Employee Medical Monitoring Plan

Medical surveillance in the occupational setting is the systematic collection and analysis of the health information on groups of workers potentially exposed to harmful agents, for the purpose of identifying health effects at an early and hopefully reversible stage. Biological monitoring, or the measurement of tissue levels of contaminants or metabolites, is often included as part of a medical monitoring program, even though these tests do not measure adverse health effects.

The California Code of Regulations (CCR) requires that employees with potential exposures to certain harmful agents shall receive medical monitoring examinations. These examinations serve the purpose of detecting adverse health effects which could possibly be related to workplace exposures. Early detection of disease will result in earlier treatment and will allow for cessation of additional exposures that could aggravate a potentially serious medical condition. In addition to monitoring of employee health, biological monitoring may also be necessary. Biological monitoring provides a correlation between external exposures and internal exposure. Biological monitoring provides a reliable indication of health risk to an individual worker.

Medical physical examinations are required for employees in the following categories:

• Police Officers, pre-employment per California Peace Officer Standards and Training
• Employees exposed to specific chemical and physical agents as defined in the CCR and CFR

Employees with occupational exposure to the following conditions and chemicals may be placed on the Employee Medical Monitoring Program (EMMP). Those on the EMMP should have a physical during probation, annually thereafter and post-employment.

It is the policy of the Cal Maritime to maintain a safe and healthy work environment for each employee (including student and contract employees), and to comply with all applicable occupational health and safety regulations. This Injury and Illness Prevention Program (IIPP) is intended to establish a framework for identifying and correcting workplace hazards within the department, while addressing legal requirements for a formal, written IIPP.

To assist Cal Maritime in providing a safe, compliant, environmentally sound, and more sustainable operation, each department or operational unit is expected to review, understand, and follow the guidance provided in the Injury Illness Prevention Program components and the and the function of the integrated campus safety management system (ICSMS) as related to operations under their control.

In a proactive behavior based environmental health and safety model that entire campus community participation reflects a process that embraces the ability to;

•  Eliminate adverse conditions which may result in injury or illness,
•  Recommend the establishment of programs to raise safety consciousness in the community, and
• Achieve and maintain a beneficial relationship through continuing communication on issues relating to environmental health and occupational safety

Employees (Including Student workers)

It is the responsibility of all faculty and staff to proactively participate and subsequently comply with all applicable health and safety regulations, Cal Maritime policies, and established safe work practices. This includes, but is not limited to:

• Observing health and safety-related signs, posters, warning signals and directions.
• Learning about the potential hazards of assigned tasks and work areas.
• Taking part in appropriate health and safety training.
• Following all safe operating procedures and precautions.
• Participating in workplace safety inspections
• Using proper personal protective equipment.
• Inform coworkers and supervisors of defective equipment and other workplace hazards without fear of reprisal.
• Reviewing the building emergency plan and assembly area.
• Reporting unsafe conditions immediately to a supervisor, and stopping work if an imminent hazard is presented.

Department of Safety and Risk Management (SRM)

The Director of Safety and Risk Management (SRM), as delegated by the University President, is responsible for the implementation and administrative management for Cal Maritime's Injury Illness Prevention Program (IIPP) that meets the requirements of California Code of Regulations (CCR), Title 8, section 3203) as well as other applicable California and Federal Occupational Safety and Health (Cal-OSHA) requirements. This Program represents a best management safe work practice or regulatory specific component of the IIPP. 

• Provide advice and guidance to all university personnel concerning IIPP compliance requirements;
• Provide centralized monitoring of campus activities related to implementation of campus IIPP;
• Ensure scheduled periodic safety inspections are performed in compliance with regulatory requirements and assist management staff in identifying unsafe or unhealthful conditions;
• Ensure safety and health training programs comply with regulatory requirements and university policy;
• Oversee the maintenance of safety and health records consistent with the requirements of this document and regulatory mandates;
• Ensure program audits, both scheduled and as required by a process, equipment or personnel change, or by a safety program mandate, are performed;
• Interpret existing or pending safety and health legislation and recommend appropriate compliance strategies to university personnel;
• Maintain centralized environmental and employee monitoring records, allowing employee access as directed by law.

