California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 4 - Division of Industrial Safety › Subchapter 7 - General Industry Safety Orders › Group 16 - Control of Hazardous Substances › Article 109 - Hazardous Substances and Processes › Appendix B to Section 5198 - Employee Standard Summary

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
This appendix summarizes key provisions of the standard
						  that you as an employee should become familiar with.
I. Permissible Exposure Limit (PEL) -- subsection
						  (c)
The standard sets a permissible exposure limit (PEL) of
						  10 micrograms of lead per cubic meter of air (10
						  µg/m3), calculated as an 8-hour time-weighted
						  average (TWA). Your lead exposure over your entire workday, when calculated as
						  an 8-hour TWA, cannot be higher than the PEL. However, since the PEL is an
						  8-hour TWA, short exposures above the PEL are permitted so long as for each
						  workday your average exposure does not exceed the PEL.
II. Exposure Monitoring -- subsection (d)
If lead is present in any quantity in the workplace
						  where you work, your employer is required to make an initial determination of
						  whether the action level (2 µg/m3 calculated
						  as an 8-hour TWA) is exceeded for any employee. This initial determination must
						  include instrument monitoring of the air for the presence of lead and must
						  cover the exposure of a representative number of employees who are reasonably
						  believed to have the highest exposure levels. If your employer has conducted
						  appropriate air sampling for lead in the past year, they may use these results.
						  If there have been any employee complaints of symptoms which may be
						  attributable to exposure to lead or if there is any other information or
						  observations which would indicate employee exposure to lead, this must also be
						  considered as part of the initial determination. If this initial determination
						  shows that a reasonable possibility exists that any employee may be exposed,
						  without regard to the use of respirators, over the action level, your employer
						  must set up an air monitoring program to determine the exposure level of every
						  employee exposed to lead at your workplace.
In carrying out this air monitoring program, your
						  employer is not required to monitor the exposure of every employee but must
						  monitor a representative number of employees and job types. Enough sampling
						  must be done to enable each employee's exposure level to be reasonably
						  represented by at least one full-shift air sample. In addition, these air
						  samples must be taken under conditions which represent each employee's regular,
						  daily exposure to lead.
The standard includes a classification for work with
						  lead that may result in significant employee exposure to airborne lead. In the
						  standard, this work is referred to as presumed signficant lead work (PSLW).
						  PSLW includes altering or disturbing material that contains or is likely to
						  contain at least 0.5% lead by weight; and torch cutting any scrap metal. In the
						  standard, "altering or disturbing" means "subjecting to a process that may
						  result in the release of lead dust, lead mist, lead fume, or other lead
						  particles. Such processes include, but are not limited to, welding, torch
						  cutting, brazing, torch soldering, melting, pouring, spraying, cutting,
						  shredding, crushing, baling, grinding, polishing, machining, drilling,
						  scraping, sanding, abrading, sweeping, raking, and shoveling." Examples of
						  materials that are likely to contain at least 0.5% lead include scrap lead,
						  lead solder, lead bullet fragments and dust, lead sheeting, lead cable housing,
						  and lead billets. Because scrap metal is likely to contain lead, and it is not
						  easy to tell if there is lead in a piece of scrap metal, all torch cutting of
						  scrap metal is classified as PSLW.
There is an exception to what counts as PSLW. Altering
						  or disturbing material, or torch cutting any scrap metal, is not PSLW when the
						  total combined duration of lead exposure resulting from altering, disturbing,
						  and torch cutting is less than 8 hours during any 30-day period.
If you are performing PSLW, your employer must provide
						  you, as interim protection, with appropriate respiratory protection, protective
						  clothing and equipment, medical surveillance, training and posted signs, until
						  your employer conducts an exposure assessment and determines actual employee
						  exposure, as required under subsection (d) of the lead standard. Once an
						  exposure assessment has been completed, your employer must provide you with the
						  appropriate protections, based on your level of exposure to lead, as required
						  by the standard.
If you are exposed to lead and air sampling is
						  performed, your employer is required to notify you in writing within 5 working
						  days of the air monitoring results which represent your exposure. If the
						  results indicate your exposure exceeds the PEL (without regard to your use of
						  respirators), then your employer must also notify you of this in writing and
						  also provide you with a description of the corrective action that has been or
						  will be taken to reduce your exposure.
Your exposure must be rechecked by monitoring, at least
						  every 12 months if your exposure is at or above the action level (2
						  µg/m3 as an 8-hour TWA) but below 30
						  µg/m3 as an 8-hour TWA. Your employer may
						  discontinue monitoring for you if two consecutive measurements, taken at least
						  7 days apart, are below the action level. Air monitoring must be repeated every
						  6 months if you are exposed at or above 30
						  µg/m3 as an 8-hour TWA but at or below 50
						  µg/m3 as an 8-hour TWA. Your employer must
						  continue monitoring for you every 6 months until two consecutive measurements,
						  taken at least 7 days apart, are below 30
						  µg/m3 as an 8-hour TWA. Air monitoring must be
						  repeated every 3 months if you are exposed above 50
						  µg/m3 as an 8-hour TWA. Your employer must
						  continue monitoring for you every 3 months until two consecutive measurements,
						  taken at least 7 days apart, are at or below 50
						  µg/m3 as an 8-hour TWA.
