OSHA requirements are set by statute, standards and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you can consult OSHA's website at https://www.osha.gov.

August 6, 1987

The Honorable Sam Gejdenson
House of Representatives
Washington, D.C. 20515

Dear Congressman Gejdenson:

This is in response to your letter of June 26 on behalf of your constituent, Kenneth E. Jacobs, a shop steward for Boilermakers Local - 614 in Groton, Connecticut. Mr. Jacobs represents an employee who was required by his employer to submit to a medical examination in order to prevent lead related illnesses.

The Occupational Safety and Health Administration's (OSHA) policy regarding medical surveillance requirements is that the employer must make the medical examination available, at no cost, to the employee, but the employee, is not required to take the examination. OSHA does not require an employer to force the employees to take medical examinations. However, OSHA's regulations are intended as minimum standards. Employers can adopt more stringent requirements for themselves, and in doing so, may enforce mandatory participation in programs within the guidelines of labor/management relations.

The medical surveillance provisions of OSHA's lead standard contain a multiple physicians review mechanism which gives workers an opportunity to obtain a second and possibly third opinion regarding the medical determinations made pursuant to the standard (29 CFR 1910.1025(j)(3)(iii)). An employee may designate a second physician to review any findings, determinations or recommendations of an initial physician chosen by the employer.

In dealing with the public in the matter of medical surveillance, OSHA realizes that many tests may be considered invasive of personal privacy. In addition, many persons only trust medical personnel that they select themselves. Nevertheless, OSHA encourages employees to participate in medical surveillance programs. Such programs can often detect changes in an employee's health status, so that the individual's exposure conditions can be corrected before serious damage is done.

We hope this information will be of help to you and your constituent. If we can be of further assistance, please do not hesitate to call on us.


John A. Pendergrass
Assistant Secretary