Occupational Health Program: Medical Assessment and Surveillance
Workers who may be exposed to a Tier 1 BSAT should receive a thorough medical evaluation prior to initiation of work or contact with these agents. In order to determine an individual’s medical fitness to perform the duties of a specific position, the healthcare provider should review each employee’s:
- Previous and ongoing medical problems
- Current medications
- Prior immunizations
- Necessary medical services to permit the individual to safely assume the duties of the position
Entities should establish criteria for fitness for duty based on the occupational health hazards identified from the site-specific comprehensive risk assessment.
Healthcare providers should be aware of potential hazards via a written description of the potential health hazards present in the work environment.
Periodic medical evaluations targeted to job requirements may be appropriate for workers with substantial risk of exposure to infectious agents or other circumstances such as clearance for respirator use or work in a pressurized suit.
Medical support for occupational illnesses should also be provided for workers with access to Tier 1 BSAT. Workers should be encouraged to seek medical evaluation for symptoms that they suspect may be related to infectious agents in their work area. A high index of suspicion for potential occupational exposures should be maintained during any unexplained illness among workers or visitors to worksites containing Tier 1 BSAT. The healthcare provider should have a working understanding of the biohazards present in the workplace and remain alert for evidence of infection and atypical presentations. All exposures to Tier 1 BSAT should be reported to the medical support services provider. Strategies for responding to biohazard exposures should be formulated in advance.
Prompt medical evaluation may be necessary in instances including:
- All potential exposures, including both direct exposures and proximity exposures
- Potential human disease
- When there is a potential impact on public health and safety
The plan should cover contingencies during work and after hours. Healthcare providers in OHPs should contain measures for infection control.
Post-Exposure Medical Surveillance
Proper post-exposure response is facilitated by exposure-specific protocols that define:
- Appropriate first aid
- Potential post-exposure prophylaxis options
- Recommended diagnostic tests
- Sources of expert medical evaluation
These protocols should address how exposures or reports of potential laboratory acquired infections (LAIs) that occur at work outside of regular work hours are handled and these protocols should be distributed to potential healthcare providers (e.g., local hospital emergency departments).