OSHA AI Agent
Get instant answers to any safety question.
Request Demo
OSHA 1926.62

Lead exposure in construction

50 Questions & Answers
10 Interpretations

Questions & Answers

Under 1926.62(a), what work does the construction lead standard cover?

Under 1926.62(a) the lead-in-construction standard covers all construction work where an employee may be occupationally exposed to lead. This includes construction, alteration, and repair activities (including painting and decorating) and specifically lists demolition/salvage, removal/encapsulation of lead-containing materials, new construction or renovation of lead-containing structures, installation of products containing lead, lead contamination/emergency cleanup, on-site transportation/storage of lead materials, and related maintenance operations (1926.62(a)).

Under 1926.62(a)(1)–(7), can you give practical examples of construction activities that are covered by the standard?

Under 1926.62(a)(1)–(7) the standard covers a wide range of activities where lead may be present. Examples include:

  • Demolition or salvage of structures containing lead or lead-based paint (1926.62(a)(1)).
  • Removal or encapsulation of materials that contain lead (1926.62(a)(2)).
  • Renovation or repair of surfaces that contain lead-based paint (1926.62(a)(3)).
  • Installing products that contain lead (for example some solders or piping) (1926.62(a)(4)).
  • Cleanup of lead contamination or emergency response to lead spills (1926.62(a)(5)).
  • On-site storage, transport, or containment of lead materials at a construction location (1926.62(a)(6)).
  • Maintenance tasks associated with any of these construction activities (1926.62(a)(7)).

Under 1926.62(b), what is the action level for lead exposure?

Under 1926.62(b) the action level is an airborne concentration of lead of 30 micrograms per cubic meter of air (30 µg/m3) calculated as an 8-hour time-weighted average (TWA), regardless of respirator use (1926.62(b)).

Under 1926.62(c), what is the permissible exposure limit (PEL) for lead and how is it adjusted if employees work more than 8 hours?

Under 1926.62(c)(1) the PEL for lead is 50 micrograms per cubic meter of air (50 µg/m3) averaged over an 8-hour period. Under 1926.62(c)(2), if employees work more than 8 hours in a day, you must reduce the allowable exposure using the formula: Allowable exposure (µg/m3) = 400 divided by the number of hours worked that day (1926.62(c)(1) and 1926.62(c)(2)).

  • Example: for a 10-hour shift the allowable daily TWA = 400 / 10 = 40 µg/m3.

Under 1926.62(c)(3), how do respirators affect how you count employee exposure to lead?

Under 1926.62(c)(3) when respirators are used to limit employee exposure and all respirator program requirements of paragraphs (e)(1) and (f) are met, you may consider the employee's exposure to be the level of protection provided by the respirator while it is worn, and you may average those protected periods with unprotected periods to determine the daily TWA (1926.62(c)(3)). Be sure the respirator program meets the requirements in 1926.62(f) and the respirator selection and use criteria in paragraph (e)(1).

Under 1926.62(d)(1)(i)–(iv), when must an employer perform an initial exposure assessment for lead?

Under 1926.62(d)(1)(i) an employer must initially determine if any employee may be exposed to lead at or above the action level (30 µg/m3). For that purpose exposure is defined as the exposure that would occur without respirators (1926.62(d)(1)(ii)). Except for monitoring addressed in paragraph (d)(3), you must collect full-shift personal samples that are representative of a regular shift for at least one employee in each job classification and work area (or for the shift with the highest exposure) and ensure the samples represent the employee's regular daily exposure (1926.62(d)(1)(i)–(iv)).

Under 1926.62(d)(1)(iii)–(iv), what does "full shift personal samples representative of regular daily exposure" mean in practice?

Under 1926.62(d)(1)(iii)–(iv) in practice you must collect personal air samples that cover the employee's entire work shift and reflect the employee's normal daily tasks and work conditions; sample at least one employee per job classification in each work area for each shift (or the shift with the highest exposure) so results represent regular, daily exposure (1926.62(d)(1)(iii) and 1926.62(d)(1)(iv)).

Under 1926.62(d)(2)(i) and (v), what must an employer do for certain lead-related tasks before exposure measurements confirm the actual levels?