However, whenever there is a production, process,
						  control, or personnel change at your workplace which may result in new or
						  additional exposure to lead, or whenever there is any other reason to suspect a
						  change which may result in new or additional exposure to lead, your employer
						  must perform additional monitoring.
III. Compliance -- subsection (e)
Your employer is required to ensure that no employee is
						  exposed to lead above the PEL. The lead standard requires employers to
						  institute engineering and work practice controls, including administrative
						  controls, to the extent feasible to reduce employee exposure to lead. Where
						  such controls are feasible but not adequate to reduce exposures to at or below
						  the PEL, they must be used to reduce exposures to the lowest level that can be
						  accomplished by these means, and then supplemented with appropriate respiratory
						  protection.
Certain processes used in the lead acid battery
						  manufacturing and recycling industries have Separate Engineering Control
						  Airborne Limits (SECALs), which will have a phase-in period. Table 1 shows the
						  specific processes, SECALs, and implementation dates:
Table 1 -- Separate Engineering Control Airborne
						  Limits (SECALs) for Selected Processes; Implementation Schedule
Industry
Process
SECAL
								  (as an 8-hour TWA) and Implementation Dates
Lead acid battery manufacturing
Oxide
								  production; paste mixing; grid pasting and parting; and battery
								  assembly.
50 µg/m3 on January 1, 2025,
								  then
40
								  µg/m3 on January 1, 2030.
Grid production and small parts
								  casting; and plate formation.
50 µg/m3
								  on January 1, 2025, then
30
								  µg/m3 on January 1, 2030.
Lead acid battery recycling
Laboratory
								  processes.
50 µg/m3 on January 1,
								  2025, then
30
								  µg/m3 on January 1, 2030.
Movement of lead ingots and blocks into
								  storage areas.
Movement of lead ingots and blocks for
								  shipping.
Maintenance processes.
Where a SECAL has been specified for particular
						  processes, your employer must implement engineering and work practice controls
						  to reduce and maintain employee exposures to or below the SECAL, except to the
						  extent that your employer can demonstrate that such controls are not feasible.
						  Note that even when there is a SECAL for a particular process, your employer
						  must ensure that your exposure to lead is not above the PEL. Respirators may be
						  used to supplement engineering and work practice controls to reduce employee
						  exposure to or below the PEL.
Your employer must also develop and implement a written
						  compliance program to reduce exposures to or below the PEL or, where
						  applicable, the SECAL, using only engineering and work practice controls. The
						  standard identifies the various elements that must be included in the program.
						  For example, employers are required to include a description of operations in
						  which lead is emitted, detailing other relevant information about the operation
						  such as the type of equipment used, the type of material involved, crew size,
						  employee job responsibilities, operating procedures and maintenance practices.
						  In addition, your employer's compliance program must specify the means that
						  will be used to achieve compliance and, where engineering controls are
						  required, include any engineering plans or studies that have been used to
						  select the control methods. If engineering and work practice controls were
						  considered but not put in place, the program must include a report that shows
						  how they were demonstrated not to be feasible. Also, if administrative controls
						  involving job rotation are used to reduce employee exposure to lead, the job
						  rotation schedule must be included in the compliance program. The program must
						  also detail the type of protective clothing and equipment, including
						  respirators, housekeeping, and hygiene practices that will be used to protect
						  you from the adverse effects of exposure to lead.
The written compliance program must be made available,
						  upon request, to affected employees and their designated representatives, the
						  Cal/OSHA Chief, and the National Institute for Occupational Safety and Health
						  (NIOSH). The program must be reviewed and updated at least every 6 months to
						  ensure it reflects the current status of exposure control.
IV. Respiratory Protection -- subsection (f)
Your employer is required to provide and ensure your
						  use of respirators when your exposure to lead is not controlled below the PEL
						  by other means, and as interim protection if you perform PSLW and an exposure
						  assessment has not been completed. The employer must pay the cost of the
						  respirator. Whenever you request one, your employer is also required to provide
						  you a respirator even if your air exposure level is not above the PEL. You
						  might want a respirator when, for example, you intend to have children in the
						  near future, and want to reduce the level of lead in your body to minimize
						  adverse reproductive effects. While respirators are the least satisfactory
						  means of controlling your exposure, they are capable of providing significant
						  protection when properly chosen, fitted, worn, cleaned, and maintained and are
						  replaced when they stop providing adequate protection.
Your employer is required to select respirators as
						  specified in the Respiratory Protection standard, in section
						  5144(d)(3)(A)(1).
