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3. For each employee who is removed from exposure to lead due to an elevated blood lead level at least monthly during the removal period.

(B) Follow-up blood sampling tests. Whenever the results of a blood lead level test indicate that an employee's blood lead level exceeds the numerical criterion for medical removal under subsection (k)(1)(A), the employer shall provide a second (follow-up) blood sampling test within two weeks after the employer receives the results of the first blood sampling test.
(C) Accuracy of blood lead level sampling and analysis. Blood lead level sampling and analysis provided pursuant to this section shall have an accuracy (to a confidence level of 95 percent) within plus or minus 15 percent or 6mg/dl, whichever is greater, and shall be conducted by a laboratory approved by OSHA.
(D) Employee notification.
1. Within five working days after the receipt of biological monitoring results, the employer shall notify each employee in writing of his or her blood lead level; and
2. the employer shall notify each employee whose blood lead level exceeds 40mg/dl that the standard requires temporary medical removal with Medical Removal Protection benefits when an employee's blood lead level exceeds the numerical criterion for medical removal under subsection (k)(1)(A).
(3) Medical examinations and consultations.
(A) Frequency. The employer shall make available medical examinations and consultations to each employee covered under subsection (j)(1)(B) on the following schedule:
1. At least annually for each employee for whom a blood sampling test conducted at any time during the preceding 12 months indicated a blood lead level at or above 40mg/dl;
2. As soon as possible, upon notification by an employee either that the employee has developed signs or symptoms commonly associated with lead intoxication, that the employee desires medical advice concerning the effects of current or past exposure to lead on the employee's ability to procreate a healthy child, that the employee is pregnant, or that the employee has demonstrated difficulty in breathing during a respirator fitting test or during use; and

3. As medically appropriate for each employee either removed from exposure to lead due to a risk of sustaining material impairment to health, or otherwise limited pursuant to a final medical determination.
(B) Content. The content of medical examinations made available pursuant to subsection (j)(3)(A)2. - 3. shall be determined by an examining physician and, if requested by an employee, shall include pregnancy testing or laboratory evaluation of male fertility. Medical examinations made available pursuant to subsection (j)(3)(A)1. shall include the following elements:
1. A detailed work history and a medical history, with particular attention to past lead exposure (occupational and non-occupational), personal habits (smoking, hygiene), and past gastrointestinal, hematologic, renal, cardiovascular, reproductive and neurological problems;
2. A thorough physical examination, with particular attention to teeth, gums, hematologic, gastrointestinal, renal, cardiovascular, and neurological systems. Pulmonary status should be evaluated if respiratory protection will be used;
3. A blood pressure measurement;

4. A blood sample and analysis which determines:
a. Blood lead level;
b. Hemoglobin and hematocrit determinations, red cell indices, and examination of peripheral smear morphology;
c. Zinc protoporphyrin;
d. Blood urea nitrogen; and,
e. Serum creatinine;
5. A routine urinalysis with microscopic examination; and
6. Any laboratory or other test relevant to lead exposure which the examining physician deems necessary by sound medical practice.
(C) Multiple physician review mechanism.
1. If the employer selects the initial physician who conducts any medical examination or consultation provided to an employee under this section, the employee may designate a second physician:
a. To review any findings, determinations or recommendations of the initial physician; and
b. To conduct such examinations, consultations, and laboratory tests as the second physician deems necessary to facilitate this review.
2. The employer shall promptly notify an employee of the right to seek a second medical opinion after each occasion that an initial physician conducts a medical examination or consultation pursuant to this section. The employer may condition its participation in, and payment for, the multiple physician review mechanism upon the employee doing the following within fifteen (15) days after receipt of the foregoing notification, or receipt of the initial physician's written opinion, whichever is later:
a. The employee informing the employer that he or she intends to seek a second medical opinion, and
b. The employee initiating steps to make an appointment with a second physician.
3. If the findings, determinations or recommendations of the second physician differ from those of the initial physician, then the employer and the employee shall assure that efforts are made for the two physicians to resolve any disagreement.
4. If the two physicians have been unable to quickly resolve their disagreement, then the employer and the employee through their respective physicians shall designate a third physician:
a. To review any findings, determinations or recommendations of the prior physicians; and
b. To conduct such examinations, consultations, laboratory tests and discussions with the prior physicians as the third physician deems necessary to resolve the disagreement of the prior physicians.
5. The employer shall act consistent with the findings, determinations and recommendations of the third physician, unless the employer and the employee reach an agreement which is otherwise consistent with the recommendations of at least one of the three physicians.
(D) Information provided to examining and consulting physicians.
1. The employer shall provide an initial physician conducting a medical examination or consultation under this section with the following information:
a. A copy of this regulation for lead including all Appendices;
b. A description of the affected employee's duties as they relate to the employee's exposure;
c. The employee's exposure level or anticipated exposure level to lead and to any other toxic substance (if applicable);
d. A description of any personal protective equipment used or to be used;
e. Prior blood lead determinations; and
f. All prior written medical opinions concerning the employee in the employer's possession or control.