Under 1926.62(d)(2)(i) and (v) for the listed lead-related tasks the employer must treat the worker as if exposed above the PEL (but not more than 10× the PEL) until monitoring shows otherwise, and must provide interim protective measures including appropriate respirators, protective clothing/equipment, change areas, handwashing facilities, and—where applicable—biological monitoring and training (1926.62(d)(2)(i) and 1926.62(d)(2)(v)).

Under 1926.62(d)(2)(i)(A)–(B), which specific tasks must be treated as potentially above the PEL until monitoring is done?

Under 1926.62(d)(2)(i)(A)–(B) when lead-containing coatings or paint are present you must treat employees performing manual demolition, manual scraping, manual sanding, heat gun applications, and power tool cleaning with dust collection systems as potentially exposed above the PEL; spray painting with lead paint is also listed (1926.62(d)(2)(i)(A) and 1926.62(d)(2)(i)(B)).

Under 1926.62(d)(2)(iii), which tasks are treated as if exposure exceeds 500 µg/m3 until monitoring shows otherwise?

Under 1926.62(d)(2)(iii) the employer must treat employees performing certain tasks as if exposed in excess of 500 µg/m3 until monitoring demonstrates otherwise. These tasks include using lead-containing mortar and lead burning (1926.62(d)(2)(iii)(A)), and, where lead-containing coatings or paint are present, rivet busting, power tool cleaning without dust collection, cleanup with dry expendable abrasives, and abrasive blasting enclosure movement/removal (1926.62(d)(2)(iii)(B)).

Under 1926.62(d)(2)(iv)–(v), which activities are treated as if exposures exceed 2,500 µg/m3 and what interim protections are required?

Under 1926.62(d)(2)(iv) certain tasks (for example abrasive blasting, welding, cutting, and torch burning where lead-containing coatings or paint are present) must be treated as if exposures exceed 2,500 µg/m3 until monitoring demonstrates otherwise. Under 1926.62(d)(2)(v) interim protections required during that assessment period include appropriate respiratory protection, personal protective clothing/equipment, change areas, and handwashing facilities (1926.62(d)(2)(iv) and 1926.62(d)(2)(v)).

Under 1926.62(d)(2)(v)(E) and 1926.62(j)(1)(i), when is biological monitoring required and what does it consist of?

Under 1926.62(d)(2)(v)(E) and 1926.62(j)(1)(i) biological monitoring is required as part of interim protection for certain tasks and consists of blood sampling and analysis for lead and zinc protoporphyrin (ZPP) levels (1926.62(d)(2)(v)(E) and 1926.62(j)(1)(i)).

Under 1926.62(d)(2)(v)(F) and 1926.62(l)(1)(i), what training must employers provide during interim protections?

Under 1926.62(d)(2)(v)(F) and 1926.62(l)(1)(i) the employer must provide training that covers Hazard Communication as required by 1926.59, respirator use per the standard, and safety training/education as required by 1926.21. This training must be given to employees covered by the interim protective measures.

Under 1926.62(d)(3)(iv) and (n)(4), when can an employer rely on objective data instead of initial exposure monitoring and what documentation is required?

Under 1926.62(d)(3)(iv) an employer may rely on objective data demonstrating that a particular lead-containing product, material, or specific process cannot result in employee exposures at or above the action level, in which case initial monitoring may not be required. When using objective data the employer must establish and maintain an accurate record documenting the nature and relevancy of that data as specified in 1926.62(n)(4) and 1926.62(d)(3)(iv).

Under 1926.62(d)(3)(iii), when may an employer use prior monitoring to satisfy the initial monitoring requirement?

Under 1926.62(d)(3)(iii) an employer may rely on previous monitoring results obtained within the past 12 months to satisfy initial monitoring requirements if the earlier data were collected during operations closely resembling the current processes, materials, controls, work practices, and environmental conditions, and if the sampling/analytical methods meet the standard's accuracy and confidence requirements (1926.62(d)(3)(iii)).

Under 1926.62(d)(2)(ii), what must an employer do if an employee has reason to believe a task may expose them above the PEL?

Under 1926.62(d)(2)(ii) if an employee has any reason to believe that a task may expose them to lead above the PEL, the employer must treat the employee as if exposed above the PEL until an exposure assessment is performed and documents that the employee's exposure is not above the PEL, and must implement the interim protective measures in paragraph (d)(2)(v) (1926.62(d)(2)(ii)).

Under 1926.62(d)(2)(iii) and (iv), how does the standard tier protections based on the task performed?

