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Medical Screening and Surveillance

Medical screening and medical surveillance are two fundamental strategies for optimizing employee health. Although the terms are often used interchangeably, they are quite distinct concepts. Medical screening is, in essence, only one component of a comprehensive medical surveillance program. The fundamental purpose of screening is early diagnosis and treatment of the individual and thus has a clinical focus. The fundamental purpose of surveillance is to detect and eliminate the underlying causes such as hazards or exposures of any discovered trends and thus has a prevention focus. Both can contribute significantly to the success of worksite health and safety programs. However OSHA "medical surveillance" requirements are generally clinically focused (e.g.,medical and work histories, physical assessment, biological testing) with information obtained from the clinical processes used in the monitoring and analysis elements of medical surveillance.

Medical screening and surveillance are addressed in specific standards for the general industry.

OSHA Standards

This section highlights OSHA standards, directives (instructions for compliance officers), and standard interpretations (official letters of interpretation of the standards) related to medical screening and surveillance.

Note: Twenty-five states, Puerto Rico and the Virgin Islands have OSHA-approved State Plans and have adopted their own standards and enforcement policies. For the most part, these States adopt standards that are identical to Federal OSHA. However, some States have adopted different standards applicable to this topic or may have different enforcement policies.

General Industry (29 CFR 1910)


  • National Emphasis Program - Microwave Popcorn Processing Plants. DIR 11-01 (CPL 03), (2011, January 18). Similar to the expired 2007 NEP, CPL 03-00-005, and described policies and procedures for implementing an emphasis program to identify and reduce or eliminate exposures to butter-flavoring chemicals - such as diacetyl and chemical substitutes - used in microwave popcorn manufacturing facilities.

  • National Emphasis Program - Facilities that Manufacture Food Flavorings Containing Diacetyl. CPL 03-00-011, (2009, October 30). Describes policies and procedures for implementing an emphasis program to identify and reduce or eliminate hazards associated with exposures to flavoring chemicals in any facility that manufactures food flavorings containing diacetyl. This instruction is available on the public page.

  • National Emphasis Program - Microwave Popcorn Processing Plants. CPL 03-00-005, (2007, July 27) (Expired as of July 27, 2008). Described policies and procedures for implementing an emphasis program to identify and reduce or eliminate exposure to butter-flavoring chemicals - such as diacetyl - used in microwave popcorn manufacturing facilities.

  • OSHA Medical Surveillance Regulations - Genetic Testing. STD 01-23-004 [STD 1-23.4], (1980, August 22). Provides an interpretation of OSHA health standards that require medical surveillance programs specifying a medical history with family and occupational background, including genetic and environmental factors.

  • Search all available directives.

Standard Interpretations

Medical Screening

Medical screening is a method for detecting disease or body dysfunction before an individual would normally seek medical care. Screening tests are usually administered to individuals without current symptoms, but who may be at high risk for certain adverse health outcomes. The following references provide information about medical screening and clinical evaluation.

Clinical Evaluation

Related Literature

  • Murthy, L.I. and W.E. Halperin. "Medical Screening and Biological Monitoring: A Guide to the Literature for Physicians." Journal of Occupational and Environmental Medicine 37.2(1995, February): 170-184. Summarizes recommended medical tests (including biologic monitoring) by independent investigators as well as OSHA and the National Institute for Occupational Safety and Health (NIOSH). Provides guidance to occupational health professionals in accessing the pertinent literature.

  • Terry, T.M. and G. Ryan. "Making Sense of OSHA Standards with Medical Requirements: Part 1." Applied Occupational and Environmental Hygiene 13.3(1998, March): 144-148.

Medical Surveillance

Medical surveillance is the analysis of health information to look for problems that may be occurring in the workplace that require targeted prevention. Thus, surveillance serves as a feedback loop to the employer. Surveillance may be based on a single case or sentinel event, but more typically uses screening results from the group of employees being evaluated to look for abnormal trends in health status. Surveillance can also be conducted on a single employee over time. Review of group results helps to identify potential problem areas and the effectiveness of existing worksite preventive strategies. The following resources contain medical surveillance information including specific hazards and surveillance guidelines.

Additional Information

Related Safety and Health Topics Pages

Other Resources

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