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.

December 30, 1991

Ms. Dee Tyler
41935 West 12 Mile Road
Novi, Michigan 48377

Dear Ms. Tyler:

This is in response to your inquiry of November 21, concerning the Occupational Safety and Health Administration's (OSHA) Hazardous Waste Operations and Emergency Response final rule (HAZWOPER), 29 CFR 1910.120.

Your questions concern medical surveillance for employees who do not choose to take part in the employer's medical surveillance program. Specifically, you ask OSHA if the employer is required to enforce medical surveillance, and what action or documentation must take place to avoid a violation of HAZWOPER.

Under HAZWOPER employers are obligated to make medical surveillance and medical consultation available, but OSHA does not require employees to participate. A record signed by the employee should be made in the employee's personnel file indicating that the employee voluntarily chose not to take part in the medical surveillance program.

Subparagraph (e)(2) specifically includes a medical surveillance training requirement, which requires employers to instruct employees on how to recognize "symptoms and signs of overexposure to hazards" on the job and make them aware of specific parts of the site safety and health plan. HAZWOPER training should also incorporate the purpose and content of the medical surveillance program required by the standard, so employees understand that it is for their protection.

We hope this information is helpful. If you have any further questions please feel free to contact us at (202) 523-8036.


Patricia Clark, Director
Directorate of Compliance Programs

November 21, 1991

Patricia Clark
Director Health Compliance
Rm OSHA N 3463
U.S. Department of Labor
Washington, D.C. 20210

Dear Ms. Clark:

I am writing for an interpretation of OSHA Standard 1910.120 - Hazardous Waste Operations and Emergency Response or HAZWOPER, Section (f)(2) on Medical Surveillance.

It is clear employers are required to offer medical surveillance after an exposure under this standard, however is the employer required to enforce medical surveillance if the employee does not comply voluntarily? If an employer is not required to enforce medical surveillance what action or documentation must the employer take under this standard to avoid violation. Is there anything in the Act which would prevent an employer from enforcing, through disciplinary procedures, an employee to comply with medical surveillance.

I appreciate your time to research these items and look forward to hearing your response.


Dee Tyler, RN
Employee Health Coordinator