Under 1926.62(d)(2)(iii) and (iv) the standard establishes tiers of presumed exposure based on task type: some tasks are presumed to potentially exceed 500 µg/m3 (e.g., lead burning, power tool cleaning without dust collection) and some are presumed to potentially exceed 2,500 µg/m3 (e.g., abrasive blasting, welding, cutting, torch burning on lead-coated surfaces) until monitoring shows otherwise. The employer must use the appropriate interim protections in paragraph (d)(2)(v) until monitoring documents actual exposures (1926.62(d)(2)(iii) and 1926.62(d)(2)(iv)).

Under 1926.62(d)(2)(v)(A)–(D) and 1926.62(i), what hygiene and change area requirements apply as interim protections?

Under 1926.62(d)(2)(v)(B)–(D) and 1926.62(i) interim protections must include appropriate personal protective clothing and equipment, change areas, and handwashing facilities. The employer must provide change areas as described in 1926.62(i)(2) and handwashing facilities as described in 1926.62(i)(5) until monitoring shows exposures are below the applicable levels (1926.62(d)(2)(v)(B)-(D)).

Under 1926.62(f), when can respirators be used and where should I look for respirator program requirements?

Under 1926.62(f) respirators may be used to limit employee exposure when required by the standard, but employers must comply with the respirator program and procedures specified in paragraph (f). For the specific program elements and requirements see 1926.62(f).

Under 1926.62(d)(3)(iv)(B), can objective data be used to satisfy the exposure assessment for paragraph (d)(2)?

No — objective data cannot be used to satisfy the exposure assessment required by paragraph (d)(2). Employers may not rely on objective data in place of the exposure assessment called for in 1926.62(d)(2); see the explicit prohibition in 1926.62(d)(3)(iv)(B).

  • Use objective data only where the standard elsewhere allows it; for the initial exposure determination under (d)(2) the rule forbids it.

Under 1926.62(d)(4)(i), when must an employer conduct initial personal monitoring for lead?

You must conduct monitoring representative of each employee whenever the initial determination shows the possibility of any employee exposure at or above the action level. If the determination under 1926.62(d)(1)–(3) indicates exposures could reach the action level, the employer shall perform representative monitoring for each exposed employee as required by 1926.62(d)(4)(i).

  • "Representative" means sampling that reflects each employee's typical exposure during their normal work activities.

Under 1926.62(d)(4)(ii), when may an employer rely on previous lead monitoring instead of new sampling?

You may rely on earlier monitoring taken within the past 12 months if the earlier data were collected during work operations closely resembling current processes, materials, controls, work practices, crew size, and environmental conditions, and if the sampling and analysis meet the accuracy/confidence requirements of paragraph (d)(9). See 1926.62(d)(4)(ii).

  • Make sure the old sampling methods meet the accuracy specified in 1926.62(d)(9) (±25% at the 95% confidence level for concentrations ≥30 µg/m3).

Under 1926.62(d)(5), what records must I make when the initial determination shows no employee is exposed at or above the action level?

You must make a written record of the negative initial determination that includes at least the items listed in paragraph (d)(3)(i), plus the date of the determination, the location within the worksite, and the name of each employee monitored. See 1926.62(d)(5).

  • Keep the record with the exposure determination details required by 1926.62(d)(3)(i).

Under 1926.62(d)(6), how often must I monitor employees whose exposures are between the action level and the PEL?

If exposures are at or above the action level but at or below the PEL you must monitor at least every 6 months until two consecutive measurements (taken at least 7 days apart) are below the action level. See 1926.62(d)(6)(ii).

  • Continue monitoring at the required frequency until you have the two qualifying below-action-level results, then you may discontinue monitoring for that employee unless paragraph (d)(7) applies.

Under 1926.62(d)(6)(iii), what is the monitoring frequency when initial exposure is above the PEL?

If the initial determination shows employee exposure is above the PEL, you must perform monitoring quarterly (every 3 months). See 1926.62(d)(6)(iii).

  • Continue quarterly monitoring until exposure controls lower exposures per the standard's discontinuation rules.

Under 1926.62(d)(7), when must an employer perform additional exposure assessments?

You must conduct additional monitoring whenever a change in equipment, process, control, personnel, or a new task may cause employees to be exposed at or above the action level or raise exposures from at/above the action level to above the PEL. See 1926.62(d)(7).

