This Guide Memo serves as an overview of Stanford's medical evaluation procedures.
The California Occupational Health and Safety Act and California Occupational Safety and Health Administration (OSHA) and other federal regulations require that employers provide programs of medical surveillance for employees in certain positions. These programs, which may include examinations and testing before a new employee starts work as well as periodic medical evaluations, for employees engaged in certain occupations or working under certain conditions. While Stanford is required to make such examinations available, only certain employees—e.g., asbestos workers, employees required to use respirators, and hazardous materials Emergency Response Team members—are required by regulations to be provided and undergo medical examinations.
Stanford University evaluates and monitors, through its programs of medical surveillance, the health of Stanford University faculty, staff, and students who are exposed to certain hazardous materials and situations as defined by law and University policy.
Medical examinations of various kinds are available to employees working in conditions outlined below. Examinations may be recommended for other personnel based on job duties, exposures, individual medical histories, departmental accident and injury experience, and other safety standards.
a. Asbestos Exposure
Examinations before a new employee starts work and periodic examinations thereafter are required for employees assigned to work with asbestos.
b. Biohazardous Agents
Those working with biohazardous agents at biosafety level 2 or 3, those working with potentially infectious materials, or those working with animals possibly carrying zoonotic diseases may need to participate in a medical surveillance program.
c. Clinic Personnel
University Clinic personnel are required to have physical examinations when they are hired and yearly tuberculosis tests. Clinic employees working with chemotherapeutic drugs also receive yearly examinations.
d. Hazardous Chemical Exposure
Those exposed to certain levels of carcinogens or other hazardous chemicals in laboratories or to specific toxic and hazardous substances as specified in OSHA regulations may require medical monitoring under certain conditions. For updated, specific information on requirements for monitoring and participation in the medical surveillance program, please call the Department of Environmental Health and Safety (EH&S) at 723-0448.
e. Hazardous Materials Emergency Response Team
Examinations are required before a new hazardous material emergency response team member, expected to perform work in response to the release of hazardous materials, including leaks or spills, starts work and annually thereafter.
f. Laser Exposure
Eye examinations are provided to those who will be exposed to class 3b or 4 laser beams prior to beginning their assignment. Call Health Physics for information at 723-3201.
g. Noise Exposure
Audiometric tests, consisting of baseline medical examinations and annual examinations thereafter, are available to those who may be exposed to noise levels equal to or exceeding an 8 hour time-weighted average of 85 decibels.
h. Police Officers
Examinations before a new police officer begins work are required by the Stanford University Department of Public Safety (SUDPS).
i. Respirator Users
Examinations before a new employee starts work and annual medical evaluations thereafter are required for those who will be using a respirator as part of their work.
j. Other Recommendations
In addition to the regulated occupations outlined above, examinations are recommended for employees whose work requires strenuous physical activity, including laborers, athletic instructors, equipment and machine operators, delivery persons, freight handlers, and truck drivers. Also included are jobs requiring acute hearing, sustained visual acuity, and any other work situation in which physical condition is critical. Supervisors or employees needing assistance in determining the applicability of criteria should ask their departmental safety representative or call EH&S at 723-0448.
a. The Department of Environmental Health and Safety
EH&S implements University-wide policies and procedures, and operates an on-site Occupational Health Center for employees which provides consultation and assistance to departments upon request.
Each University school/department administers the program for those faculty, staff and students covered by this policy. This includes scheduling the examinations, processing the papers, and keeping records.
Supervisors in each department determine which of their employees are within the criteria for participation, and ensure that those employees receive the appropriate medical examinations. EH&S can assist supervisors in determining if a medical examination is appropriate.
a. Payment for Services
Medical examination expenses are charged to the employing department or project, unless previous arrangements have been made with The Stanford University Occupational Health Center (SUOHC). SUOHC will perform journal transfers for the costs of medical examinations of Stanford employees and prospective employees. All departments must arrange medical examinations with the SUOHC.
b. Making Appointments
The department schedules the medical appointment with the SUOHC (650-725-5308). If an appointment cannot be kept, it is the responsibility of the department or individual to notify SUOHC and reschedule the appointment. If SUOHC is not notified at least 24 hours in advance, the department may be charged for the missed appointment.
c. New Employees
Employees entering certain jobs, (e.g., respirator users, asbestos workers, police officers, hazardous materials emergency response team members, etc.) may be required to successfully complete a job-related physical examination before starting work. Employment in these positions is conditional upon satisfactory completion of the medical evaluation, and candidates for these positions should be so advised.
Currently, all records of medical examinations conducted under this policy are maintained at the SUOHC for the duration of an individual's participation in the Medical Surveillance Program and in accordance with State and Federal requirements.
The examining clinician is expected to review the results of the examination with each program participant and provide appropriate referral(s) for abnormal findings.
SUOHC will mail or email one copy of the medical clearance form to EH&S. The clearance form outlines the participant's ability to perform a particular job, work in a potentially hazardous environment, and/or wear a respirator. SUOHC also sends a copy of the clearance form directly to the employing department/laboratory. If there are restrictions in an individual's ability to perform his/her job, the supervisor should contact EH&S to determine the proper course of action. If necessary, Human Resources may be consulted.
Each department with employees participating in the medical surveillance program must maintain a Medical Surveillance Program file which contains the clearance forms for all program participants. An additional copy is also kept at SUOHC.
Employees or their designated representatives may obtain access to or a copy of medical records within 15 days of a request, without cost.