Published Date: July 01, 2009
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Section 40 Health assessment for workers exposed to asbestos, silica or coal dust
A worker exposed to asbestos, silica, coal or lead must have a health assessment within 30 days of becoming an “exposed worker” as defined in section 1. When hiring a worker to perform work involving exposure to these substances, the employer is responsible for knowing if the worker has received a health assessment in the last two years and it is the worker’s responsibility to inform the employer of the date of that assessment. The employer should get verification that the health assessment was performed by checking documents the worker has.
Health assessments must be done every two years after the first assessment as long as the worker continues to be an “exposed worker”. If at any time during the preceding two years a worker performed work that qualified him or her to be an exposed worker, an employer must ensure that the worker undergoes a health assessment unless the worker provides the employer with a written statement refusing it. It is the worker’s employer at the time the worker becomes an exposed worker who is responsible for ensuring that the health assessment is done.
The purpose of the health assessment is to provide the worker with a baseline health evaluation, providing an opportunity to detect early changes to the lungs. Periodic health assessments serve as a means of documenting changes that, compared to the baseline evaluation, may have occurred over time. This permits the early detection of changes and provides an opportunity to investigate the cause of the changes.
The health assessment for exposure to asbestos, coal and silica consists of health history information, a chest x-ray, a radiologist’s report, a lung function test and a copy of the physician’s interpretation and explanation of the health assessment. The history includes identifying the worker, employer, the worker’s previous work and non-work exposures to coal dust, silica, asbestos, or other dusts, indications of any respiratory disease, smoking history and the date on which the worker had their most recent chest x-ray and lung function test.
The chest x-ray consists of a single back to front (postero-anterior) view of the chest and needs to be interpreted by a radiologist and the report sent to a physician. Where diagnostic imaging facilities no longer maintain x-ray film, the digital imaging format of x-rays is allowed provided the imaging facility can print to film when requested. As well, the employer must have this included in the procedure for health assessments.
The lung function test, conducted by a pulmonary function technician, consists of forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) test. The physician reviewing the health assessment must give a written interpretation of the results to the worker within 60 days of the health assessment. Physicians must keep the health assessment records for 30 years. Further details on medical monitoring are discussed in the Workplace Health and Safety Bulletins listed below.
For more information
|Asbestos at the Work Site|
|Crystalline Silica in the Workplace|
|Coal Dust in the Workplace|
The information obtained during a health assessment is confidential. The person having custody of the health assessment record is responsible for ensuring that the information is kept confidential. Only the worker and the health professionals who conducted the assessment have access to the information. If others require the information, including the worker’s family physician, the worker must give written consent indicating to whom the information is to be given and the specific information that can be provided. Some larger employers have developed a Release of Information form for this purpose.
For the purposes of evaluating programs, assessment information can be released in grouped data provided that an individual cannot be identified. For example, if a job category has one worker, that worker’s data should be included in a category with more workers. The purpose of evaluating programs is to identify the number of workers with abnormal tests and determine if the control program is effective.
Although a worker has the right to refuse a health assessment, the employer must not coerce, threaten or force a worker into refusing part or all of a health assessment.
The employer is responsible for paying for the health assessment and interpretation of the results. Every effort should be made to have the health assessment conducted during normal work hours. If the assessment takes place during the worker’s hours of work, the worker’s wages, salary or benefits cannot be deducted for the period of time the worker is being assessed. If travel to or from the assessment occurs during working hours, the worker’s wages, salary or benefits cannot be deducted for this period of time. Other mutually agreeable arrangements can be made to have the health assessment done.