2. The employer shall provide the foregoing information to a second or third physician conducting a medical examination or consultation under this section upon request either by the second or third physician, or by the employee.
(E) Written medical opinions.
1. The employer shall obtain and furnish the employee with a copy of a written medical opinion from each examining or consulting physician which contains only the following information:
a. The physician's opinion as to whether the employee has any detected medical condition which would place the employee at increased risk of material impairment of the employee's health from exposure to lead;
b. Any recommended special protective measures to be provided to the employee, or limitations to be placed upon the employee's exposure to lead;
c. Any recommended limitations upon the employee's use of respirators, including a determination of whether the employee can wear a powered air purifying respirator if an physician determines that the employee cannot wear a negative pressure respirator; and
d. The results of the blood lead determinations.
2. The employer shall instruct each examining and consulting physician to:
a. Not reveal either in the written opinion or orally, or in any other means of communication with the employer, findings, including laboratory results, or diagnoses unrelated to an employee's occupational exposure to lead; and
b. Advise the employee of any medical condition, occupational or nonoccupational, which dictates further medical examination or treatment.
(F) Alternate physician determination mechanisms. The employer and an employee or authorized employee representative may agree upon the use of any alternate physician determination mechanism in lieu of the multiple physician review mechanism provided by subsection (j)(3)(C) so long as the alternate mechanism is as expeditious and protective as the requirements contained in this subsection.
(4) Chelation.

(A) The employer shall assure that any person whom he/she retains, employs, supervises or controls does not engage in prophylactic chelation of any employee at any time.
(B) If therapeutic or diagnostic chelation is to be performed by any person in subsection (j)(4)(A), the employer shall assure that it be done under the supervision of a licensed physician in a clinical setting with thorough and appropriate medical monitoring and that the employee is notified in writing prior to its occurrence.
(k) Medical removal protection.
(1) Temporary medical removal and return of an employee.
(A) Temporary removal due to elevated blood lead level. The employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that a periodic and a follow-up blood sampling test conducted pursuant to this section indicate that the employee's blood lead level is at or above 50mg/dl; and,

(B) Temporary removal due to a final medical determination.
1. The employer shall remove an employee from work having an exposure to lead at or above the action level on each occasion that a final medical determination results in a medical finding, determination, or opinion that the employee has a detected medical condition which places the employee at increased risk of material impairment to health from exposure to lead.
2. For the purposes of this section, the phrase "final medical determination" means the written medical opinion on the employees' health status by the examining physician or, where relevant, the outcome of the multiple physician review mechanism or alternate medical determination mechanism used pursuant to the medical surveillance provisions of this section.
3. Where a final medical determination results in any recommended special protective measures for an employee, or limitations on an employee's exposure to lead, the employer shall implement and act consistent with the recommendation.
(C) Return of the employee to former job status. 1. The employer shall return an employee to his or her former job status:

a. For an employee removed due to a blood lead level at or above 50mg/dl when two consecutive blood sampling tests indicate that the employee's blood lead level is at or below 40mg/dl;
b. For an employee removed due to a final medical determination, when a subsequent final medical determination results in a medical finding, determination, or opinion that the employee no longer has a detected medical condition which places the employee at increased risk of material impairment to health from exposure to lead.
2. For the purposes of this section, the requirement that an employer return an employee to his or her former job status is not intended to expand upon or restrict any rights an employee has or would have had, absent temporary medical removal, to a specific job classification or position under the terms of a collective bargaining agreement.
(D) Removal of other employee special protective measure or limitations. The employer shall remove any limitations placed on an employee or end any special protective measures provided to an employee pursuant to a final medical determination when a subsequent final medical determination indicates that the limitations or special protective measures are no longer necessary.
(E) Employer options pending a final medical determination. Where the multiple physician review mechanism, or alternate medical determination mechanism used pursuant to the medical surveillance provisions of this section, has not yet resulted in a final medical determination with respect to an employee, the employer shall act as follows:
1. Removal. The employer may remove the employee from exposure to lead, provide special protective measures to the employee, or place limitations upon the employee, consistent with the medical findings, determinations, or recommendations of any of the physicians who have reviewed the employee's health status.
2. Return. The employer may return the employee to his or her former job status, end any special protective measures provided to the employee, and remove any limitations placed upon the employee, consistent with the medical findings, determinations, or recommendations of any of the physicians who have reviewed the employee's health status, with two exceptions. If:
a. the initial removal, special protection, or limitation of the employee resulted from a final medical determination which differed from the findings, determinations, or recommendations of the initial physician or;
b. If the employee has been on removal status for the preceding eighteen months due to an elevated blood lead level, then the employer shall await a final medical determination.
(2) Medical removal protection benefits.
(A) Provision of medical removal protection benefits. The employer shall provide an employee up to eighteen (18) months of medical removal protection benefits on each occasion that an employee is removed from exposure to lead or otherwise limited pursuant to this section.
(B) Definition of medical removal protection benefits. For the purposes of this section, the requirement that an employer provide medical removal protection benefits means that, as long as the job the employee was removed from continues, the employer shall maintain the total normal earnings, seniority and other employment rights and benefits of an employee, including the employee's right to his or her former job status as though the employee had not been medically removed from the employee's job or otherwise medically limited.