						  If your employer selects filtering facepiece respirators for protection against
						  lead, they shall be N100, R100, or P100. Any respirator chosen must be approved
						  by NIOSH under the provisions of 42 CFR part 84 . The respirator selection
						  table in section
						  5144 will enable your employer to
						  choose a type of respirator which will give you proper protection based on your
						  airborne lead exposure. Your employer may select a type of respirator that
						  provides greater protection than that required by the standard; that is, one
						  recommended for a higher concentration of lead than that to which you are
						  exposed.
An air-purifying respirator works by removing
						  particles, gases, or vapors from the air you breathe, if the correct type of
						  filter, cartridge, or canister is used with the facepiece. The typical
						  air-purifying respirator is a negative pressure respirator because it requires
						  the force of your inhalation to draw air through the purifying element. A
						  powered air-purifying respirator (PAPR) is much more protective than a typical
						  negative pressure respirator, and may also be more comfortable to wear. A PAPR
						  also has a filter, cartridge, or canister to clean the air, and a power source
						  which continuously blows filtered air into your breathing zone. A PAPR may ease
						  the burden of having to wear a negative pressure air-purifying respirator for
						  long periods of time. The standard requires that your employer must provide you
						  with a PAPR upon request. Your employer also must provide high-efficiency
						  particulate air (HEPA) filters for PAPRs and N100, R100, or P100 filters for
						  non-powered air-purifying respirators. In addition, if you are exposed to lead
						  aerosols that cause eye or skin irritation at the use concentrations, your
						  employer must provide you with a full facepiece respirator instead of a half
						  mask respirator.
A supplied-air respirator (SAR) can also be more
						  protective than a typical negative pressure respirator. A SAR is supplied with
						  breathing-quality air from a source such as an air compressor or compressed air
						  cylinder. Three types of supplied-air respirators are demand, pressure-demand,
						  and continuous flow. The demand-type provides protection equivalent to that of
						  a non-powered negative pressure air-purifying respirator of the same facepiece
						  type. Greater protection is provided by either the pressure-demand or
						  continuous-flow types because positive air pressure exists within the
						  respirator at all times.
Your employer must implement a Respiratory Protection
						  Program in accordance with section
						  5144. This program must include
						  written procedures for proper respirator selection, medical evaluations, fit
						  testing, use, cleaning, storage, and maintenance of respirators, and training,
						  as well as procedures to ensure adequate air quality, quantity and flow for
						  supplied-air respirators.
Your employer must ensure that your respirator
						  facepiece fits properly. Proper fit of a respirator facepiece is critical and
						  no single facepiece fits all facial configurations equally well. Obtaining a
						  proper fit thus may require your employer to make available two or three
						  different mask types, in various sizes, in order that facepiece leakage is
						  minimized for each employee. In order to ensure that your respirator fits
						  properly and that facepiece leakage is minimized, your employer must give you
						  either a quantitative or qualitative fit test as specified in Appendix A of
						  section 5144, Respiratory
						  Protection.
You must also receive from your employer proper
						  training in the use of respirators. Your employer is required to teach you how
						  to wear a respirator, to know why it is needed, and to understand its
						  limitations.
The standard provides that if your respirator uses
						  filter elements, you must be given an opportunity to change the filter elements
						  whenever an increase in breathing resistance is detected. You also must be
						  permitted to periodically leave your work area to wash your face and respirator
						  facepiece whenever necessary to prevent skin irritation. Before you begin using
						  a respirator, and again if you ever have difficulty in breathing during a fit
						  test or while using a respirator, your employer must make a medical examination
						  available to you to determine whether you can safely wear a respirator. The
						  result of this examination may be to give you a positive pressure respirator
						  (which reduces breathing resistance) or to provide alternative means of
						  protection.
V. Protective Work Clothing and Equipment -- subsection
						  (g)
If you are exposed to lead above the PEL or perform
						  PSLW and an exposure assessment has not been completed, or if you are exposed
						  to lead compounds such as lead arsenate or lead azide which can cause skin and
						  eye irritation, your employer must provide you with protective work clothing
						  and equipment appropriate for the hazard. If work clothing is provided, it must
						  be provided in a clean and dry condition at least weekly, and daily if your
						  exposure to airborne lead without regard to respirator use is greater than 30
						  µg/m3. Appropriate protective work clothing
						  and equipment includes, but is not limited to, coveralls or similar full-body
						  work clothing, hats or other head coverings, shoes or disposable shoe
						  coverlets, and where needed, gloves, face shields or vented goggles, or other
						  protective equipment. Your employer is required to provide all such equipment
						  at no cost to you. Your employer is responsible for providing repairs and
						  replacement as necessary, and also is responsible for the cleaning, laundering
						  or disposal of protective clothing and equipment. Contaminated work clothing or
						  equipment must be removed in change rooms and not be brought home or into
						  personal vehicles or you will extend your exposure and expose your family since
						  lead from your clothing can accumulate in your house, car, etc. Contaminated
						  clothing which is to be cleaned, laundered or disposed of must be placed in
						  closed containers in the change room. At no time may lead be removed from
						  protective clothing or equipment by any means which disperses lead into the
						  workroom air.