  • Document the reason for the new monitoring and ensure it is representative of the new conditions.

Under 1926.62(d)(8)(i)-(ii), how and when must I notify employees of monitoring results?

You must notify each affected employee of monitoring results as soon as possible but no later than 5 working days after you receive the results, either individually in writing or by posting in a location accessible to employees; if results show exposures at or above the PEL you must state that explicitly and describe corrective actions taken or planned. See 1926.62(d)(8)(i)-(ii).

  • Keep documentation of the notifications and the corrective-action description required when results meet or exceed the PEL.

Under 1926.62(d)(9), what accuracy must my monitoring and analytical methods meet?

Your monitoring and analysis methods must have an accuracy of ±25% at the 95% confidence level for airborne lead concentrations equal to or greater than 30 µg/m3. See 1926.62(d)(9).

  • Use validated sampling and laboratory procedures that document meeting this accuracy requirement.

Under 1926.62(e)(1) and (e)(2)(i), when and why must I implement a written compliance program for lead?

You must establish and implement a written compliance program before the job starts whenever engineering and work-practice controls alone cannot feasibly reduce exposures to the PEL; the program must be designed to achieve compliance with the PEL. See 1926.62(e)(1) and 1926.62(e)(2)(i).

  • The written plan documents how you will control lead exposures and must be in place before work begins.

Under 1926.62(e)(2)(ii), what specific elements must a written compliance program include?

The written compliance program must include at least: a description of activities that emit lead; equipment, materials, controls, crew size, job duties, operating and maintenance procedures; the means selected to achieve compliance and engineering plans if required; a report on technology considered; air monitoring data documenting lead sources; an implementation schedule; a work-practice program incorporating (g),(h),(i); any administrative control schedule; inter-contractor arrangements per 1926.16; and other relevant information as specified in 1926.62(e)(2)(ii).

  • Keep the plan current and revise it at least annually as required by 1926.62(e)(2)(v).

Under 1926.62(e)(2)(iii) and (e)(2)(iv), who must inspect job sites and where must written programs be made available?

A competent person must make frequent and regular inspections of job sites, materials, and equipment as provided in the compliance program, and the written program must be submitted upon request to any affected employee or authorized representative and be available at the worksite for examination and copying by the Assistant Secretary and the Director. See 1926.62(e)(2)(iii)-(iv).

  • Ensure inspection records and program copies are accessible to employees and OSHA upon request.

Under 1926.62(e)(3), what must I do if I use mechanical ventilation to control lead exposure?

If you use ventilation to control lead exposure you must evaluate the mechanical performance of the system as necessary to maintain its effectiveness. See 1926.62(e)(3).

  • Regularly inspect, test, and maintain ventilation to ensure it continues to control exposures as intended.

Under 1926.62(e)(4), what must an administrative control job rotation schedule include?

A job rotation schedule used to reduce TWA exposures must include the name or ID of each affected employee, the duration and exposure levels at each job or workstation where each employee works, and any other information useful in assessing the reliability of administrative controls. See 1926.62(e)(4)(i)-(iii).

  • Keep accurate exposure tracking tied to the rotation schedule to verify administrative controls actually reduce TWA exposures.

Under 1926.62(f)(1), when must I provide respirators to employees working with lead?

You must provide an appropriate respirator when an employee's exposure exceeds the PEL, when engineering and work practices can't reduce exposures to or below the PEL, when an employee requests a respirator, or as interim protection during operations specified in paragraph (d)(2). See 1926.62(f)(1)(i)-(iv).

  • Respirators must comply with the program requirements in 1926.62(f)(2).

Under 1926.62(f)(3)(i)-(ii), how do I select respirators and what options must I provide?

You must select respirators specified in 1910.134(d)(3)(i)(A), provide full facepiece respirators instead of half masks when lead aerosols may irritate eyes or skin, provide HEPA filters for air-purifying respirators, and provide a powered air-purifying respirator if an employee chooses it and it gives adequate protection. See 1926.62(f)(3)(i)-(ii).

  • Follow the selection and assigned protection factors in 1910.134.

Under 1926.62(g)(1)-(2), what protective work clothing and equipment must I provide and how often must it be cleaned?