(C) Follow-up medical surveillance during the period of employee removal or limitation. During the period of time that an employee is medically removed from his or her job or otherwise medically limited, the employer may condition the provision of medical removal protection benefits upon the employee's participation in follow-up medical surveillance made available pursuant to this section.
(D) Workers' compensation claims. If a removed employee files a claim for workers' compensation payments for a lead-related disability, then the employer shall continue to provide medical removal protection benefits pending disposition of the claim. To the extent that an award is made to the employee for earnings lost during the period of removal, the employer's medical removal protection obligation shall be reduced by such amount. The employer shall receive no credit for workers' compensation payments received by the employee for treatment-related expenses.
(E) Other credits. The employer's obligation to provide medical removal protection benefits to a removed employee shall be reduced to the extent that the employee receives compensation for earnings lost during the period of removal either from a publicly or employer-funded compensation program, or receives income from employment with another employer made possible by virtue of the employee's removal.
(F) Voluntary removal or restriction of an employee. Where an employer, although not required by this section to do so, removes an employee from exposure to lead or otherwise places limitations on an employee due to the effects of lead exposure on the employee's medical condition, the employer shall provide medical removal protection benefits to the employee equal to that required by subsection (k)(2)(A) and (B).
(l) Employee information, training and certification.
(1) General.
(A) The employer shall communicate information concerning lead hazards according to the requirements of the Hazard Communication Standard, section 5194, including but not limited to the requirements concerning warning signs and labels, material safety data sheets (MSDS), and employee information and training.
(B) For all employees who are subject to exposure to lead at or above the action level on any day or who are subject to exposure to lead compounds which may cause skin or eye irritation (e.g. lead arsenate, lead azide), the employer shall provide a training program in accordance with subsection (l)(2) and assure employee participation.
(C) The employer shall provide the training program as initial training prior to the time of job assignment or prior to the start up date for this requirement, whichever comes last.
(D) The employer shall also provide the training program at least annually for each employee who is subject to lead exposure at or above the action level on any day.
(E) Where the certification of employee and supervisor training is required, as described in subsection (l)(3), the training shall be conducted by a training provider accredited by the California Department of Health Services, in accordance with Title 17, California Code of Regulations, Division 1, Chapter 8.
(2) Training program.

The employer shall assure that each employee is trained in the following:
(A) The content of this standard and its appendices;
(B) The specific nature of the operations which could result in exposure to lead above the action level;
(C) The purpose, proper selection, fitting, use, and limitations of respirators;
(D) The purpose and a description of the medical surveillance program, and the medical removal protection program including information concerning the adverse health effects associated with excessive exposure to lead (with particular attention to the adverse reproductive effects on both males and females and hazards to the fetus and additional precautions for employees who are pregnant);
(E) The engineering controls and work practices associated with the employee's job assignment including training of employees to follow relevant good work practices described in Appendix B of this section;

(F) The contents of any compliance plan and the location of regulated areas in effect;
(G) Instructions to employees that chelating agents should not routinely be used to remove lead from their bodies and should not be used at all except under the direction of a licensed physician; and
(H) The employee's right of access to records under section 3204.
(3) Certification of training for residential and public buildings.
The employer shall ensure that all employees and supervisors who are engaged in lead related construction work as defined in Title 17, California Code of Regulations, Section 35040, and have been shown to be exposed to lead at or above the permissible exposure limit, meet the training requirements of this section, are trained by an accredited training provider and are certified by the California Department of Health Services. Lead related construction work is defined in Title 17 to be any construction, alteration, painting, demolition, salvage, renovation, repair, or maintenance of any residential or public building, including preparation and cleanup, that, by using or disturbing lead containing material or soil, may result in significant exposure of adults or children to lead. As used in the definition of lead related construction work, "public building" means a structure which is generally accessible to the public, including but not limited to, schools, daycare centers, museums, airports, hospitals, stores, convention centers, government facilities, office buildings and any other building which is not an industrial building or a residential building. Regulations for accreditation of training providers and for the certification of employees and supervisors are found in Title 17, California Code of Regulations, Division 1, Chapter 8.
(4) Access to information, training and certification materials.
(A) The employer shall make readily available to all affected employees a copy of this standard and its appendices.
(B) The employer shall provide, upon request, all materials relating to the employee information training program and certification to affected employees, their designated representatives, the Chief and NIOSH.
(m) Signs.
(1) General.

