Medical Surveillance

1. Under the OSHA standard (1910.20), you as an individual are entitled to your individual test results. The union is also entitled to the results without individual identities.

2. Corporations have many programs relating to health and medicine, such as alcoholism programs and drug testing. But these are not occupational health surveillance programs. An occupational health surveillance program is a program that tests for job exposures to toxic chemicals or conducts OSHA-mandated medical tests.

3. Medical surveillance for work-related hazards is only useful to the extent that the medical tests are the right ones to assess the possible health effects of the specific hazards that you face on your job. For example, if you are exposed to lead, you should have a blood test, not a chest X-ray.

4. You have the right and the obligation to your membership to make certain that the health care providers who implement the company program are competent to do the job. Not every doctor has the experience and training to understand occupational medicine. A qualified "B" reader should read your X-rays, and a board-certified doctor for occupational medicine should be running the company program. We included a list of "B" readers, and a list of excellent clinics that can help you evaluate your doctors.

5. You also have the skill to evaluate your medical surveillance program. By looking at the MSDSs and the results of your surveys, you can make a list of the tests that should be done. If they are not being done, the program needs to be changed.

6. If whatever program you have spots any kind of pattern of health problems, these problems should not be assumed to be caused by lifestyle factors like drinking or smoking. Any pattern of problems will need further analysis by a trained professional. If you see such a pattern, call the OCAW hot-line immediately, and/or contact any one of the recommended clinics.

7. There are always potential conflicts of interest when a company directly provides a medical surveillance program, or directly hires doctors to do the job. It would be far better if you could negotiate a program where the company would provide the funds and the union and management pick the medical provider. In that way, you could insist that one of the qualified clinics perform the work.

Summary written by Dr. Steven Markowitz, MD, Mt. Sinai School of Medicine, New York, N.Y.