteins (Ex. 29). Excretion of high-
molecular weight proteins is typically indicative of damage to the
glomeruli of the kidney. Bernard et al., (1979) suggest that damage
to the glomeruli and damage to the proximal tubules of the kidney
may both be linked to cadmium exposure but they may occur
independently of each other.
Several studies indicate that the onset of low-molecular weight
proteinuria is a sign of irreversible kidney damage (Friberg et al.,
1974; Roels et al., 1982; Piscator 1984; Elinder et al., 1985; Smith
et al., 1986). Above specific levels of 2-M associated
with cadmium exposure it is unlikely that 2-M levels
return to normal even when cadmium exposure is eliminated by removal
of the individual from the cadmium work environment (Friberg, Ex.
29, 1990).
Some studies indicate that such proteinuria may be progressive;
levels of 2-M observed in the urine increase with time
even after cadmium exposure has ceased. See, for example, Elinder et
al., 1985. Such observations, however, are not universal, and it has
been suggested that studies in which proteinuria has not been
observed to progress may not have tracked patients for a
sufficiently long time interval (Jarup, Ex. 8-661).
When cadmium exposure continues after the onset of proteinuria,
chronic nephrotoxicity may occur (Friberg, Ex. 29). Uremia results
from the inability of the glomerulus to adequately filter blood.
This leads to severe disturbance of electrolyte concentrations and
may lead to various clinical complications including kidney stones
(L-140-50).
After prolonged exposure to cadmium, glomerular proteinuria,
glucosuria, aminoaciduria, phosphaturia, and hypercalciuria may
develop (Exs. 8-86, 4-28, 14-18). Phosphate, calcium, glucose, and
amino acids are essential to life, and under normal conditions,
their excretion should be regulated by the kidney. Once low
molecular weight proteinuria has developed, these elements dissipate
from the human body. Loss of glomerular function may also occur,
manifested by decreased glomerular filtration rate and increased
serum creatinine. Severe cadmium-induced renal damage may eventually
develop into chronic renal failure and uremia (Ex. 55).
Studies in which animals are chronically exposed to cadmium
confirm the renal effects observed in humans (Friberg et al., 1986).
Animal studies also confirm problems with calcium metabolism and
related skeletal effects which have been observed among humans
exposed to cadmium in addition to the renal effects. Other effects
commonly reported in chronic animal studies include anemia, changes
in liver morphology, immunosuppression and hypertension. Some of
these effects may be associated with co-factors. Hypertension, for
example, appears to be associated with diet as well as cadmium
exposure. Animals injected with cadmium have also shown testicular
necrosis (Ex. 8-86B).
2. Biological Markers
It is universally recognized that the best measures of cadmium
exposures and its effects are measurements of cadmium in biological
fluids, especially urine and blood. Of the two, CdU is
conventionally used to determine body burden of cadmium in workers
without kidney disease. CdB is conventionally used to monitor for
recent exposure to cadmium. In addition, levels of CdU and CdB
historically have been used to predict the percent of the population
likely to develop kidney disease (Thun et al., Ex. L-140-50; WHO,
Ex. 8-674; ACGIH, Exs. 8-667, 140-50).
The third biological parameter upon which OSHA relies for
medical surveillance is Beta-2-microglobulin in urine
(2-M), a low molecular weight protein. Excess
2-M has been widely accepted by physicians and
scientists as a reliable indicator of functional damage to the
proximal tubule of the kidney (Exs. 8-447, 144-3-C, 4-47, L-140-45,
19-43-A).
Excess 2-M is found when the proximal tubules can
no longer reabsorb this protein in a normal manner. This failure of
the proximal tubules is an early stage of a kind of kidney disease
that commonly occurs among workers with excessive cadmium exposure.
Used in conjunction with biological test results indicating abnormal
levels of CdU and CdB, the finding of excess 2-M can
establish for an examining physician that any existing kidney
disease is probably cadmium-related (Trs. 6/6/90, pp. 82-86, 122,
134). The upper limits of normal levels for cadmium in urine and
cadmium in blood are 3 g Cd/gram creatinine in urine and 5
gCd/liter whole blood, respectively. These levels were
derived from broad-based population studies.