(A) The employer may use signs required by other statutes, regulations or ordinances in addition to, or in combination with, signs required by this subsection.
(B) The employer shall assure that no statement appears on or near any sign required by this subsection which contradicts or detracts from the meaning of the required sign.
(2) Signs.
(A) The employer shall post the following warning signs in each regulated area or work area where an employees exposure to lead is above the PEL.
WARNING
LEAD WORK AREA
POISON
NO SMOKING OR EATING

(B) The employer shall assure that signs required by this subsection are illuminated and cleaned as necessary so that the legend is readily visible.
(n) Recordkeeping.
(1) Exposure assessment.
(A) The employer shall establish and maintain an accurate record of all monitoring and other data used in conducting employee exposure assessments as required in subsection (d).
(B) Exposure monitoring records shall include:
1. The date(s), number, duration, location and results of each of the samples taken if any, including a description of the sampling procedure used to determine representative employee exposure where applicable;
2. A description of the sampling and analytical methods used and evidence of their accuracy;
3. The type of respiratory protective devices worn, if any;
4. Name, social security number, and job classification of the employee monitored and of all other employees whose exposure the measurement is intended to represent; and
5. The environmental variables that could affect the measurement of employee exposure.
(C) The employer shall maintain monitoring and other exposure assessment records in accordance with the provisions of section 3204.
(2) Medical surveillance.
(A) The employer shall establish and maintain an accurate record for each employee subject to medical surveillance as required by subsection (j).
(B) This record shall include:
1. The name, social security number, and description of the duties of the employee;
2. A copy of the physician's written opinions;
3. Results of any airborne exposure monitoring done on or for that employee and provided to the physician; and
4. Any employee medical complaints related to exposure to lead.
(C) The employer shall keep, or assure that the examining physician keeps, the following medical records:
1. A copy of the medical examination results including medical and work history required under subsection (j);
2. A description of the laboratory procedures and a copy of any standards or guidelines used to interpret the test results or references to that information;
3. A copy of the results of biological monitoring.
(D) The employer shall maintain or assure that the physician maintains medical records in accordance with the provisions of section 3204.
(3) Medical removals.
(A) The employer shall establish and maintain an accurate record for each employee removed from current exposure to lead pursuant to subsection (k).
(B) Each record shall include:
1. The name and social security number of the employee;
2. The date of each occasion that the employee was removed from current exposure to lead as well as the corresponding date on which the employee was returned to his or her former job status;
3. A brief explanation of how each removal was or is being accomplished; and
4. A statement with respect to each removal indicating whether or not the reason for the removal was an elevated blood lead level.
(C) The employer shall maintain each medical removal record for at least the duration of an employee's employment.
(4) "Objective data for exemption from requirement for initial monitoring".
(A) For purposes of this section, objective data are information demonstrating that a particular product or material containing lead or a specific process, operation, or activity involving lead cannot release dust or fumes in concentrations at or above the action level under any expected conditions of use. Objective data can be obtained from any industry-wide study or from laboratory product test results from manufacturers of lead containing products, including surface coatings or other materials. The data the employer uses from an industry-wide survey must be obtained under workplace conditions closely resembling the processes, types of material, control methods, work practices and environmental conditions in the employer's current operations.
(B) The employer shall maintain the record of the objective data relied upon for at least 30 years.
(5) Availability. The employer shall make available upon request all records required to be maintained by subsection (n) to affected employees, former employees, and their designated representatives, and to the Chief and NIOSH for examination and copying.
(6) Transfer of records.
(A) Whenever the employer ceases to do business, the successor employer shall receive and retain all records required to be maintained by subsection (n).
(B) Whenever the employer ceases to do business and there is no successor employer to receive and retain the records required to be maintained by this section for the prescribed period, these records shall be transmitted to NIOSH.
(C) At the expiration of the retention period for the records required to be maintained by this section, the employer shall notify NIOSH at least 3 months prior to the disposal of such records and shall transmit those records to NIOSH if requested within the period.
(D) The employer shall also comply with any additional requirements involving transfer of records set forth in section 3204(h).
(o) Observation of monitoring.