Deans, Directors, Department or Operating Unit Management (DM)

Campus Department or Operating Unit Head Management (DM) have an integral campus role and shall have a thorough understanding of Injury Illness Prevention Program components and the function of the integrated campus safety management system (ICSMS) as related to operations under their control.

• The DM have primary authority and responsibility to ensure the health and safety of the department's faculty, staff and students through the implementation of the Injury Illness Prevention Program components. This is accomplished through a collaborative approach with SRM by communicating Cal Maritime's campus emphasis on health and safety, analyzing work procedures for hazard identification and correction, ensuring regular workplace inspections, providing health and safety training, and encouraging prompt employee reporting of health and safety concerns without fear of reprisal.
• The "Owner Department" is responsible to identify hazardous activities in their workplace and design into locations engineering controls such as guards, barriers, edge protection, etc., to prevent access to a known hazard.  Only when engineering controls cannot be used or implemented, personal protective equipment (PPE) may be used to aid in controlling hazards to personnel in a Department's operation.
• The department owning or exposing personnel to hazards is responsible for the selection of the proper equipment based upon a hazard analysis of work tasks. In addition, Owner Departments must ensure regulatory applicable training is provided to their personnel who use the equipment, keep the records of training completed, and schedule periodic inspections of all equipment under their ownership or control.
• Toward this end, the Department owning the equipment must:

•       Notify SRM of training needs to designated personnel. Refer to section 4 of this document for training requirements applicable to this Program.
•       Notify SRM when new equipment is purchased so that it can be inspected and added to the JHA and Equipment inventory.
•       Schedule with SRM a periodic inspection.
•       Render unusable and then dispose of any equipment that is in any way questionably unsafe as determined by the inspector or the person using the equipment.

• DM's are encouraged to designate an individual as the department safety coordinator, to assist with the specific operational environmental, health and safety process management components.

Supervisors and Principal Investigators

Supervisors play a key role in the implementation of the Cal Maritime's Injury Illness Prevention Program components. Supervisors may be Management, Senior Research Associates, Department Chairs, Principal Investigators, or others who oversee a project and/or staff. They are responsible for but not limited to:

• Communicating to their staff and students about Cal Maritime campus's emphasis on health and safety.
• Ensuring periodic, documented inspection of workspaces under their authority.
• Promptly correcting identified hazards.
• Modeling and enforcing safe and healthful work practices.
• Providing appropriate safety training and personal protective equipment.
• Implementing measures to eliminate or control workplace hazards.
• Stopping any employee's work that poses an imminent hazard to either the employee or any other individual.
• Encouraging employees to report health and safety issues without fear of reprisal.

Academic Programming Faculty & Advisors

It is the responsibility of Faculty, Academic Programming Advisors other Cal Maritime related activities and student clubs to:

• Develop procedures to ensure effective compliance and support of the Injury and Illness Prevention Program components as it relates to operations under their control. Specific areas of responsibility include student education and training, identification and correction of unsafe conditions, and incident reporting.
• Develop and maintain written classroom, laboratory, and activity procedures which conform to regulatory, campus and departmental guidelines.
• Instruct students in the recognition, avoidance, and response to unsafe conditions, including hazards associated with non-routine tasks and emergency operations
• Permit only those persons qualified by education and training to operate potentially hazardous equipment or use hazardous materials, unless under close supervision.
• Supervise students in the performance of activities.

Students- Cadets

Students are expected to always adhere to safety practices presented by faculty, technical staff, student assistants, graduate assistants or other authorized individuals.  They must also report potentially hazardous conditions that become known to them. These reports should be made to their supervisors, faculty advisers, Department of Safety and Risk Management, or other responsible parties.