VI. Housekeeping -- subsection (h)
Your employer must establish a housekeeping program
						  sufficient to maintain all surfaces as free as practicable of accumulations of
						  lead dust. HEPA vacuuming is the preferred method of meeting this requirement,
						  and the use of compressed air to clean floors and other surfaces is absolutely
						  prohibited. Dry or wet sweeping, shoveling, or brushing may not be used except
						  where vacuuming or other equally effective methods have been tried and do not
						  work. Vacuums must be equipped with a special filter called a HEPA filter and
						  be used and emptied in a manner which minimizes the reentry of lead into the
						  workplace.
VII. Hygiene Facilities and Practices -- subsection
						  (i)
In areas where employees are exposed to lead, the
						  employer must ensure that food and beverage is not present or consumed, tobacco
						  products are not present or used, and cosmetics are not applied. There is one
						  exception to these requirements. In areas where employees are exposed to lead
						  at or below 50 µg/m3 without regard to the use
						  of respirators, the employer may provide employees access to potable drinking
						  water if the employer has trained on, implemented and is ensuring compliance
						  with written safe hydration procedures which, when followed, ensure that
						  employees are not exposed to lead above the PEL in accordance with subsection
						  (c)(2) and that the manner in which water is consumed prevents lead
						  ingestion.
The standard requires that washing facilities be
						  provided, and used, where occupational exposure to lead occurs. Employees
						  exposed to lead must wash their hands, exposed arms, and faces prior to
						  entering eating areas, eating, drinking, smoking or applying cosmetics, and at
						  the end of their shift.
In addition, clean change rooms, showers, and
						  lunchrooms must be made available to and used by employees exposed to lead
						  above the PEL without regard to the use of respirators. Where employee
						  exposures are greater than the PEL but not greater than 50
						  µg/m3 without regard to the use of
						  respirators, these requirements are effective January 1, 2026.
After showering, no clothing or equipment worn during
						  the shift may be worn home, and this includes shoes and underwear. Your own
						  clothing worn during the shift should be carried home and cleaned carefully so
						  that it does not contaminate your home. Lunchrooms may not be entered with
						  protective clothing or equipment unless surface dust has been removed by HEPA
						  vacuuming, downdraft booth, or other cleaning method.
All of the facilities and hygiene practices just
						  discussed are essential to minimize additional sources of lead absorption from
						  inhalation or ingestion of lead that may accumulate on you, your clothes, or
						  your possessions. Strict compliance with these provisions can virtually
						  eliminate several sources of lead exposure which significantly contribute to
						  excessive lead absorption.
VIII. Medical Surveillance -- subsection (j)
The medical surveillance program is part of the
						  standard's comprehensive approach to the prevention of lead-related disease.
						  Its purpose is to supplement the main thrust of the standard which is aimed at
						  minimizing airborne concentrations of lead and sources of ingestion. Only
						  medical surveillance can determine if the other provisions of the standard have
						  effectively protected you as an individual. Compliance with the standard's
						  provisions will protect most employees from the harmful effects of lead
						  exposure, but may not be satisfactory to protect individual employees (1) who
						  have high body burdens of lead acquired over past years, (2) who have
						  additional uncontrolled sources of non-occupational lead exposure, (3) who
						  absorb lead at an unusually high rate, or (4) who have specific non-work
						  related health-related conditions which could be aggravated by lead exposure
						  (e.g., kidney disease, anemia). In addition, control systems may fail, or
						  hygiene and respirator programs may be inadequate. Periodic medical
						  surveillance of individual employees will help detect those failures. Medical
						  surveillance is also important to protect your reproductive health, regardless
						  of your gender.
All medical surveillance required by the standard must
						  be performed by a physician or other licensed health care professional (PLHCP).
						  The employer must provide required medical surveillance without cost to the
						  employees and at a reasonable time and place. The standard's medical
						  surveillance program has two parts, blood lead testing and medical
						  examinations.
A. Blood Lead Testing
Blood lead testing must be made available to you when
						  you are assigned to work in which you may be exposed to lead at or above the
						  action level, and as interim protection, if you perform PSLW. There are two
						  exceptions to this requirement. The first exception is if you are not exposed
						  to lead at or above the action level for 30 or more days in any 12 consecutive
						  months, and your exposure is not on any day above 10
						  µg/m3 as an 8-hour TWA, without regard to
						  respirator use, then blood lead testing is not required to be provided. The
						  second exception is if you are not exposed to lead at or above the action level
						  for 15 or more days in any 12 consecutive months, and your exposure is not on
						  any day above 20 µg/m3 as an 8-hour TWA,
						  without regard to respirator use, then blood lead testing is not required to be
						  provided. Blood lead test results show your blood lead level (BLL). BLL means
						  the concentration of lead measured in whole blood, expressed as micrograms per
						  deciliter (µg/dl).
Unless your exposure to lead falls under one of the
						  exceptions described above, blood lead testing must be made available to you
						  prior to assignment to lead work, or as soon as possible thereafter. There is
						  an exception to this requirement. Blood lead testing is not required prior to
						  assignment to lead work if you had a blood lead test in the preceding two
						  months.