(1) Employee observation. The employer shall provide affected employees or their designated representatives an opportunity to observe any monitoring of employee exposure to lead conducted pursuant to subsection (d).
(2) Observation procedures.
(A) Whenever observation of the monitoring of employee exposure to lead requires entry into an area where the use of respirators, protective clothing or equipment is required, the employer shall provide the observer with and assure the use of such respirators, clothing and equipment, and shall require the observer to comply with all other applicable safety and health procedures.
(B) Without interfering with the monitoring, observers shall be entitled to:
1. Receive an explanation of the measurement procedures;
2. Observe all steps related to the monitoring of lead performed at the place of exposure; and
3. Record the results obtained or receive copies of the results when returned by the laboratory.

(p) Lead-Work Pre-Job Notification. The employer shall provide written notification to the nearest Division District Office in the manner prescribed by subsections (p)(1) through (p)(4) when work is planned that includes any of the tasks listed in subsection (d)(2).
Exception No. 1: The employer is not required to notify the Division if:
A. The amount of lead-containing materials to be disturbed is less than 100 square or 100 linear feet; or
B. The only subsection (d)(2) task to be performed consists of torch cutting or welding, not to exceed a duration of 1 hour in any shift.
Exception No. 2: The employer is not required to notify the Division if the percentage of lead in the material disturbed is less than 0.5%, 5,000 parts per million (weight by weight), or 1.0 mg/cm 2.
(1) The employer shall ensure that the information required by subsection (p)(2) is received by the nearest Division District Office at least 24 hours prior to the commencement of the work by any of the following means:

(A) Letter;
(B) Facsimile;
(C) Electronic mail; or
(D) Telephone call, followed by written notification sent or mailed within 24 hours of placing the call.
Exception: When an employer intends to initiate unforeseen lead-work on an urgent basis within 24 hours, the notification requirement may be met by giving telephone notice to the Division at any time prior to commencement of the work, followed by written notification sent or mailed within 24 hours of telephoning the Division.
(2) The written notification provided by the employer shall contain the following:
(A) The name, address and phone number of the employer;

(B) The address of the job (or common name of the site with closest streets or roadways identified);
(C) The precise physical location of the lead related work at the job site;
(D) The projected starting date;
(E) The expected completion date or approximate duration of the work in days;
(F) The approximate number of workers planned to do the lead-related work;
(G) The type of structure(s) in which or on which the work is to be performed;
(H) The amount of lead containing material to be disturbed in square feet or linear feet;
(I) A description of the type of lead-related work to be performed and work practices that will be utilized;
(J) The name of the supervisor who will be responsible for the lead-related work; and

(K) The amount of lead in the disturbed materials (percent by weight, parts per million or milligrams per square centimeter) if known.
(3) The employer shall notify the Division, and provide the current information, if changes are made to the starting date, the surface area to be disturbed, or the type of lead-related work performed or work practices to be utilized, before or upon adoption of that change.
(4) An employer conducting ongoing, lead-related operations and maintenance work on stationary steel structures need only notify the Division once for each structure if the duration of the operations and maintenance work is less than one year. If the duration of the work is more than one year, the employer shall submit to the Division at least once per year a supplemental written notification updating all of the information required by subsection (p)(2) for each structure.
(q) Appendices. The information contained in the appendices to this section is not intended by itself, to create any additional obligations not otherwise imposed by this standard nor detract from any existing obligation.