Three issues confront the physicians in the use of
2-M as a marker of kidney dysfunction and material
impairment. First, there are a few other causes of elevated levels
of 2-M not related to cadmium exposures, some of which
may be rather common diseases and some of which are serious diseases
(e.g., myeloma or transient flu, Exs. 29 and 8-086). These can be
medically evaluated as alternative causes (Friberg, Ex. 29). Also,
there are other factors that can cause 2-M to degrade
so that low levels would result in workers with tubular dysfunction.
For example, regarding the degradation of 2-M, workers
with acidic urine (pH<6) might="" have="">2-M levels that
are within the ``normal'' range when in fact kidney dysfunction has
occurred (Ex. L-140-1) and the low molecular weight proteins are
degraded in acid urine. Thus, it is very important that the pH of
urine be measured, that urine samples be buffered as necessary (See
appendix F.), and that urine samples be handled correctly, i.e.,
measure the pH of freshly voided urine samples, then if necessary,
buffer to pH>6 (or above for shipping purposes), measure pH again
and then, perhaps, freeze the sample for storage and shipping. (See
also appendix F.) Second, there is debate over the pathological
significance of proteinuria, however, most world experts believe
that 2-M levels greater than 300 g/g Cr are
abnormal (Elinder, Ex. 55, Friberg, Ex. 29). Such levels signify
kidney dysfunction that constitutes material impairment of health.
Finally, detection of 2-M at low levels has often been
considered difficult, however, many laboratories have the capability
of detecting excess 2-M using simple kits, such as the
Phadebas Delphia test, that are accurate to levels of 100 g
2-M/g Cr U (Ex. L-140-1).
Specific recommendations for ways to measure 2-M
and proper handling of urine samples to prevent degradation of
2-M have been addressed by OSHA in appendix F, in the
section on laboratory standardization. All biological samples must
be analyzed in a laboratory that is proficient in the analysis of
that particular analyte, under paragraph (l)(1)(iv). (See appendix
F). Specifically, under paragraph (l)(1)(iv), the employer is to
assure that the collecting and handling of biological samples of
cadmium in urine (CdU), cadmium in blood (CdB), and beta-2
microglobulin in urine (2-M) taken from employees is
collected in a manner that assures reliability. The employer must
also assure that analysis of biological samples of cadmium in urine
(CdU), cadmium in blood (CdB), and beta-2 microglobulin in urine
(2-M) taken from employees is performed in
laboratories with demonstrated proficiency for that particular
analyte. (See appendix F.)
3. Lung and Prostate Cancer
The primary sites for cadmium-associated cancer appear to be the
lung and the prostate (L-140-50). Evidence for an association
between cancer and cadmium exposure derives from both
epidemiological studies and animal experiments. Mortality from
prostate cancer associated with cadmium is slightly elevated in
several industrial cohorts, but the number of cases is small and
there is not clear dose-response relationship. More substantive
evidence exists for lung cancer.
The major epidemiological study of lung cancer was conducted by
Thun et al., (Ex. 4-68). Adequate data on cadmium exposures were
available to allow evaluation of dose-response relationships between
cadmium exposure and lung cancer. A statistically significant excess
of lung cancer attributed to cadmium exposure was observed in this
study even when confounding variables such as co-exposure to arsenic
and smoking habits were taken into consideration (Ex. L-140-50).
The primary evidence for quantifying a link between lung cancer
and cadmium exposure from animal studies derives from two rat
bioassay studies; one by Takenaka et al., (1983), which is a study
of cadmium chloride and a second study by Oldiges and Glaser (1990)
of four cadmium compounds.
Based on the above cited studies, the U.S. Environmental
Protection Agency (EPA) classified cadmium as ``B1'', a probable
human carcinogen, in 1985 (Ex. 4-4). The International Agency for
Research on Cancer (IARC) in 1987 also recommended that cadmium be
listed as ``2A'', a probable human carcinogen (Ex. 4-15). The
American Conference of Governmental Industrial Hygienists (ACGIH)
has recently recommended that cadmium be labeled as a carcinogen.
Since 1984, NIOSH has concluded that cadmium is possibly a human
carcinogen and has recommended that exposures be controlled to the
lowest level feasible.
