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.

October 15, 2015

Mr. Kenneth J. Yotz
Environmental, Management and Training Systems, Inc.
919 St. Andrews Circle
Geneva, Illinois 60134-2995

Dear Mr. Yotz:

Thank you for your April 6, 2015, letter to the Occupational Safety and Health Administration's (OSHA) Directorate of Enforcement Programs regarding medical surveillance requirements for workers who may be exposed to chromic acid while performing electroplating operations. This reply letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not detailed in your original correspondence and your subsequent discussions with a member of my staff. Your paraphrased questions are below, followed by our responses.

Background: Your client has employees who perform electroplating operations involving chromic acid. The OSHA standard for Chromium (VI), 29 CFR 1910.1026, generally applies to occupational exposures to all forms and compounds of hexavalent chromium (chromium (VI) or Cr(VI)), including chromic acid. The Chromium (VI) standard contains medical surveillance provisions at 29 CFR 1910.1026(k). Those provisions require employers to make medical surveillance available for all employees who are or may be occupationally exposed to chromium (VI) at or above the action level (2.5 µg/m3 as an 8-hour time-weighted average) for 30 or more days per year.1 See 29 CFR 1910.1026(k)(1)(i)(A). Medical examinations required under the Chromium (VI) standard must include a physical examination of both the employee's skin and the employee's respiratory tract. See 29 CFR 1910.1026(k)(3)(ii).

In addition, OSHA standards at 29 CFR 1910.123 through 1910.126 contain requirements specific to dipping and coating operations, such as electroplating. Paragraph (h)(4) of 29 CFR 1910.124 states that for employees who work with chromic acid, employers must provide "periodic examinations of their exposed body parts, especially their nostrils." Effects to the skin and nose from chromic acid exposures, causing dermatitis, ulceration and perforation, have long been reported in the medical literature (Legge 1902).

Question 1: For plating operations that use chromic acid, do the medical surveillance requirements in the Chromium (VI) standard trump or modify the requirement for periodic examinations in 29 CFR 1910.124(h)(4)?

Reply: No. As explained in a note to Ch. IX, Section K.2 of OSHA's Chromium (VI) Directive (Instruction CPL 02-02-074, Inspection Procedures for the Chromium (VI) Standards, Jan. 24, 2008), 29 CFR 1910.124(h)(4) applies irrespective of whether medical surveillance is required under the Chromium (VI) standard. Thus, employees may need periodic medical examinations under 29 CFR 1910.124(h)(4) even if medical surveillance is not required under the Chromium (VI) standard because the employees are not exposed above the action level for 30 or more days per year.

The standard covering dipping and coating operations (29 CFR 1910.124) is a "vertical" standard because it applies to specific types of operations. And the Chromium (VI) standard is a "horizontal" standard because it applies more broadly and covers multiple industries and operations. OSHA's Field Operations Manual (FOM), CPL 02-00-159 (October 1, 2015), explains that in situations covered by both a horizontal and a vertical standard, the vertical standard generally takes precedence. However, the FOM also states that both a horizontal and a vertical standard can apply if the requirements of the two standards are not in conflict with one another and the horizontal standard addresses a hazard that is not also addressed by the vertical standard. See FOM, Chapter 4, Section I.A.4. In the case of 1910.124 and the Chromium (VI) standard, both criteria are met:

  • First, there are no conflicts or inconsistencies between the medical surveillance requirements at 29 CFR 1910.124(h)(4) and the medical surveillance requirements in the Chromium (VI) standard (29 CFR 1910.1026(k)). Nothing in either standard precludes an employer from developing a medical surveillance program that would satisfy both sets of requirements.
  • Second, the medical surveillance provisions in the horizontal (Chromium (VI)) standard address hazards beyond those covered by the medical surveillance requirements in the vertical standard (1910.124(h)). The requirement for periodic medical examinations at 29 CFR 1910.124(h)(4) is designed to address hazards to employees' skin and nostrils. The introductory language in 29 CFR 1910.124(h) limits the requirement for medical examinations to "employees [who] work with liquids that may burn, irritate, or otherwise harm their skin." And with respect to chromic acid specifically, 29 CFR 1910.124(h)(4) requires examination only of "exposed body parts," including nostrils. In contrast, OSHA's Chromium (VI) standard addresses additional hazards from Chromium (VI) exposures, including lung cancer and asthma. Thus, the medical exams required under the Chromium (VI) standard must include an examination of the employee's respiratory tract, as well as an examination of the employee's skin. See 29 CFR 1910.1026(k)(3)(ii).

Therefore, OSHA has determined that for plating operations involving chromic acid, the medical surveillance requirements in both the vertical standard (29 CFR 1910.124) and the horizontal standard (29 CFR 1910.1026) apply.

Question 2: What is the meaning of "periodic" as used in 29 CFR 1910.124(h)(4)?

Reply: For purposes of 29 CFR 1910.124(h)(4), OSHA interprets "periodic" to mean at least annually and any time there is a chromic acid spill that touches the employee's skin or saturates the employee's clothing. At least annually is a reasonable interpretation, especially in this case where shorter periods of exposure have caused ulcerations, one of the hallmark adverse health effects of chromium exposure. Medical literature has documented that the time interval between first exposure to chromic acid and the development of serious health effects, including nasal ulceration and perforation, can be between 6 and 12 months among workers in plating operations (Hunter 1965). Zimmermann et al documented nasal ulcerations after only a few days of plating work (Zimmermann 1986). More recently, nasal perforations have been reported to occur within three and five months after initial exposure (Williams 1998).

OSHA also notes that all medical examinations under this standard need to be performed by a physician or other healthcare professional with the appropriate training to identify skin and nasal injuries from exposures to chromic acid.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA's requirements are set by statute, standards, and regulations. Our letters of interpretation do not create new or additional requirements but rather explain these requirements and how they apply to particular circumstances. This letter constitutes OSHA's interpretation of the requirements discussed. From time to time, letters are affected when the Agency updates a standard, a legal decision impacts a standard, or changes in technology affect the interpretation. To assure that you are using the correct information and guidance, please consult OSHA's website at www.osha.gov. If you have further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.


Thomas Galassi, Director
Directorate of Enforcement Programs

1 The Chromium (VI) standard also requires that medical surveillance be made available to employees experiencing signs or symptoms of the adverse health effects associated with chromium (VI) exposure and to employees exposed in an emergency. See 29 CFR 1910.1026(k)(1)(i)(B) and (C).


  1. Legge TM. The lesions resulting from the manufacture and uses of potassium and sodium bichromate. In: Dangerous Trades (Oliver T, Ed), J Murray Press, London, 1902; pp 447-454.
  2. Hunter D. Diseases of Occupations. First Edition. English Universities Press Ltd., 1965.
  3. Zimmermann HJ, Konietzo H, Apel H. Nasal septum perforations in workers in a plating plant [translated title]. Zbl Arbeitsmed 1986; 36:65-67.
  4. Williams N. Case Report: Nasal septal ulceration and perforation in jiggers. Occup. Med. Vol. 48, No. 2, 135-137, 1998.