Appendix A to s 1532.1 - Substance Data Sheet for Occupational Exposure to Lead
I. Substance Identification
A. Substance: Pure lead (Pb) is a heavy metal at room temperature and pressure and is a basic chemical element. It can combine with various other substances to form numerous lead compounds.
B. Compounds covered by the standard: The word "lead" when used in this standard means elemental lead, all inorganic lead compounds and a class of organic lead compounds called lead soaps. This standard does not apply to other organic lead compounds.
C. Uses: Exposure to lead occurs in several different occupations in the construction industry, including demolition or salvage of structures where lead or lead-containing materials are present; removal or encapsulation of lead-containing materials, new construction, alteration, repair, or renovation of structures that contain lead or materials containing lead; installation of products containing lead. In addition, there are construction related activities where exposure to lead may occur, including transportation, disposal, storage, or containment of lead or materials containing lead on construction sites, and maintenance operations associated with construction activities.
D. Permissible exposure: The permissible exposure limit (PEL) set by the standard is 50 micrograms of lead per cubic meter of air (50mg/m 3) averaged over an 8-hour workday.
E. Action level: The standard establishes an action level of 30 micrograms of lead per cubic meter of air (30mg/m 3) averaged over an 8-hour workday. The action level triggers several ancillary provisions of the standard such as exposure monitoring, medical surveillance, and training.
II. Health Hazard Data
A. Ways in which lead enters your body. When absorbed into your body in certain doses, lead is a toxic substance. The object of the lead standard is to prevent absorption of harmful quantities of lead. The standard is intended to protect you not only from the immediate toxic effects of lead, but also from the serious toxic effects that may not become apparent until years of exposure have passed. Lead can be absorbed into your body by inhalation (breathing) and ingestion (eating). Lead (except for certain organic lead compounds not covered by the standard, such as tetraethyl lead) is not absorbed through your skin. When lead is scattered in the air as a dust, fume or mist it can be inhaled and absorbed through your lungs and upper respiratory tract. Inhalation of airborne lead is generally the most important source of occupational lead absorption. You can also absorb lead through your digestive system if lead gets into your mouth and is swallowed. If you handle food, cigarettes, chewing tobacco, or make-up which have lead on them or handle them with hands contaminated with lead, this will contribute to ingestion. A significant portion of the lead that you inhale or ingest gets into your blood stream. Once in your blood stream, lead is circulated throughout your body and stored in various organs and body tissues. Some of this lead is quickly filtered out of your body and excreted, but some remains in the blood and other tissues. As exposure to lead continues, the amount stored in your body will increase if you are absorbing more lead than your body is excreting. Even though you may not be aware of any immediate symptoms of disease, this lead stored in your tissues can be slowly causing irreversible damage, first to individual cells, then to your organs and whole body systems.
B. Effects of overexposure to lead.
(1) Short term (acute) overexposure. Lead is a potent, systemic poison that serves no known useful function once absorbed by your body. Taken in large enough doses, lead can kill you in a matter of days. A condition affecting the brain called acute encephalopathy may arise which develops quickly to seizures, coma, and death from cardiorespiratory arrest. A short term dose of lead can lead to acute encephalopathy. Short term occupational exposures of this magnitude are highly unusual, but not impossible. Similar forms of encephalopathy may, however, arise from extended, chronic exposure to lower doses of lead. There is no sharp dividing line between rapidly developing acute effects of lead, and chronic effects which take longer to acquire. Lead adversely affects numerous body systems, and causes forms of health impairment and disease which arise after periods of exposure as short as days or as long as several years.
(2) Long-term (chronic) overexposure. Chronic overexposure to lead may result in severe damage to your blood-forming, nervous, urinary and reproductive systems. Some common symptoms of chronic overexposure include loss of appetite, metallic taste in the mouth, anxiety, constipation, nausea, pallor, excessive tiredness, weakness, insomnia, headache, nervous irritability, muscle and joint pain or soreness, fine tremors, numbness, dizziness, hyperactivity and colic. In lead colic there may be severe abdominal pain. Damage to the central nervous system in general and the brain (encephalopathy) in particular is one of the most severe forms of lead poisoning. The most severe, often fatal, form of encephalopathy may be preceded by vomiting, a feeling of dullness progressing to drowsiness and stupor, poor memory, restlessness, irritability, tremor, and convulsions. It may arise suddenly with the onset of seizures, followed by coma, and death. There is a tendency for muscular weakness to develop at the same time. This weakness may progress to paralysis often observed as a characteristic "wrist drop" or "foot drop" and is a manifestation of a disease to the nervous system called peripheral neuropathy. Chronic overexposure to lead also results in kidney disease with few, if any, symptoms appearing until extensive and most likely permanent kidney damage has occurred. Routine laboratory tests reveal the presence of this kidney disease only after about two-thirds of kidney function is lost. When overt symptoms of urinary dysfunction arise, it is often too late to correct or prevent worsening conditions, and progression to kidney dialysis or death is possible. Chronic overexposure to lead impairs the reproductive systems of both men and women. Overexposure to lead may result in decreased sex drive, impotence and sterility in men. Lead can alter the structure of sperm cells raising the risk of birth defects. There is evidence of miscarriage and stillbirth in women whose husbands were exposed to lead or who were exposed to lead themselves. Lead exposure also may result in decreased fertility, and abnormal menstrual cycles in women. The course of pregnancy may be adversely affected by exposure to lead since lead crosses the placental barrier and poses risks to developing fetuses. Children born of parents either one of whom were exposed to excess lead levels are more likely to have birth defects, mental retardation, behavioral disorders or die during the first year of childhood. Overexposure to lead also disrupts the blood-forming system resulting in decreased hemoglobin (the substance in the blood that carries oxygen to the cells) and ultimately anemia. Anemia is characterized by weakness, pallor and fatigability as a result of decreased oxygen carrying capacity in the blood.