When employees are exposed above the PEL without regard to respirators, to lead compounds that may irritate skin or eyes, or as interim protection, you must provide at no cost appropriate protective clothing and equipment (e.g., coveralls, gloves, hats, shoe covers, face shields, vented goggles that comply with 1910.133). See 1926.62(g)(1). Clothing must be provided clean and dry at least weekly, and daily for employees with exposures over 200 µg/m3 (8-hour TWA). See 1926.62(g)(2)(i).

Under 1926.62(e)(5), what work practices should employees follow to limit lead exposure?

Employees should follow good work practices to limit lead exposure as described in Appendix B of the standard and incorporated by 1926.62(e)(5).

  • Examples include housekeeping methods that minimize dust, using HEPA-filtered vacuums instead of dry sweeping, proper donning/doffing of protective clothing, and hygiene practices to prevent take-home contamination.

Under 1926.62(e)(2)(ii)(H) and 1926.16, what must contractors do on multi-contractor sites regarding lead compliance responsibility?

Contractors must describe in the written compliance program the arrangements made among contractors on multi-contractor sites for informing affected employees of potential lead exposure and for assigning responsibility for compliance, consistent with 1926.62(e)(2)(ii)(H) and the multi-employer responsibilities in 1926.16.

  • Clearly document who implements controls, monitoring, training, and medical surveillance so each employer knows its obligations.

Under 1926.62(g)(2)(iv), where must workers remove protective clothing contaminated with lead?

Protective clothing contaminated with lead must be removed only in change areas provided for that purpose at the end of each work shift. Employers must follow the requirement in 1926.62(g)(2)(iv) and make sure change areas meet the specifications in 1926.62(i)(2).

  • Make change areas separate from work areas and provide storage that prevents cross-contamination as required by 1926.62(i)(2)(ii).
  • Do not allow employees to leave the workplace wearing required protective clothing per 1926.62(i)(2)(iii).

Under 1926.62(g)(2)(vii)(A)-(B), what labeling is required for containers holding lead-contaminated clothing and when is the older label allowed?

Containers of contaminated protective clothing and equipment must be labeled with the full danger message in 1926.62(g)(2)(vii)(A). Employers may use the simpler label "Caution: Clothing contaminated with lead." only for containers prepared before June 1, 2015, as allowed in 1926.62(g)(2)(vii)(B).

  • Required modern label text is: "DANGER: CLOTHING AND EQUIPMENT CONTAMINATED WITH LEAD. MAY DAMAGE FERTILITY OR THE UNBORN CHILD. CAUSES DAMAGE TO THE CENTRAL NERVOUS SYSTEM. DO NOT EAT, DRINK OR SMOKE WHEN HANDLING. DO NOT REMOVE DUST BY BLOWING OR SHAKING. DISPOSE OF LEAD CONTAMINATED WASH WATER IN ACCORDANCE WITH APPLICABLE LOCAL, STATE, OR FEDERAL REGULATIONS." (see 1926.62(g)(2)(vii)(A)).
  • Replace older labels on any new or re-used containers after June 1, 2015.

Under 1926.62(g)(2)(v) and 1926.62(g)(2)(vi), what must an employer do before sending contaminated clothing to a laundry or cleaner?

Before sending contaminated clothing or equipment for cleaning, the employer must place it in a closed container that prevents lead dispersion and must inform the cleaner in writing about the potential hazards of lead exposure. This is required by 1926.62(g)(2)(v) and 1926.62(g)(2)(vi).

  • Use sealed bags or containers labeled per 1926.62(g)(2)(vii)(A).
  • The written notice should clearly state the items are contaminated with lead and warn about health risks and handling precautions as required by 1926.62(g)(2)(vi).

Under 1926.62(g)(2)(viii) and 1926.62(h)(2)-(5), is it acceptable to shake or blow lead dust off clothing or surfaces and when may compressed air be used?

No — employers must prohibit removing lead from clothing or equipment by blowing or shaking, and they must minimize airborne lead during cleanup using vacuuming, wet methods, or HEPA-equipped vacuums; compressed air may be used only when it is coupled with a ventilation system that captures the dust. These requirements are in 1926.62(g)(2)(viii) and 1926.62(h)(2)-(5).

  • Prefer HEPA vacuuming or wet-cleaning; shoveling and dry sweeping are allowed only if those methods have been tried and found ineffective (1926.62(h)(3)).
  • HEPA-equipped vacuums must be emptied to minimize lead reentry as required by 1926.62(h)(4).
  • Compressed air can be used only with a capture ventilation system as stated in 1926.62(h)(5).