Additional blood lead testing under the standard must
						  be provided on the following schedule: at least every two months for the first
						  6 months after initial placement, and also for the 6 months after any change in
						  task resulting in higher exposure; and at least every 6 months thereafter. If
						  your last BLL is at or above 10 µg/dl but below 20 µg/dl, the
						  testing frequency must be at least every 2 months and not reduced until two
						  consecutive tests, taken at least 30 days apart, indicate a blood lead level
						  below 10 µg/dl. Blood lead testing then must be provided as described in
						  the schedule given at the start of this paragraph. If your last BLL is at or
						  above 20 µg/dl, or you are removed from exposure to lead due to an
						  elevated BLL, blood lead testing must be provided to you at least
						  monthly.
Each time your BLL is tested, your employer must notify
						  you of the results in writing within five working days of their receipt of the
						  test results. The employer must also inform you that the standard requires
						  temporary medical removal with economic protection when your BLL exceeds
						  certain criteria (see Part IX below, Medical Removal Protection). Finally, if
						  you have a BLL at or above 10 µg/dl, your employer must establish and
						  implement a written elevated blood lead level response plan designed to reduce
						  and maintain your BLL below 10 µg/dl. There is an exception to this
						  requirement. A written elevated blood lead level response plan is not required
						  when a blood lead level at or above 10 µg/dl is detected only in your
						  blood lead test done prior to your first assignment to lead work.
B. Medical Examination and Consultation
An examination and consultation must be made available
						  to you when you are assigned to work in which you may be exposed to lead at or
						  above the action level, and as interim protection, if you perform PSLW. There
						  are two exceptions to this requirement. The first exception is if you are not
						  exposed to lead at or above the action level for 30 or more days in any 12
						  consecutive months, and your exposure is not on any day above 10
						  µg/m3 as an 8-hour TWA, without regard to
						  respirator use, then a medical examination is not required to be provided. The
						  second exception is if you are not exposed to lead at or above the action level
						  for 15 or more days in any 12 consecutive months, and your exposure is not on
						  any day above 20 µg/m3 as an 8-hour TWA,
						  without regard to respirator use, then a medical examination is not required to
						  be provided.
Unless your exposure to lead falls under one of the
						  exceptions described above, medical examinations must be made available to you
						  prior to assignment for the first time to an area where the concentration of
						  airborne lead may be at or above the action level.
The initial examination will provide information to
						  establish a baseline with which subsequent data can be compared.
A medical examination and consultation beyond the
						  initial one must be made available on an annual basis if your blood lead level
						  is 20 µg/dl or greater at any time during the preceding year. This
						  medical examination must be made available as soon as possible upon receiving a
						  blood lead test result of 20 µg/dl or greater if you have not had a
						  lead-specific medical examination in the last 12 months.
In addition, a medical examination or consultation
						  beyond the initial one must be made available as soon as possible if you notify
						  your employer that you are experiencing signs or symptoms commonly associated
						  with lead poisoning or that you have difficulty breathing while wearing a
						  respirator or during a respirator fit test. You must also be provided a medical
						  examination or consultation beyond the initial one if you notify your employer
						  that you desire medical advice concerning the effects of current or past
						  exposure to lead on your ability to procreate a healthy child.
Finally, beyond the initial medical examination or
						  consultation, appropriate follow-up medical examinations or consultations must
						  also be provided for employees who have been temporarily removed from exposure
						  under the medical removal protection provisions of the standard (see Part IX
						  below, Medical Removal Protection).
The standard specifies the minimum content of
						  pre-assignment and annual medical examinations. The content of other types of
						  medical examinations and consultations is left up to the sound discretion of
						  the examining PLHCP. Pre-assignment and annual medical examinations must
						  include (1) a detailed work history and medical history; (2) a thorough
						  physical examination, including an evaluation of your pulmonary status if you
						  will be using a respirator; (3) a blood pressure measurement; (4) a series of
						  laboratory tests designed to check your blood chemistry and your kidney
						  function; and (5) a zinc protoporphyrin level if your last blood lead level was
						  at or above 20 µg/dl. In addition, at any time upon your request, a
						  laboratory evaluation of male fertility will be made (microscopic examination
						  of a sperm sample), or a pregnancy test will be given.
The standard does not require that you participate in
						  any of the medical procedures, tests, etc. which your employer is required to
						  make available to you. Medical surveillance can, however, play a very important
						  role in protecting your health. You are strongly encouraged, therefore, to
						  participate in a meaningful fashion. The standard contains a multiple PLHCP
						  review mechanism which provides you with the right to a second medical opinion
						  from a PLHCP of your choice if you are dissatisfied with an examination by a
						  PLHCP chosen by your employer. The standard requires the two PLHCPs to attempt
						  a resolution of any difference in their opinions. If any dispute remains
						  unresolved, the standard provides that a third PLHCP, selected by you and your
						  employer, shall make a final, binding medical determination unless you and your
						  employer reach an agreement which is otherwise consistent with the
						  recommendations of one of the PLHCPs. Generally, your employer will choose the
						  PLHCP who conducts medical surveillance under the lead standard, unless you and
						  your employer otherwise agree on the choice of a PLHCP or PLHCPs. Some
						  companies and unions have agreed in advance, for example, to use certain
						  independent medical laboratories or panels of PLHCPs. Any of these arrangements
						  are acceptable so long as required medical surveillance is made available to
						  employees.