4. Non-carcinogenic Effects
Acute pneumonitis occurs 10 to 24 hours after initial acute
inhalation of high levels of cadmium fumes with symptoms such as
fever and chest pain (Exs. 30, 8-86B). In extreme exposure cases
pulmonary edema may develop and cause death several days after
exposure. Little actual exposure measurement data is available on
the level of airborne cadmium exposure that causes such immediate
adverse lung effects, nonetheless, it is reasonable to believe a
cadmium concentration of approximately 1 mg/m3 over an eight
hour period is ``immediately dangerous'' (55 FR 4052, ANSI; Ex. 8-
86B).
In addition to acute lung effects and chronic renal effects,
long term exposure to cadmium may cause other severe effects on the
respiratory system. Reduced pulmonary function and chronic lung
disease indicative of emphysema have been observed in workers who
have had prolonged exposure to cadmium dust or fumes (Exs. 4-29, 4-
22, 4-42, 4-50, 4-63). In a study of workers conducted by Kazantzis
et al., a statistically significant excess of worker deaths due to
chronic bronchitis was found, which in his opinion was directly
related to high cadmium exposures of 1 mg/m3 or more (Tr. 6/8/
90, pp. 156-157).
Cadmium need not be respirable to constitute a hazard.
Inspirable cadmium particles that are too large to be respirable but
small enough to enter the tracheobronchial region of the lung can
lead to bronchoconstriction, chronic pulmonary disease, and cancer
of that portion of the lung. All of these diseases have been
associated with occupational exposure to cadmium (Ex. 8-86B).
Particles that are constrained by their size to the extra-thoracic
regions of the respiratory system such as the nose and maxillary
sinuses can be swallowed through mucocillary clearance and be
absorbed into the body (ACGIH, Ex. 8-692). The impaction of these
particles in the upper airways can lead to anosmia, or loss of sense
of smell, which is an early indication of overexposure among workers
exposed to heavy metals. This condition is commonly reported among
cadmium-exposed workers (Ex. 8-86-B).
C. Medical Surveillance
In general, the main provisions of the medical surveillance
section of the standard, under paragraphs (l)(1)-(17) of the
regulatory text, are as follows:
1. Workers exposed above the action level are covered;
2. Workers with intermittent exposures are not covered;
3. Past workers who are covered receive biological monitoring
for at least one year;
4. Initial examinations include a medical questionnaire and
biological monitoring of cadmium in blood (CdB), cadmium in urine
(CdU), and Beta-2-microglobulin in urine (2-M);
5. Biological monitoring of these three analytes is performed at
least annually; full medical examinations are performed biennially;
6. Until five years from the effective date of the standard,
medical removal is required when CdU is greater than 15 g/
gram creatinine (g Cr), or CdB is greater than 15 g/liter
whole blood (lwb), or 2-M is greater than 1500
g/g Cr, and CdB is greater than 5 g/lwb or CdU is
greater than 3 g/g Cr;
7. Beginning five years after the standard is in effect, medical
removal triggers will be reduced;
8. Medical removal protection benefits are to be provided for up
to 18 months;
9. Limited initial medical examinations are required for
respirator usage;
10. Major provisions are fully described under section (l) of
the regulatory text; they are outlined here as follows:
A. Eligibility
B. Biological monitoring
C. Actions triggered by levels of CdU, CdB, and 2-
M (See Summary Charts and Tables in Attachment-1.)
D. Periodic medical surveillance
E. Actions triggered by periodic medical surveillance (See
appendix A Summary Chart and Tables in Attachment-1.)
F. Respirator usage
G. Emergency medical examinations
H. Termination examination
I. Information to physician
J. Physician's medical opinion
K. Medical removal protection
L. Medical removal protection benefits
M. Multiple physician review
N. Alternate physician review
O. Information employer gives to employee
P. Recordkeeping
Q. Reporting on OSHA form 200
11. The above mentioned summary of the medical surveillance
provisions, the summary chart, and tables for the actions triggered
at different levels of CdU, CdB and 2-M (in appendix A
Attachment-1) are included only for the purpose of facilitating
understanding of the provisions of paragraphs (l)(3) of the final
cadmium standard. The summary of the provisions, the summary chart,
and the tables do not add to or reduce the requirements in paragraph
(l)(3).