Integrated Safety Management (ISM)

Cal Maritime is committed to having all campus-related work performed safely and in a manner that strives for the highest degree of protection for the Campus Community. To achieve these goals, Cal Maritime implements, the principles of safety through an Integrated Campus Safety Management System (ICSMS).

Simply put, ICSMS applies a plan-do-check-act approach to campus safety management. Five core activities represent the plan-do-check-act approach, and comprise the underlying process for any construction work activity. The five core activities are:

1. Define the Scope of Work
2. Analyze the Hazards
3. Develop and Implement Hazard Controls
4. Perform Work Within Controls
5. Provide Feedback and Manage Change

The identification and analysis of workplace hazards is part of the pre-work planning process. The goal of this core activity is to ensure that the hazards associated with construction work activities are clearly understood and appropriately managed. All new campus work activities, changes to existing work or introduction of new equipment or processes (which introduce new hazards or increase the hazard level) need to be reviewed to analyze hazards, identify safety standards/requirements, and establish appropriate controls. Safety conditions and requirements need to be formally established and in place before construction work is initiated.

The campus Job Hazards Analysis (JHA) process is the principle method for achieving this.

Hazard Identification, Risk Assessment & Determining Control Table (HIRAC)

The SRM Hazard Identification, Risk Assessment and Determining Control Table (HIRAC) process is used to identify, assess and risk-rank Cal Maritime campus-related activities in order to ensure that Cal Maritime Campus Safety programs, activities and work controls are appropriately addressing construction risks. The initial HIRAC assessment and risk-ranking of campus-related activities was conducted during the third quarter, AY 2016-2017. The HIRAC assessment will be reviewed annually, when new campus-related activities are introduced that create or modify assessed risks, and when worksite observations or accident/incident experience identify previously unrecognized or incorrectly categorized risks.

Application of Hierarchy of Controls

In developing hazard controls and preparing the Job Hazard Analysis submittal, the campus shall select means and methods to mitigate worker exposure to workplace hazards using the Hierarchy of Controls as specified in the American National Standards Institute (ANSI) Z10-2005 Occupational Health and Safety Management Systems.

The campus shall make a good faith effort to analyze each hazard and identify the appropriate control(s) using the following hierarchy:

• Elimination or substitution of the hazards where feasible and appropriate;
• Use of engineering controls where feasible and appropriate;
• Application of work practices and administrative controls that limit worker exposures; and
• Provision and use of personal protective equipment

Job Hazards Analysis (JHA)

For the purposes of this section Job Hazard Analysis (JHA) and Job Safety Analysis (JSA) can be used synonymously.  A JHA/JSA can be incorporated into a Pre Task Plan, provided there is a section for employees to review, comment and sign. Core components of the scope of work and relative hazards can be electronically completed ahead of time, provided there is room for current site conditions are able to be readily added as applicable. When the scope or conditions change, the change in work plan should be noted in a different colored pen with employee's initially that they have been briefed on the change.

The Department of Safety and Risk Management will work with individual Departments to develop a master Campus JHA library.

• Each employee scheduled to work in the activities identified below shall receive safety training in those activities prior to working on them.
• Subcontractors shall submit a Job Hazards Analysis (JHA) for those construction activities meeting the requirements for performing JHA (see below). The JHA shall be reviewed and authorized to proceed by the Cal Maritime Department of Safety and Risk Management before work commences.
• Subcontractor shall be responsible for submitting a JHA and work procedures to Cal Maritime Department of Safety and Risk Management for review a minimum of seven days prior to the start of work for most work activities.

JHA Requirements

A JHA shall be written based on the following conditions:

• Jobs with the highest injury or illness rates
• Jobs with the potential to cause severe or disabling injuries or illness, even if there is no history of previous accidents
• Jobs in which one simple human error could lead to a severe accident or injury
• Jobs that are new to your operation or have undergone changes in processes and procedures
• Jobs complex enough to require written instructions.

If not otherwise specified in a particular project specification, the JHA shall be performed in accordance with the OSHA 3071.