The standard requires your employer to provide certain
						  information to a PLHCP to aid in their examination of you. This information
						  includes (1) the standard and these appendices, (2) a description of your
						  duties as they relate to lead exposure, (3) your exposure level, (4) a
						  description of personal protective equipment you wear, (5) prior blood lead
						  level results, (6) prior written medical opinions concerning you that the
						  employer may have, and (7) a copy of your employer's written elevated blood
						  lead level response plan (required when an employee's BLL is at or above 10
						  µg/dl).
After a medical examination or consultation the PLHCP
						  must prepare a written opinion for your employer which must contain (1) the
						  PLHCP's opinion as to whether you have any health-related condition which
						  places your health, including the ability to procreate a healthy child, at
						  increased risk of material impairment from exposure to lead, (2) any
						  recommended special protective measures to be provided to you, (3) blood lead
						  test results, and (4) any recommended limitation on your use of respirators.
						  This last element must include a determination of whether you can wear a
						  powered air-purifying respirator (PAPR) if you are found unable to wear a
						  negative pressure respirator. Your employer must ensure that you also receive a
						  copy of the PLHCP's written medical opinion. In addition, the PLHCP who
						  conducts your medical examination will explain the results of your medical
						  examination to you and provide you with a separate written medical report
						  within 30 days of your medical exam. This report will contain the information
						  in the PLHCP's written medical opinion, plus additional information, including
						  a determination of whether you should wear a PAPR instead of a non-powered
						  (negative pressure) air-purifying respirator, any recommended follow-up blood
						  lead testing or medical exams, and the PLHCP's opinion as to whether you have
						  any health-related condition, work-related or not for which you should have a
						  further medical examination or treatment.
C. Additional Information about Medical
						  Surveillance
The medical surveillance program of the lead standard
						  may at some point in time serve to notify certain employees that they have
						  acquired a disease or other adverse health-related condition as a result of
						  occupational lead exposure. If this is true, employees may have legal rights to
						  compensation from public agencies, their employers, firms that supply hazardous
						  products to their employers, or other persons. The results of the medical
						  surveillance program can significantly affect the legal remedies of an employee
						  who has acquired a job-related disease or impairment. Some states have laws,
						  including workers' compensation laws, that disallow an employee who learns of a
						  job-related health impairment to sue, unless the employee sues within a short
						  period of time after learning of the impairment (this period of time may be a
						  matter of months or years). An attorney can be consulted about these
						  possibilities. It should be stressed that Cal/OSHA is in no way trying to
						  either encourage or discourage claims or lawsuits. However, since results of
						  the standard's medical surveillance program can significantly affect the legal
						  remedies of an employee who has acquired a job-related disease or impairment,
						  it is proper for Cal/OSHA to make you aware of this.
The medical surveillance subsection of the standard
						  also contains provisions dealing with chelation. Chelation is the use of
						  certain drugs (administered in pill form or injected into the body) to reduce
						  the amount of lead absorbed in body tissues. Experience accumulated by the
						  medical and scientific communities has largely confirmed the effectiveness of
						  this type of therapy for the treatment of very severe lead poisoning. On the
						  other hand, it has also been established that there can be a long list of
						  extremely harmful side effects associated with the use of chelating agents. The
						  medical community has balanced the advantages and disadvantages resulting from
						  the use of chelating agents in various circumstances and has established when
						  the use of these agents is acceptable. The standard includes these accepted
						  limitations due to a history of abuse of chelation therapy by some lead
						  companies. The most widely used chelating agents are succimer and calcium
						  disodium EDTA (Ca Na2 EDTA).
The standard prohibits "prophylactic chelation" of any
						  employee by any person the employer retains, supervises or controls.
						  "Prophylactic chelation" is the routine use of chelating or similarly acting
						  drugs to prevent elevated blood lead levels in employees who are occupationally
						  exposed to lead, or the use of these drugs to routinely lower blood lead levels
						  to predesignated concentrations believed to be 'safe.' It should be emphasized
						  that where an employer takes an employee who has no symptoms of lead poisoning
						  and has chelation carried out by a PLHCP (either inside or outside of a
						  hospital) solely to reduce the employee's blood lead level, such practice is
						  generally considered prophylactic chelation. The use of a hospital and a PLHCP
						  does not mean that prophylactic chelation is not being performed. Routine
						  chelation to prevent increased or reduce current blood lead levels is
						  unacceptable whatever the setting.