(3) Health protection goals of the standard. Prevention of adverse health effects for most workers from exposure to lead throughout a working lifetime requires that a worker's blood lead level (BLL, also expressed as PbB) be maintained at or below forty micrograms per deciliter of whole blood (40mg/dl). The blood lead levels of workers (both male and female workers) who intend to have children should be maintained below 30mg/dl to minimize adverse reproductive health effects to the parents and to the developing fetus. The measurement of your blood lead level (BLL) is the most useful indicator of the amount of lead being absorbed by your body. Blood lead levels are most often reported in units of milligrams (mg) or micrograms (ug) of lead (1 mg=1000mg) per 100 grams (100g), 100 milliliters (100 ml) or deciliter (dl) of blood. These three units are essentially the same. Sometime BLLs are expressed in the form of mg% ormg%. This is a shorthand notation for 100g, 100 ml, or dl. (Reference to BLL measurements in this standard are expressed in the form ofmg/dl.)
BLL measurements show the amount of lead circulating in your blood stream, but do not give any information about the amount of lead stored in your various tissues. BLL measurements merely show current absorption of lead, not the effect that lead is having on your body or the effects that past lead exposure may have already caused. Past research into lead-related diseases, however, has focused heavily on associations between BLLs and various diseases. As a result, your BLL is an important indicator of the likelihood that you will gradually acquire a lead-related health impairment or disease.
Once your blood lead level climbs about 40mg/dl, your risk of disease increases. There is a wide variability of individual response to lead, thus it is difficult to say that a particular BLL in a given person will cause a particular effect. Studies have associated fatal encephalopathy with BLLs as low as 150mg/dl. Other studies have shown other forms of diseases in some workers with BLLs well below 80mg/dl. Your BLL is a crucial indicator of the risks to your health, but one other factor is also extremely important. This factor is the length of time you have had elevated BLLs. The longer you have an elevated BLL, the greater the risk that large quantities of lead are being gradually stored in your organs and tissues (body burden). The greater your overall body burden, the greater the chances of substantial permanent damage. The best way to prevent all forms of lead-related impairments and diseases -- both short term and long term -- is to maintain your BLL below 40mg/dl. The provisions of the standard are designed with this end in mind.
Your employer has prime responsibility to assure that the provisions of the standard are complied with both by the company and by individual workers. You, as a worker, however, also have a responsibility to assist your employer in complying with the standard. You can play a key role in protecting your own health by learning about the lead hazards and their control, learning what the standard requires, following the standard where it governs your own actions, and seeing that your employer complies with provisions governing his or her actions.
(4) Reporting signs and symptoms of health problems. You should immediately notify your employer if you develop signs or symptoms associated with lead poisoning or if you desire medical advice concerning the effects of current or past exposure to lead or your ability to have a healthy child. You should also notify your employer if you have difficulty breathing during a respirator fit test or while wearing a respirator. In each of these cases, your employer must make available to you appropriate medical examinations or consultations. These must be provided at no cost to you and at a reasonable time and place. The standard contains a procedure whereby you can obtain a second opinion by a physician of your choice if your employer selected the initial physician.