JHA processes. In general the JHA will include:

• Description of work phase or activity
• Identification of potential hazards associated with the activity
• Address further hazards revealed by supplemental site information (e.g., site characterization data, as-built drawings) provided by the subcontractors construction manager.
• A list of the Subcontractor's planned controls to mitigate the identified hazards
• Identification of specialized training required
• Identification of special permits required
• Name of the Subcontractor's Competent Person(s) responsible for inspecting the activity and ensuring that all proposed safety measures are followed.

Objectives

• Evaluate the health status of potential employees, and determine whether they can perform the job in a safe and effective manner.
• Detect exposure-related adverse health effects at an early and hopefully reversible stage so that occupational diseases can be prevented, and proper medical care can be rendered, if necessary.
• Periodically assess employee suitability for ongoing or new assignments that involve potential contact with hazardous agents.
• Correlate past occupational or environmental exposures with future workplace activities and exposures, to arrive at an opinion on the risk that the job might represent to the health status of the individual.
• Provide a medical monitoring program that complies with all the pertinent Federal, State, and local regulations.
• Identify unrecognized effects of exposure by continually evaluating group employee health data to detect possible adverse health trends.

Medical Monitoring Program Operations

Examination Frequency

The Initial Baseline Examination - The purpose of the baseline examination is pre-placement or probationary screening. All affected employees shall be given a baseline examination before being assigned to work with respirators or in occupations with known potentially hazardous exposures or Cal/OSHA regulated substances.

Periodic/Annual Examination - All personnel who have taken the initial pre-placement examination and have reviewed clearance by the examining physician shall be re-examined periodically in accordance with hazard-specific regulations. The date of each periodic examination should fall on or as closely as possible to, the anniversary of the previous examination.

Any employee who has not participated in potentially hazardous work or who is no longer required to use a respirator during the 12 month period following his/her last annual examination, and who is not expected to continue to participate, may discontinue participation in the medical monitoring program as determined by the EH&S Officer and the employee's appropriate administrator/supervisor.

Record must be kept by EH&S clearly documenting the reasoning and approval for each individual discontinuation of participation.

Exit Examination - An exit examination shall be given to any employee whose employment has included contact with OSHA regulated agents and who has been a participant in medical monitoring. If a medical exam has been administered within one year of exit, this requirement may be waived in certain cases.

However, the employee must have a termination (of program inclusion) physical examination and not have been exposed to asbestos or Cal/OSHA regulated carcinogens during this period.

Special / Emergency Examination (situational medical clearance) - Special testing may be required on certain projects due to the potential for exposure to specific substances. This may be necessary where the potential for heat or cold stress exists, or after an exposure that results in a toxicity reaction. The need for special testing will be assessed on an ongoing basis. Emergency testing may be necessary in the event the of employee exposure.

Physician's reports - Examining physicians will use the information provided by the employee in the questionnaire, the examination results, and the results of the laboratory tests to determine if any work restrictions or occupational health problems appear to be present. The physician must send a report of the examination directly to the employee as will the campus medical record custodian who will maintain the employees' records. These records are confidential and can only be viewed by the employee, the employee's representative, and authorized representatives of the Chief of the Division of Occupational Safety and Health.

Non-work related health issues may arise during the course of the medical evaluation. The examining physician may recommend that employees see their family doctor or a specialist. Any additional tests required to investigate non-work related health issues will be the employee's responsibility.

EH&S identifies employees covered by these regulations and coordinates the completion of baseline, periodic / annual and exit examinations with the employee or his or her supervisor.

EH&S completes the Employee Medical Monitoring Examination Appointment form, which includes pre-examination instructions. One copy is given to the employee, another is sent to the employee's appropriate administrator.

Safety and Risk Management prepares a package for the employee that includes:

• Medical Monitoring Program Exam Appointment and Pre- Examination Instructions.
• Authorization to Release Medical Information Form.
• Authorization to release Previous Medical Information (if applicable).
• Physical Examination Form.
• The Health Status Report Form.

The Employee Medical Examination Findings Form.