D. Recommendations to Physicians
1. It is strongly recommended that patients with tubular
proteinuria are counseled on: The hazards of smoking; avoidance of
nephrotoxins and certain prescriptions and over-the-counter
medications that may exacerbate kidney symptoms; how to control
diabetes and/or blood pressure; proper hydration, diet, and exercise
(Ex. 19-2). A list of prominent or common nephrotoxins is attached.
(See appendix A Attachment-2.)
2. DO NOT CHELATE; KNOW WHICH DRUGS ARE NEPHROTOXINS OR ARE
ASSOCIATED WITH NEPHRITIS.
3. The gravity of cadmium-induced renal damage is compounded by
the fact there is no medical treatment to prevent or reduce the
accumulation of cadmium in the kidney (Ex. 8-619). Dr. Friberg, a
leading world expert on cadmium toxicity, indicated in 1992, that
there is no form of chelating agent that could be used without
substantial risk. He stated that tubular proteinuria has to be
treated in the same way as other kidney disorders (Ex. 29).
4. After the results of a workers' biological monitoring or
medical examination are received the employer is required to provide
an information sheet to the patient, briefly explaining the
significance of the results. (See Attachment 3 of this appendix A.)
5. For additional information the physician is referred to the
following additional resources:
a. The physician can always obtain a copy of the preamble, with
its full discussion of the health effects, from OSHA's Computerized
Information System (OCIS).
b. The Docket Officer maintains a record of the rulemaking. The
Cadmium Docket (H-057A), is located at 200 Constitution Ave. NW.,
room N-2625, Washington, DC 20210; telephone: 202-219-7894.
c. The following articles and exhibits in particular from that
docket (H-057A):
------------------------------------------------------------------------
Exhibit No. Author and paper title
------------------------------------------------------------------------
8-447....... Lauwerys et. al., Guide for physicians, ``Health
Maintenance of Workers Exposed to Cadmium,'' published by
the Cadmium Council.
4-67........ Takenaka, S., H. Oldiges, H. Konig, D. Hochrainer, G.
Oberdorster. ``Carcinogenicity of Cadmium Chloride
Aerosols in Wistar Rats''. JNCI 70:367-373, 1983. (32)
4-68........ Thun, M.J., T.M. Schnoor, A.B. Smith, W.E. Halperin, R.A.
Lemen. ``Mortality Among a Cohort of U.S. Cadmium
Production Workers--An Update.'' JNCI 74(2):325-33, 1985.
(8)
4-25........ Elinder, C.G., Kjellstrom, T., Hogstedt, C., et al.,
``Cancer Mortality of Cadmium Workers.'' Brit. J. Ind.
Med. 42:651-655, 1985. (14)
4-26........ Ellis, K.J. et al., ``Critical Concentrations of Cadmium
in Human Renal Cortex: Dose Effect Studies to Cadmium
Smelter Workers.'' J. Toxicol. Environ. Health 7:691-703,
1981. (76)
4-27........ Ellis, K.J., S.H. Cohn and T.J. Smith. ``Cadmium
Inhalation Exposure Estimates: Their Significance with
Respect to Kidney and Liver Cadmium Burden.'' J. Toxicol.
Environ. Health 15:173-187, 1985.
4-28........ Falck, F.Y., Jr., Fine, L.J., Smith, R.G., McClatchey,
K.D., Annesley, T., England, B., and Schork, A.M.
``Occupational Cadmium Exposure and Renal Status.'' Am.
J. Ind. Med. 4:541, 1983. (64)
8-86A....... Friberg, L., C.G. Elinder, et al., ``Cadmium and Health a
Toxicological and Epidemiological Appraisal, Volume I,
Exposure, Dose, and Metabolism.'' CRC Press, Inc., Boca
Raton, FL, 1986. (Available from the OSHA Technical Data
Center)
8-86B....... Friberg, L., C.G. Elinder, et al., ``Cadmium and Health: A
Toxicological and Epidemiological Appraisal, Volume II,
Effects and Response.'' CRC Press, Inc., Boca Raton, FL,
1986. (Available from the OSHA Technical Data Center)
L-140-45.... Elinder, C.G., ``Cancer Mortality of Cadmium Workers'',
Brit. J. Ind. Med., 42, 651-655, 1985.
L-140-50.... Thun, M., Elinder, C.G., Friberg, L, ``Scientific Basis
for an Occupational Standard for Cadmium, Am. J. Ind.
Med., 20; 629-642, 1991.
