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This instruction cancels OSHA Instructions PER 04-00-003 [PER 8-2.5] and PER 04-00-002 [PER 8-2.4] and issues the OSHA Medical Examination Program to revise the description of employees eligible for the Medical Examination Program and to update program elements to better match the occupational needs of covered employees. The 1989 OSHA Instruction PER 04-00-003 [PER 8-2.5] implemented the Single Agency Qualification Standard: Compliance Safety and Health Officers, which mandated that covered employees meet a set of physical requirements as determined by an annual physical examination (Appendix A). This directive replaces the Compliance Safety and Health Officers (CSHO) Medical Examination Program and establishes a new scope of applicability and periodicity requirements for the OSHA Medical Examination Program. The expanded scope now includes both CSHOs and any other OSHA personnel who perform field work that places them at risk for occupational exposures or other hazardous work conditions. Therefore, the medical program title and scope now reflect inclusion of personnel other than CSHOs. The revised periodicity is based on recognition that comprehensive medical evaluations, when performed annually, are not significantly beneficial for some employees, particularly those younger than 50 years of age. Therefore, medical examination frequency will be aligned with age, individual medical conditions and occupational exposures, when applicable. The medical evaluation requirements mandated by OSHA standards will continue to be applied (Appendix B). This directive allows the Office of Occupational Medicine to exercise flexibility and practical judgment in determining the appropriate medical evaluation periodicity for each covered employee. The OSHA Medical Examination Program is based on a review of: current medical literature, professional guidance, medical examination protocols in other agencies and non-occupational medical public health recommendations. Annual medical evaluations of covered employees will continue, but the more extensive medical histories and physical examinations will now be performed during Pre-placement examinations, every three years until age 50 and then every two years until age 65, at which time the frequency of examinations will change to every year. The frequency of the periodic medical history and physical examination, or parts of the examination, may be changed by the Office of Occupational Medicine (OOM) in accordance with prudent medical practice. An Interim Medical Evaluation of each covered employee will be provided in the years in which the Periodic Physical Examination is not done. The Interim Medical Evaluation will include audiometric testing, a respirator questionnaire as required by the Respiratory Protection standard, 29 CFR 1910.134, and a blood pressure determination. Additional testing, such as pulmonary function testing, may also be indicated. Participation in Periodic Physical Examinations and Interim Medical Evaluations is mandatory for all covered employees.

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