• The employee completes all applicable forms prior to the examination and observes the pre- exam instructions.
• The employee attends the appointment.
• The examining Physician completes Health Status Report Form and forwards it to EH&S.
• The examining Physician prepares the Employee Medical Findings Form and forwards it directly to the employee.
• The examining Physician forwards records to the University Custodian of Medical Records.
• Environmental  Health  and  Safety  reviews  the  Health  Status  Review  Form  and  initiates appropriate action.

If situations arise in which an employee may have experienced a hazardous exposure or alleges symptoms, EH&S will evaluate the potential workplace problems and arrange for appropriate medical diagnosis and treatment if indicated or required.

EH&S will contact the examining physician who will coordinate investigations and treatment to determine if overexposure to a hazardous substance has occurred.

An Incident Report detailing the hazardous exposure will be completed by the appropriate administrator and forwarded to EH&S.

Comprehensive Medical Examination

Identification provided: Name, birth date, gender, job title, department, etc.

Personal medical history:

• Medications
• Allergies
• Illness, injuries, hospitalizations, surgeries
• Smoking, alcohol, drug histories
• Medical conditions-specifically lung disease, heart disease, liver disease, skin conditions, neurological condition

Family medical history: specifically cancers and lung, heart, liver, kidneys or neurological diseases

General Appearance and Physical Development and Posture: Height and weight are recorded.

Head-Eyes: Titimus vision testing including near, far, color vision and depth, lateral phoria, esophoric, exphoric and vertical phoria (right and left hemisphere) and peripheral vision. Also noting ptosis, discharge, visual fields, ocular muscle imbalance, presence of corneal scarring, exophthalomos or srabismus uncorrected by corrective lenses. If the applicant wears contact lenses, it will be noted whether they have good tolerance and has adapted to their use. All vision testing is done without corrective lenses and then with the corrective lenses. This is done in order to determine a baseline vision as well as effectiveness of corrective lenses. Note that certain positions do not allow the use of contact lenses.

Ears: Audiometric tests shall be pure tone, air conduction, hearing threshold examinations with test frequencies including as a minimum, 500, 1000, 2000, 3000, 4000 and 6000 Hz. Tests at each frequency shall be taken separately for each ear. Audiometric screening should meet specifications of, and be maintained and used in accordance with ANSI, S 3.6-1969. Audiometry testing room should meet the requirements for maximum allowable octave-band sound pressure levels for audiometric test rooms. In addition, audiometric calibration should be checked acoustically on an annual basis according to Title 8 California Code of Regulations, Section 5097 Appendix D. Ear examination also includes noting any evidence of mastoid or middle ear disease, discharge symptoms of aural vertigo or Meniere's Syndrome.

Throat: Examination includes detection of any deformities of the throat, larynx, masses or nodes which may interfere with normal breathing and eating.

Heart: Auscultation by stethoscope for heart sounds, presence of murmurs, clicks, rubs, additional heart sounds and dysrhythmias. PMI will be ascertained and full cardiac history is obtained for symptoms such as dyspnea, palpitations, syncope. Blood pressure determinations are also made.

Pulmonary: Examination of lungs and thoracic area. Breath sounds are examined specifically noting any signs of chronic obstructive pulmonary disease, congestive heart failure and history of lung disease like asthma or bronchitis.

Gastrointestinal System: Complete history, and current signs and symptoms will be noted. Noting will be made specifically for presence of hernia, scars, weakness or injuries, location, size and character of any abdominal masses. Bowl sounds will also be noted. A rectal examination with stool guaiac will be obtained on all male employees over 50 years of age.

Genitourinary: Examination for presence of infection or other abnormal findings including urinalysis (noting uncontrolled diabetes, presence of albumin).

Neurological: Examination includes pupil reflexes for light and accommodation, sensory, vibratory and positional movements.

Extremities: Close examination of all extremities for color, warmth, presence of peripheral pulses and skin tugor. Any deformities, paralysis or varicose veins and leg muscle weakness will be documented.

Spine: History of pain, injuries, and physical examination for deformities will be performed.