------------------------------------------------------------------------
V. Information Sheet
The information sheet (appendix A Attachment-3.) or an equally
explanatory one should be provided to you after any biological
monitoring results are reviewed by the physician, or where
applicable, after any medical examination.
Appendix A
Attachment 1--Appendix A Summary Chart and Tables A and B of Actions
Triggered by Biological Monitoring
Appendix A Summary Chart: Section (1)(3) Medical Surveillance
Categorizing Biological Monitoring Results
(A) Biological monitoring results categories are set forth in
Appendix A Table A for the periods ending December 31, 1998 and for
the period beginning January 1, 1999.
(B) The results of the biological monitoring for the initial
medical exam and the subsequent exams shall determine an employee's
biological monitoring result category.
Actions Triggered by Biological Monitoring
(A)
(i) The actions triggered by biological monitoring for an
employee are set forth in Appendix A Table B.
(ii) The biological monitoring results for each employee under
section (1)(3) shall determine the actions required for that
employee. That is, for any employee in biological monitoring
category C, the employer will perform all of the actions for which
there is an X in column C of Appendix A Table B.
(iii) An employee is assigned the alphabetical category (``A''
being the lowest) depending upon the test results of the three
biological markers.
(iv) An employee is assigned category A if monitoring results
for all three biological markers fall at or below the levels
indicated in the table listed for category A.
(v) An employee is assigned category B if any monitoring result
for any of the three biological markers fall within the range of
levels indicated in the table listed for category B, providing no
result exceeds the levels listed for category B.
(vi) An employee is assigned category C if any monitoring result
for any of the three biological markers are above the levels listed
for category C.
(B) The user of Appendix A Tables A and B should know that these
tables are provided only to facilitate understanding of the relevant
provisions of paragraph (l)(3) of this section. Appendix A Tables A
and B are not meant to add to or subtract from the requirements of
those provisions.
Appendix A Table A
Categorization of Biological Monitoring Results
Applicable Through 1998 Only
----------------------------------------------------------------------------------------------------------------
Monitoring result categories
Biological marker ----------------------------------------------
A B C
----------------------------------------------------------------------------------------------------------------
Cadmium in urine (CdU) (g/g creatinine)................. 3 and 15 >15
2-microglobulin (2-M) (g/g creatinine) 300 and 1500 >1500*
Cadmium in blood (CdB) (g/liter whole blood)............ 5 and 15 >15
----------------------------------------------------------------------------------------------------------------
* If an employee's 2-M levels are above 1,500 g/g creatinine, in order for mandatory medical
removal to be required (See Appendix A Table B.), either the employee's CdU level must also be >3 g/g
creatinine or CdB level must also be >5 g/liter whole blood.
Applicable Beginning January 1, 1999
----------------------------------------------------------------------------------------------------------------
Monitoring result categories
Biological marker ----------------------------------------------
A B C
----------------------------------------------------------------------------------------------------------------
Cadmium in urine (CdU) (g/g creatinine)................. 3 and 7 >7
2-microglobulin (2-M) (g/g creatinine) 300 and 750 >750*
Cadmium in blood (CdB) (g/liter whole blood)............ 5 and 10 >10
----------------------------------------------------------------------------------------------------------------
* If an employee's 2-M levels are above 750 g/g creatinine, in order for mandatory medical
removal to be required (See Appendix A Table B.), either the employee's CdU level must also be >3 g/g
creatinine or CdB level must also be >5 g/liter whole blood.
Appendix A Table B--Actions Determined by Biological Monitoring
This table presents the actions required based on the monitoring
result in Appendix A Table A. Each item is a separate requirement in
citing non-compliance. For example, a medical examination within 90
days for an employee in category B is separate from the requirement to
administer a periodic medical examination for category B employees on
an annual basis.
------------------------------------------------------------------------
Monitoring result category
Required actions -----------------------------------
A\1\ B\1\ C\1\
------------------------------------------------------------------------
(1) Biological monitoring:
(a) Annual...................... X .......... ..........
(b) Semiannual.................. .......... X ..........
(c) Quarterly................... .......... .......... X
(2) Medical examination:
(a) Biennial.................... X .......... ..........
(b) Annual...................... .......... X ..........