The standard allows the use of "therapeutic" or
						  "diagnostic" chelation if administered by a PLHCP in a clinical setting with
						  thorough and appropriate medical monitoring. Therapeutic chelation responds to
						  severe lead poisoning where there are marked symptoms. Diagnostic chelation
						  involves giving a patient a dose of the drug then collecting all urine excreted
						  for some period of time as an aid to the diagnosis of lead poisoning.
In cases where the examining PLHCP determines that
						  chelation is appropriate, you must be notified in writing of this fact before
						  such treatment. This will inform you of a potentially harmful treatment and
						  allow you to obtain a second medical opinion if you choose to do so.
IX. Medical Removal Protection -- subsection (k)
Excessive lead absorption subjects you to increased
						  risk of disease. Medical removal protection (MRP) is a means of protecting you
						  when, for whatever reasons, other methods such as engineering and
						  administrative controls, work practices, and respirators have failed to provide
						  the protection you need. MRP involves the temporary removal of an employee from
						  their regular job to a place of significantly lower exposure without any loss
						  of earnings, seniority, or other employment rights or benefits. The purpose of
						  this program is to cease further lead absorption and allow your body to
						  naturally excrete lead which has previously been absorbed. Temporary medical
						  removal can result from an elevated blood lead level, or a medical opinion. Up
						  to 18 months of protection is provided as a result of either form of removal.
						  The vast majority of removed employees, however, will return to their former
						  jobs long before this 18-month period expires. The standard contains special
						  provisions to deal with the extraordinary but possible case where an employee's
						  blood lead level does not adequately decline during 18 months of
						  removal.
Your employer must remove you from work having an
						  exposure to lead at or above the action level of 2
						  µg/m3 as an 8-hour TWA, from work altering or
						  disturbing any material containing lead at a concentration greater than or
						  equal to 0.5% by weight, or from work torch cutting any scrap metal on each
						  occasion that your last BLL is 30 µg/dl or above; or effective January 1,
						  2026, your last 2 blood lead results are at or above 20 µg/dl; or
						  effective January 1, 2026, the average of the results of all of your blood lead
						  tests in the last 6 months is at or above 20 µg/dl, unless the last blood
						  test indicates a blood lead level below 15 µg/dl, in which case you need
						  not be removed. If you are removed from your normal job because of a high BLL,
						  your employer must returnyou to your former job status when your BLL declines
						  to below 15 µg/dl, and two consecutive blood lead tests, taken at least
						  30 days apart, both indicate this level.
You may also be removed from exposure even if your
						  blood lead levels are below 30 µg/dl or the other criteria described
						  above if a medical determination indicates that you temporarily need reduced
						  lead exposure for medical reasons. If the PLHCP who is implementing your
						  employer's medical program makes a written opinion recommending your removal or
						  other special protective measures, your employer must implement the PLHCP's
						  recommendation. If you are removed in this manner, you must be returned when
						  the doctor indicates that it is safe for you to do so.
The standard does not give specific instructions
						  dealing with what an employer must do with a removed employee. Your job
						  assignment upon removal is a matter for you, your employer and your union (if
						  any) to work out consistent with procedures or agreements for job assignments
						  which may exist in your place of employment. Each removal must be accomplished
						  in a manner consistent with existing collective bargaining relationships. Your
						  employer is given broad discretion to implement temporary removals so long as
						  no attempt is made to override existing agreements. Similarly, a removed
						  employee is provided no right to veto an employer's choice which satisfies the
						  standard.
In most cases, employers will likely transfer removed
						  employees to other jobs with sufficiently low lead exposure. Alternatively, an
						  employee's hours may be reduced so that the time-weighted average exposure is
						  reduced to below the action level, or they may be temporarily laid off if no
						  other alternative is feasible.
In all of these situations, MRP benefits must be
						  provided during the period of removal that is, you continue to receive the same
						  earnings, seniority, and other rights and benefits you would have had if you
						  had not been removed. Earnings include more than just your base wage; they
						  include overtime, shift differentials, incentives, and other compensation you
						  would have earned if you had not been removed. During the period of removal you
						  must also be provided with appropriate follow-up medical surveillance. If you
						  were removed because your blood lead level was too high, you must be provided
						  with a monthly blood lead test. If a medical opinion caused your removal, you
						  must be provided medical tests or examinations that the doctor believes to be
						  appropriate. If you do not participate in this follow up medical surveillance,
						  you may lose your eligibility for MRP benefits.
When you are medically eligible to return to your
						  former job, your employer must return you to your "former job status." This
						  means that you are entitled to the position, wages, benefits, etc., you would
						  have if you had not been removed. If you would still be in your old job if no
						  removal had occurred, you are to be returned to this job. If you would not be
						  in your old job, the job assignment to which you return must be consistent with
						  the decision which your employer would have been obliged to make had no removal
						  occurred. MRP only seeks to maintain your rights, not expand them or diminish
						  them.
If you are removed under MRP and you are also eligible
						  for workers' compensation or other compensation for lost wages, your employer's
						  MRP benefits obligation is reduced by the amount that you actually receive from
						  these other sources. Similarly, if you obtain other employment during the time
						  you are laid off, the benefits you receive under MRP are reduced by the amount
						  you earn in such other employment.