Additional Tests as Required

• Resting 12-lead Electrocardiogram: Electrocardiograms will be read by a Board Certified Cardiologist.
• Treadmill EKG: or MASTER STEP TEST
• Pulmonary Function Testing: To include (at the discretion of the examining physician):

• FVC- Forced Vital Capacity
• FEV 1.0-Forced Expired Volume in one second
• FEV 3.0-Forced Expired Volume in three seconds
• FEF 25-75 - Forced Expiratory flow
• RV - Residual Volume

Results of pulmonary function testing are calibrated in prediction equations. Degree of respiratory impairment is assessed. Some obstructive diseases that may be associated with abnormal findings include: chronic bronchitis, asthma and emphysema. Restrictive diseases like pleural thickening, pulmonary fibrosis and congestive heart failure are associated with other abnormalities found in pulmonary function testing. All pulmonary function testing equipment must be approved by the American Thoracic Society and the operators must be certified by NIOSH (National Institute for Occupational Safety and Health).

Complete Blood Count (RBC, Hgb, HCT, WBC, differential)

Blood Chemistry Panel, Requiring any/all of the following tests:

 

All laboratory testing is performed by a CLIA approved and licensed clinical laboratory.

Chest X-Rays: Posterior / anterior view x-rays. Radiologist interpretation should be done by a Board Certified Radiologist. For employees with potential asbestos exposure, Certified "B" readers will interpret x-rays.

Urinalysis (with Microscopy) to test for:

• Specific Gravity                                                                        
• pH
• Albumin Glucose                                                                     
• Acetone Protein

Biological Monitoring for Lead:

Blood lead level

• Hemoglobin and hematocrit, red cell indices and peripheral smear morphology Zinc protoporphyrin (ZPP)
• Blood Urea nitrogen and creatinine

Red blood cell and Plasma Cholinesterase Tests

Stool Specimen

• Submitted for culture and examination for OVA and parasites

Effective dissemination of safety information lies at the very heart of a successful Injury and Illness Prevention Program.  It is essential to provide training for employees concerning general safe work practices as well as specific instruction with respect to hazards unique to each employee's job assignment.

Training content is determined by the Department of Safety and Risk Management, as well as Department Management which is based upon observed hazards, type of equipment, Department need, and work requirements.

• Providing training from within the department, or
• Safety Training provided by SRM, or
• A training provider outside the University.
  • Note: All outside trainer venders are to be reviewed and content approved by SRM.

Training shall be provided to each affected employee:

• Before the employee is first assigned duties that require him or her to serve as a first aid responder.

Before there is a change in assigned duties.

• Whenever there is a change first aid procedures or operations.
• Whenever the company has reason to believe that there are deviations from the first aid response procedures required by this instruction or inadequacies in the employee's knowledge or use of these procedures.

The training shall establish employee proficiency in the duties required by this instruction and shall introduce new or revised procedures, as necessary, for compliance with this instruction or when future revisions occur.

Cal Maritime shall certify that the training required by this section has been accomplished. The certification shall contain each employee's name, the signatures or initials of the trainers, and the dates of training. The certification shall be available for inspection by employees and their authorized representatives.

Training Information –

Training is provided to employees at the time of initial task assignment where occupational exposure may take place and annually thereafter.  Training is recorded on the employee's Safety Training Checklist.  Additional training is provided when changes such as modification of tasks/procedures or institution of new tasks/procedures affect the employee's occupational exposure.  The additional training may be limited to addressing the new exposures created.

The training program contains, at a minimum, the following elements:

Refer to Cal/OSHA Safety & Health Training and Instruction Requirements as outlined in Appendix C of the Injury Illness Prevention Program

Employee Medical Records and Confidentiality

Access

Employees, their designated representatives, and authorized representatives of Cal/OSHA have full right of access to relevant exposure and medical records. Designated representatives must be given the employees written authorization to exercise the right of access. The legal representative of a deceased or legally incapacitated employee may exercise full right of access to all of an employee's medical record.