(c) Semiannual.................. .......... .......... X
(d) Within 90 days.............. .......... X X
(3) Assess within two weeks:
(a) Excess cadmium exposure..... .......... X X
(b) Work practices.............. .......... X X
(c) Personal hygiene............ .......... X X
(d) Respirator usage............ .......... X X
(e) Smoking history............. .......... X X
(f) Hygiene facilities.......... .......... X X
(g) Engineering controls........ .......... X X
(h) Correct within 30 days...... .......... X X
(i) Periodically assess .......... .......... X
exposures.
(4) Discretionary medical removal... .......... X X
(5) Mandatory medical removal....... .......... .......... X\2\
------------------------------------------------------------------------
\1\For all employees covered by medical surveillance exclusively because
of exposures prior to the effective date of this standard, if they are
in Category A, the employer shall follow the requirements of
paragraphs (l)(3)(i)(B) and (l)(4)(v)(A). If they are in Category B or
C, the employer shall follow the requirements of paragraphs
(l)(4)(v)(B)-(C).
\2\See footnote Appendix A Table A.
Appendix A--Attachment-2: List of Medications
A list of the more common medications that a physician, and the
employee, may wish to review is likely to include some of the
following: (1) Anticonvulsants: Paramethadione, phenytoin,
trimethadone; (2) antihypertensive drugs: Captopril, methyldopa; (3)
antimicrobials: Aminoglycosides, amphotericin B, cephalosporins,
ethambutol; (4) antineoplastic agents: Cisplatin, methotrexate,
mitomycin-C, nitrosoureas, radiation; (4) sulfonamide diuretics:
Acetazolamide, chlorthalidone, furosemide, thiazides; (5)
halogenated alkanes, hydrocarbons, and solvents that may occur in
some settings: Carbon tetrachloride, ethylene glycol, toluene;
iodinated radiographic contrast media; nonsteroidal anti-
inflammatory drugs; and, (7) other miscellaneous compounds:
Acetominophen, allopurinol, amphetamines, azathioprine, cimetidine,
cyclosporine, lithium, methoxyflurane, methysergide, D-
penicillamine, phenacetin, phenendione. A list of drugs associated
with acute interstitial nephritis includes: (1) Antimicrobial drugs:
Cephalosporins, chloramphenicol, colistin, erythromycin, ethambutol,
isoniazid, para-aminosalicylic acid, penicillins, polymyxin B,
rifampin, sulfonamides, tetracyclines, and vancomycin; (2) other
miscellaneous drugs: Allopurinol, antipyrene, azathioprine,
captopril, cimetidine, clofibrate, methyldopa, phenindione,
phenylpropanolamine, phenytoin, probenecid, sulfinpyrazone,
sulfonamid diuretics, triamterene; and, (3) metals: Bismuth, gold.
This list have been derived from commonly available medical
textbooks (e.g., Ex. 14-18). The list has been included merely to
facilitate the physician's, employer's, and employee's
understanding. The list does not represent an official OSHA opinion
or policy regarding the use of these medications for particular
employees. The use of such medications should be under physician
discretion.
Attachment 3--Biological Monitoring and Medical Examination Results
Employee---------------------------------------------------------------
Testing Date-----------------------------------------------------------
Cadmium in Urine ______ g/g Cr--Normal Levels:
3 g/g Cr.
Cadmium in Blood ______ g/lwb--Normal Levels:
5 g/lwb.
Beta-2-microglobulin in Urine ______ g/g Cr--Normal
Levels: 300 g/g Cr.
Physical Examination Results: N/A ______ Satisfactory ______
Unsatisfactory ______ (see physician again).
Physician's Review of Pulmonary Function Test: N/A ______ Normal
______ Abnormal ______.
Next biological monitoring or medical examination scheduled for--------
The biological monitoring program has been designed for three
main purposes: 1) to identify employees at risk of adverse health
effects from excess, chronic exposure to cadmium; 2) to prevent
cadmium-induced disease(s); and 3) to detect and minimize existing
cadmium-induced disease(s).
The levels of cadmium in the urine and blood provide an estimate
of the total amount of cadmium in the body. The amount of a specific
protein in the urine (beta-2-microglobulin) indicates changes in
kidney function. All three tests must be evaluated together. A
single mildly elevated result may not be important if testing at a
later time indicates that the results are normal and the workplace
has been evaluated to decrease possible sources of cadmium exposure.
