To better protect workers exposed to respirable crystalline silica, OSHA issued respirable crystalline silica standards.

These standards require employers to limit worker exposures to respirable crystalline silica and to take other steps to protect workers including medical surveillance, with chest X-rays and lung function tests, for those required by the standard to wear a respirator for 30 or more days per year.

The purpose of medical surveillance is to:

• Identify adverse health effects associated with respirable crystalline silica exposure so that appropriate actions can be taken.
• Determine if an employee has any condition, such as a lung disease, that might make him or her more sensitive to respirable crystalline silica exposure.
• Determine the employee's fitness to use respirators.

Employers must offer medical examinations:

• Within 30 days of initial assignment (the day the employee starts working in a job/task in which he or she will be required by the silica standard to wear a respirator for 30 or more days per year), unless the employee has had an examination that meets the requirements of the silica standard within the last three years.
• Every three years from the employee’s last examination that met the requirements of the silica standard, or more frequently if recommended by a health care provider, if the employee will continue to perform tasks that require respirator use under the silica standard for 30 or more days per year.

In response to the information gained through medical surveillance, employees can take actions to improve their health, such as making job choices to reduce exposures, wearing a respirator for extra protection or making personal lifestyle or health decisions, such as quitting smoking or getting flu shots.

“Employees who are required to wear respirators must receive medical evaluations required by the respiratory protection standard before they are fit tested for a respirator or wear a respirator in the workplace," says Tom Kibby, MD, MPH, BarnesCare’s chief medical officer. "The medical evaluation for the respiratory protection standard can be combined with the medical examination for silica, and employers can have BarnesCare conduct both the evaluation for respirator use and the examination for silica at the same time. They can also have employees evaluated for respirator use before they wear a respirator and then offer the silica examination later, according to the required time limits of the silica standard.”

• Employers are required to offer medical examinations to employees exposed above the permissible exposure level PEL 50 μg/m³ (micrograms of silica per cubic meter of air, averaged over an 8-hour day) for 30 or more days per year.
• Employers are required to offer medical examinations to employees exposed at or above the action level of 25 μg/m³ (micrograms of silica per cubic meter of air, averaged over an 8-hour day) for 30 or more days per year beginning on June 23, 2020.

“OSHA established these standards in an effort to prevent deaths from silica-related diseases – such as silicosis, lung cancer, other respiratory diseases and kidney disease – and to prevent new cases of silicosis each year,” says Dr. Kibby.

Learn more about OSHA’s respirable crystalline silica standards here.

To establish a respirable crystalline silica medical surveillance program for your organization, email BarnesCare or call 314.747.5859.