All requests for employee medical or exposure records shall be in writing to the University Medical Record Custodian. A copy or the requested records shall be provided to the employee or designated representative at no cost and no later than fifteen (15) days after the request is made. In the case of an original x-ray, access shall be restricted to on-site examination. Whenever a record has previously been provided without cost to the employee or designated representative, the university may charge for the record search and the cost of additional copies.

In the rare case that a request for records is denied, the employee may appeal the denial to the Division of Occupational Safety and Health (DOSH), State of California. The Chief of DOSH will make a decision on the appeal and may issue an order to release the information to the employee or their designated representative. Designated representatives must be given the employee's written authorization to exercise rights of access. A written authorization shall contain the following:

• The name and signature of the employee authorizing the release of the medical information.
• The date of the written authorization.
• The name of the individual or organization authorized to release the medical information.
• The name of the individual or organization authorized to receive the medical information.
• A general description of the medical information that is authorized to be released.
• A general description of the purpose for release of the medical information, and a date or condition upon which the written authorization will expire. The employee or representative will be provided a copy of the requested medical records at no charge to the employee.

Retention, Recordkeeping and Confidentiality

An important part of the Employee Medical Monitoring Program (EMMP) is the confidentiality of the medical and exposure records generated by the program. This program has been carefully designed to ensure that the medical information for individual employees be made available only to medical professionals (including medical records services personnel) and the employee. Specifically, individual medical information is not available to Cal Maritime management personnel, and in the absence of a subpoena, will not be made available to any person other than the employee or their designated representative of State or Federal regulatory agencies, e.g. Cal/OSHA.

The only information kept on file at the University is a cover-letter describing the employee's medical qualification to perform regular work, a description of work restrictions (if any) and the names of tests completed by the occupational medicine provider.

To ensure that the employee has a complete understanding of these confidentiality procedures and the limited uses that will be made of the employee's medical data, each Cal Maritime employee enrolled in the EMMP is given an Authorization for Use or Disclosure of Health Information form by the occupational medicine provider. Employees are asked to sign the form before beginning an exam. The signed authorization form allows the occupational medicine provider to send the records to the campus.

Often, an employee may have undergone a previous medical examination. This information may be of value to the physician performing the exam. If the employee authorizes, copies of these old records may be obtained. The form, Authorization for Use or Disclosure of Health Information, is to be used for this purpose. Medical and exposure records are maintained for 30 years after the termination of employment at California State University Maritime Academy

Definition of Medical and Exposure Records

Medical records include the following:

• Medical and employment questionnaires and histories.
• The results of medical examinations and laboratory tests.
• Medical opinions and diagnosis, progress rates and recommendations.
• First aid records.
• Description of treatment and prescriptions.
• Employee medical complaints.

Medical records do not include medical information in the form of:

• Physical specimens (e.g. blood or urine samples) which are routinely discarded as part of normal medical practice.
• Records created solely in preparation for litigation which are protected from discovery under applicable rules of procedure on evidence.
• Records concerning voluntary employee assistance programs.

Exposure records

• A record containing measurements or monitoring results of the amount of a toxic substance or harmful physical agent to which the employee is or has been exposed.
• In the absence of directly relevant records, records of other employees with past or present job duties or working conditions related to or similar to those of the employee, may be used to indicate the amount and nature of the toxic substances or harmful physical agents to which the employee is or has been subjected.
• Exposure records to the extent necessary to reasonably indicate the amount and nature of the toxic substance or harmful physical agent at workplaces or working conditions to which the employee is being assigned or transferred.

California Division of Occupational Safety and Health (DOSH), Department of Industrial Relations (CalOSHA)

Code of Federal Regulations (CFR) Title 29 §1910, Title 40; California Code of Regulations (CCR) Title 3, Title 8 §5139 – 5223 Control of Hazardous Substances, and Title 8 §3203 Injury and Illness Prevention Program; CSU Employee Medical Monitoring Plan Management §1.3 and 1.4; CSU Executive Order 1039.