The levels of cadmium or beta-2-microglobulin may change over a
period of days to months and the time needed for those changes to
occur is different for each worker.
If the results for biological monitoring are above specific
``high levels'' [cadmium urine greater than 10 micrograms per gram
of creatinine (g/g Cr), cadmium blood greater than 10
micrograms per liter of whole blood (g/lwb), or beta-2-
microglobulin greater than 1000 micrograms per gram of creatinine
(g/g Cr)], the worker has a much greater chance of
developing other kidney diseases.
One way to measure for kidney function is by measuring beta-2-
microglobulin in the urine. Beta-2-microglobulin is a protein which
is normally found in the blood as it is being filtered in the
kidney, and the kidney reabsorbs or returns almost all of the beta-
2-microglobulin to the blood. A very small amount (less than 300
g/g Cr in the urine) of beta-2-microglobulin is not
reabsorbed into the blood, but is released in the urine. If cadmium
damages the kidney, the amount of beta-2-microglobulin in the urine
increases because the kidney cells are unable to reabsorb the beta-
2-microglobulin normally. An increase in the amount of beta-2-
microglobulin in the urine is a very early sign of kidney
dysfunction. A small increase in beta-2-microglobulin in the urine
will serve as an early warning sign that the worker may be absorbing
cadmium from the air, cigarettes contaminated in the workplace, or
eating in areas that are cadmium contaminated.
Even if cadmium causes permanent changes in the kidney's ability
to reabsorb beta-2-microglobulin, and the beta-2-microglobulin is
above the ``high levels'', the loss of kidney function may not lead
to any serious health problems. Also, renal function naturally
declines as people age. The risk for changes in kidney function for
workers who have biological monitoring results between the ``normal
values'' and the ``high levels'' is not well known. Some people are
more cadmium-tolerant, while others are more cadmium-susceptible.
For anyone with even a slight increase of beta-2-microglobulin,
cadmium in the urine, or cadmium in the blood, it is very important
to protect the kidney from further damage. Kidney damage can come
from other sources than excess cadmium-exposure so it is also
recommended that if a worker's levels are ``high'' he/she should
receive counseling about drinking more water; avoiding cadmium-
tainted tobacco and certain medications (nephrotoxins,
acetaminophen); controlling diet, vitamin intake, blood pressure and
diabetes; etc.
Appendix B to Sec. 1915.1027--Substance Technical Guidelines for
Cadmium
I. Cadmium Metal.
A. Physical and Chemical Data.
1. Substance Identification.
Chemical name: Cadmium.
Formula: Cd.
Molecular Weight: 112.4.
Chemical Abstracts Service (CAS) Registry No.: 7740-43-9.
Other Identifiers: RETCS EU9800000; EPA D006; DOT 2570 53.
Synonyms: Colloidal Cadmium: Kadmium (German): CI 77180.
2. Physical data.
Boiling point: (760 mm Hg): 765 degrees C.
Melting point: 321 degrees C.
Specific Gravity: (H[email protected] 20 deg.C): 8.64.
Solubility: Insoluble in water; soluble in dilute nitric acid
and in sulfuric acid.
Appearance: Soft, blue-white, malleable, lustrous metal or
grayish-white powder.
B. Fire, Explosion and Reactivity Data.
1. Fire.
Fire and Explosion Hazards: The finely divided metal is
pyrophoric, that is the dust is a severe fire hazard and moderate
explosion hazard when exposed to heat or flame. Burning material
reacts violently with extinguishing agents such as water, foam,
carbon dioxide, and halons.
Flash point: Flammable (dust).
Extinguishing media: Dry sand, dry dolomite, dry graphite, or
sodimum chloride.
2. Reactivity.
Conditions contributing to instability: Stable when kept in
sealed containers under normal temperatures and pressure, but dust
may ignite upon contact with air. Metal tarnishes in moist air.
Incompatibilities: Ammonium nitrate, fused: Reacts violently or
explosively with cadmium dust below 20 deg.C. Hydrozoic acid:
Violent explosion occurs after 30 minutes. Acids: Reacts violently,
forms hydrogen gas. Oxidizing agents or metals: Strong reaction with
cadmium dust. Nitryl fluoride at slightly elevated temperature:
Glowing or white incandescence occurs. Selenium: Reacts
exothermically. Ammonia: Corrosive reaction. Sulfur dioxide:
Corrosive reaction. Fire extinguishing agents (water, foam, carbon
dioxide, and halons): Reacts violently. Tellurium: Incandescent
reaction in hydrogen atmosphere.