The standard also covers situations where an employer
						  voluntarily removes an employee from exposure to lead due to the effects of
						  lead on the employee's health-related condition, even though the standard does
						  not require removal. In these situations MRP benefits must also be provided as
						  though the standard required removal. Finally, it is important to note that in
						  all cases where removal is required, respirators cannot be used as a
						  substitute. Respirators may be used before removal becomes necessary, but not
						  as an alternative to a transfer to a low exposure job or to a lay-off with MRP
						  benefits.
X. Employee Information and Training -- subsection
						  (
l
)
All employees occupationally exposed to lead must be
						  trained, prior to initial assignment and at least annually thereafter, on
						  housekeeping and hygiene practices, including, where applicable, written safe
						  hydration procedures. Your employer is also required to provide an information
						  and training program for all employees exposed to lead at or above the action
						  level on any day, or who may experience skin or eye irritation from lead
						  compounds such as lead arsenate or lead azide, and as interim protection for
						  employees who perform PSLW. This program must inform these employees of the
						  specific hazards associated with their work environment, protective measures
						  which can be taken, the danger of lead to their bodies (including their
						  reproductive health), and their rights under the standard. In addition your
						  employer must make readily available to all employees, including those exposed
						  below the action level, a copy of the standard and these appendices.
Your employer is required to complete this training
						  program for all employees described above prior to initial job assignment. This
						  training program must also be provided at least annually thereafter.
XI. Communication of Hazards -- subsection (m)
Your employer must include lead in their hazard
						  communication program and training.
The standard requires that the following warning sign
						  must be posted in work areas where the exposure to lead is at or above the
						  action level, and as interim protection in each work area where PSLW is
						  performed:
DANGER
LEAD WORK AREA
MAY DAMAGE FERTILITY OR THE UNBORN
						  CHILD
CAUSES DAMAGE TO THE CENTRAL NERVOUS
						  SYSTEM
DO NOT EAT, DRINK OR SMOKE IN THIS
						  AREA
These signs are to be posted and maintained in a manner
						  which ensures that the legend is readily visible, and must be in a language
						  understandable to employees.
Your employer is not required to post the specified
						  warning sign in work areas where employees are exposed to lead at or below 50
						  µg/m3, without regard to the use of
						  respirators, and the employer has implemented compliant written safe hydration
						  procedures.
XII. Recordkeeping -- subsection (n)
Your employer is required to keep all records of
						  exposure monitoring for airborne lead. These records must include the name and
						  job classification of employees measured, details of the sampling and analytic
						  techniques, the result of this sampling, and the type of respiratory protection
						  being worn by the person sampled. Your employer is also required to keep all
						  records of blood lead testing and medical examination results. These must
						  include the name of the employee, the PLHCP's written opinion, and a copy of
						  the results of the examination. All of the above kinds of records must be kept
						  for 40 years or for at least 20 years after your termination of employment,
						  whichever is longer.
Recordkeeping is also required if you are temporarily
						  removed from your job under the medical removal protection program. This record
						  must include your name and unique identifier, the date of your removal and
						  return, how the removal was or is being accomplished, and whether or not the
						  reason for the removal was an elevated blood lead level. Your employer is
						  required to keep each medical removal record only for the duration of an
						  employee's employment.
In addition, the standard requires that your employer
						  keep records of their semi-annual review of their written compliance program,
						  and written elevated blood lead level response plans, for three years. They are
						  also required to keep records of any training required by this standard for
						  three years.
The standard requires that if you request to see or
						  copy environmental monitoring, blood lead level (BLL) testing, or medical
						  removal records, they must be made available to you or to a representative that
						  you authorize. Your union also has access to these records. Upon your request,
						  your complete medical records must also be provided to you, to your PLHCP or to
						  any other person whom you may specifically designate. Your union does not have
						  access to your personal medical records unless you authorize such
						  access.
XIII. Observation of Monitoring -- subsection
						  (o)
When air monitoring for lead is performed at your
						  workplace as required by the standard, your employer must allow you or someone
						  you designate to observe the monitoring. The observer is entitled to an
						  explanation of the measurement procedure and to observe all steps related to
						  the lead monitoring performed and record the results obtained. Since results
						  will not normally be available at the time of the monitoring, the observer is
						  entitled to record or receive the results of the monitoring when returned by
						  the laboratory. Your employer is required to provide the observer with any
						  personal protective devices required to be worn by employees working in the
						  area that is being monitored. The employer must require the observer to wear
						  all such equipment and to comply with all other applicable safety and health
						  procedures.
XIV. For Additional Information
A. A copy of the standard for lead in general industry
						  can be obtained free of charge at
http://www.dir.ca.gov/Title8/5198.html
,
						  or by calling or writing your local Cal/OSHA office.
B. Additional information about the lead standard for
						  general industry, its enforcement, and your employer's compliance can be
						  obtained at
http://www.dir.ca.gov/dosh/EnforcementPage.htm
or from the nearest Cal/OSHA District Office.