Appendix B to s 1532.1 -Employee Standard Summary
This appendix summarizes key provisions of the standard for lead in construction that you as a worker should become familiar with.
I. Permissible Exposure Limit (PEL) - subsection (c)
The standard sets a permissible exposure limit (PEL) of 50 micrograms of lead per cubic meter of air (50mg/m 3), averaged over an 8-hour workday which is referred to as a time-weighted average (TWA). This is the highest level of lead in air to which you may be permissibly exposed over an 8-hour workday. However, since this is an 8-hour average, short exposures above the PEL are permitted so long as for each 8-hour work day your average exposure does not exceed this level. This standard, however, takes into account the fact that your daily exposure to lead can extend beyond a typical 8-hour workday as the result of overtime or other alterations in your work schedule. To deal with this situation, the standard contains a formula which reduces your permissible exposure when you are exposed more than 8 hours. For example, if you are exposed to lead for 10 hours a day, the maximum permitted average exposure would be 40mg/m 3.
II. Exposure Assessment - Subsection (d)
If lead is present in your workplace in any quantity, your employer is required to make an initial determination of whether any employee's exposure to lead exceeds the action level (30mg/m 3 averaged over an 8-hour day). Employee exposure is that exposure which would occur if the employee were not using a respirator. This initial determination requires your employer to monitor workers' exposures unless he or she has objective data which can demonstrate conclusively that no employee will be exposed to lead in excess of the action level. Where objective data is used in lieu of actual monitoring the employer must establish and maintain an accurate record, documenting its relevancy in assessing exposure levels for current job conditions. If such objective data is available, the employer need proceed no further on employee exposure assessment until such time that conditions have changed and the determination is no longer valid. Objective data for surfaces and materials that is less than 0.06% lead dry weight (600 ppm) is indicative of materials that will not give lead concentrations above the action level. Lead analysis must be performed for each unique surface coating or material. Surface coating or material objective data cannot be used to replace air monitoring for exposure assessments required for the lead-related tasks listed in subsection (d)(2). Objective data may be compiled from various sources, e.g., insurance companies and trade associations and information from suppliers or exposure data collected from similar operations. Objective data may also comprise previously-collected sampling data including area monitoring. If it cannot be determined through using objective data that worker exposure is less than the action level, your employer must conduct monitoring or must rely on relevant previous personal sampling, if available. Where monitoring is required for the initial determination, it may be limited to a representative number of employees who are reasonably expected to have the highest exposure levels. If your employer has conducted appropriate air sampling for lead in the past 12 months, he or she may use these results, provided they are applicable to the same employee tasks and exposure conditions and meet the requirements for accuracy as specified in the standard. As with objective data, if such results are relied upon for the initial determination, your employer must establish and maintain a record as to the relevancy of such data to current job conditions.
If there have been any employee complaints of symptoms which may be attributable to exposure to lead or if there is any other information or observations which would indicate employee exposure to lead, this must also be considered as part of the initial determination.
If this initial determination shows that a reasonable possibility exists that any employee may be exposed, without regard to respirators, over the action level, your employer must set up an air monitoring program to determine the exposure level representative of each employee exposed to lead at your workplace. In carrying out this air monitoring program, your employer is not required to monitor the exposure of every employee, but he or she must monitor a representative number of employees and job types. Enough sampling must be done to enable each employee's exposure level to be reasonably represent full shift exposure. In addition, these air samples must be taken under conditions which represent each employee's regular, daily exposure to lead. Sampling performed in the past 12 months may be used to determine exposures above the action level if such sampling was conducted during work activities essentially similar to present work conditions.
The standard lists certain tasks which may likely result in exposures to lead in excess of the PEL and, in some cases, exposures in excess of 50 times the PEL. If you are performing any of these tasks, your employer must provide you with appropriate respiratory protection, protective clothing and equipment, change areas, hand washing facilities, biological monitoring, and training until such time that an exposure assessment is conducted which demonstrates that your exposure level is below the PEL. Objective data cannot be used to replace air monitoring for this exposure assessment.
If you are exposed to lead and air sampling is performed, your employer is required to notify you in writing within 5 working days of the air monitoring results which represent your exposure. If the results indicate that your exposure exceeds the PEL (without regard to your use of a respirator), then your employer must also notify you of this in writing, and provide you with a description of the corrective action that has been taken or will be taken to reduce your exposure.
Your exposure must be rechecked by monitoring, at least every six months if your exposure is at or over the action level but below the PEL. Your employer may discontinue monitoring for you if 2 consecutive measurements, taken at least 7 days apart, are at or below the action level. Air monitoring must be repeated every 3 months if you are exposed over the PEL. Your employer must continue monitoring for you at this frequency until 2 consecutive measurements, taken at least 7 days apart, are below the PEL but above the action level, at which time your employer must repeat monitoring of your exposure every six months and may discontinue monitoring only after your exposure drops to or below the action level. However, whenever there is a change of equipment, process, control, or personnel or a new type of job is added at your workplace which may result in new or additional exposure to lead, your employer must perform additional monitoring.
III. Methods of Compliance - Subsection (e)
Your employer is required to assure that no employee is exposed to lead in excess of the PEL as an 8-hour TWA. The standard for lead in construction requires employers to institute engineering and work practice controls including administrative controls to the extent feasible to reduce employee exposure to lead. Where such controls are feasible but not adequate to reduce exposures below the PEL they must be used nonetheless to reduce exposures to the lowest level that can be accomplished by these means and then supplemented with appropriate respiratory protection. Your employer must establish a regulated area that includes the work area where airborne exposure to lead is above the PEL, or where the lead-related tasks listed in subsection (d)(2) are performed.
Your employer is required to develop and implement a written compliance program prior to the commencement of any job where employee exposures may reach the PEL as an 8-hour TWA. The standard identifies the various elements that must be included in the plan. For example, employers are required to include a description of operations in which lead is emitted, detailing other relevant information about the operation such as the type of equipment used, the type of material involved, employeejob responsibilities, operating procedures and maintenance practices. In addition, your employer's compliance plan must specify the means that will be used to achieve compliance and, where engineering controls are required, include any engineering plans or studies that have been used to select the control methods. If administrative controls involving job rotation are used to reduce employee exposure to lead, the job rotation schedule must be included in the compliance plan. The plan must also detail the type of protective clothing and equipment, including respirators, housekeeping and hygiene practices that will be used to protect you from the adverse effects of exposure to lead. (continued)