Hazardous decomposition products: The heated metal rapidly forms
highly toxic, brownish fumes of oxides of cadmium.
C. Spill, Leak and Disposal Procedures.
1. Steps to be taken if the materials is released or spilled. Do
not touch spilled material. Stop leak if you can do it without risk.
Do not get water inside container. For large spills, dike spill for
later disposal. Keep unnecessary people away. Isolate hazard area
and deny entry. The Superfund Amendments and Reauthorization Act of
1986 Section 304 requires that a release equal to or greater than
the reportable quantity for this substance (1 pound) must be
immediately reported to the local emergency planning committee, the
state emergency response commission, and the National Response
Center (800) 424-8802; in Washington, DC metropolitan area (202)
426-2675.
II. Cadmium Oxide.
A. Physical and Chemical Date.
1. Substance identification.
Chemical name: Cadmium Oxide.
Formula: CdO.
Molecular Weight: 128.4.
CAS No.: 1306-19-0.
Other Identifiers: RTECS EV1929500.
Synonyms: Kadmu tlenek (Polish).
2. Physical data.
Boiling point (760 mm Hg): 950 degrees C decomposes.
Melting point: 1500 deg.C.
Specific Gravity: (H[email protected] deg.C): 7.0.
Solubility: Insoluble in water; soluble in acids and alkalines.
Appearance: Red or brown crystals.
B. Fire, Explosion and Reactivity Data.
1. Fire.
Fire and Explosion Hazards: Negligible fire hazard when exposed
to heat or flame.
Flash point: Nonflammable.
Extinguishing media: Dry chemical, carbon dioxide, water spray
or foam.
2. Reactivity.
Conditions contributing to instability: Stable under normal
temperatures and pressures.
Incompatibilities: Magnesium may reduce CdO2 explosively on
heating.
Hazardous decomposition products: Toxic fumes of cadmium.
C. Spill Leak and Disposal Procedures.
1. Steps to be taken if the material is released or spilled. Do
not touch spilled material. Stop leak if you can do it without risk.
For small spills, take up with sand or other absorbent material and
place into containers for later disposal. For small dry spills, use
a clean shovel to place material into clean, dry container and then
cover. Move containers from spill area. For larger spills, dike far
ahead of spill for later disposal. Keep unnecessary people away.
Isolate hazard area and deny entry. The Superfund Amendments and
Reauthorization Act of 1986 Section 304 requires that a release
equal to or greater than the reportable quantity for this substance
(1 pound) must be immediately reported to the local emergency
planning committee, the state emergency response commission, and the
National Response Center (800) 424-8802; in Washington, DC
metropolitan area (202) 426-2675.
III. Cadmium Sulfide.
A. Physical and Chemical Data.
1. Substance Identification.
Chemical name: Cadmium sulfide.
Formula: CdS.
Molecular weight: 144.5.
CAS No. 1306-23-6.
Other Identifiers: RTECS EV3150000.
Synonyms: Aurora yellow; Cadmium Golden 366; Cadmium Lemon
Yellow 527; Cadmium Orange; Cadmium Primrose 819; Cadmium Sulphide;
Cadmium Yellow; Cadmium Yellow 000; Cadmium Yellow Conc. Deep;
Cadmium Yellow Conc. Golden; Cadmium Yellow Conc. Lemon; Cadmium
Yellow Conc. Primrose; Cadmium Yellow Oz. Dark; Cadmium Yellow
Primrose 47-1400; Cadmium Yellow 10G Conc.; Cadmium Yellow 892;
Cadmopur Golden Yellow N; Cadmopur Yellow: Capsebon; C.I. 77199;
C.I. Pigment Orange 20; CI Pigment Yellow 37; Ferro Lemon Yellow;
Ferro Orange Yellow; Ferro Yellow; Greenockite; NCI-C02711.
2. Physical data.
Boiling point (760 mm. Hg): sublines in N2 at 980 deg.C.
Melting point: 1750 degrees C (100 atm).
Specific Gravity: (H