Under 1926.62(i)(4)(i)-(iv), what must employers provide and control for employees who are exposed above the PEL when it comes to eating areas and hygiene?

Employers must provide lunchroom or eating areas that are readily accessible and kept as free as practicable from lead contamination, and they must ensure affected employees wash hands and face before eating and do not enter eating areas wearing contaminated protective clothing unless it has been cleaned to prevent dust spread. These duties are set out in 1926.62(i)(4)(i)-(iv).

  • Eating areas must be separate and accessible and kept clean per 1926.62(i)(4)(ii).
  • Employees exposed above the PEL must wash hands and face before eating, drinking, or applying cosmetics as required by 1926.62(i)(4)(iii) and 1926.62(i)(5)(i) (see also 1926.51(f)).
  • Do not allow entry to lunchrooms in contaminated work clothing unless surface dust has been removed by vacuuming or similar methods per 1926.62(i)(4)(iv).

Under 1926.62(i)(2)(ii)-(iii), how must change areas be equipped to prevent cross-contamination and can employees leave the workplace wearing protective clothing?

Change areas must have separate storage for protective work clothing and for street clothes that prevents cross-contamination, and employers must ensure employees do not leave the workplace wearing any protective clothing required during the shift. These requirements are stated in 1926.62(i)(2)(ii)-(iii).

  • Provide lockers, bins, or sealed containers that keep contaminated clothing separate from street clothes as required by 1926.62(i)(2)(ii).
  • Prohibit employees from leaving the site in protective clothing to avoid taking lead home on clothing per 1926.62(i)(2)(iii).

Under 1926.62(i)(3)(i)-(ii), when are showers required and what must the employer provide if showers are available?

Employers must provide showers, where feasible, for employees whose airborne exposure to lead is above the PEL, and where showers are provided the employer must ensure employees shower at the end of the shift and supply adequate cleansing agents and towels. See 1926.62(i)(3)(i)-(ii).

  • Showers are required when feasible for affected employees per 1926.62(i)(3)(i).
  • If showers are available, ensure end-of-shift showering and provide soap and towels as required by 1926.62(i)(3)(ii).
  • Where showers are not provided, require hand and face washing at end of shift per 1926.62(i)(5)(ii).

Under 1926.62(j)(1)(i) and (j)(2)(i), when must employers offer initial biological monitoring for lead and what is the required testing schedule?

Employers must offer initial biological monitoring (blood sampling for lead and zinc protoporphyrin) to any employee exposed on any day at or above the action level, and thereafter must provide blood testing at least every 2 months for the first 6 months and every 6 months after for employees exposed above the action level for more than 30 days in any consecutive 12 months. These requirements are found in 1926.62(j)(1)(i) and 1926.62(j)(2)(i)(A).

  • If an employee's last blood lead was ≥ 40 µg/dl, testing must be at least every 2 months until two consecutive tests are below 40 µg/dl per 1926.62(j)(2)(i)(B).
  • If removed from exposure, monthly testing is required during the removal period per 1926.62(j)(2)(i)(C).

Under 1926.62(j)(2)(iii)-(iv), what accuracy and notification rules apply to blood lead testing?

Blood lead analyses must be performed by an OSHA-approved laboratory with an accuracy (95% confidence) within ±15% or ±6 µg/dl (whichever is greater), and employers must notify each employee in writing of their blood lead level within five working days of receiving results. These requirements are in 1926.62(j)(2)(iii) and 1926.62(j)(2)(iv)(A).

  • If an employee's blood lead is ≥ 40 µg/dl, the employer must also notify them that the standard requires temporary medical removal with Medical Removal Protection benefits per 1926.62(j)(2)(iv)(B).
  • Ensure laboratory selection meets OSHA approval as required by 1926.62(j)(2)(iii).

Under 1926.62(j)(3)(i)-(ii) and (j)(3)(iii), when must employers provide medical examinations and what rights do employees have if they want a second medical opinion?

Employers must provide medical examinations at least annually for employees with a blood lead ≥ 40 µg/dl in the prior 12 months and whenever an employee reports symptoms, pregnancy, reproductive concerns, or breathing problems with respirator use; employees may designate a second physician to review or reexamine findings and the employer must promptly notify workers of this right as set out in 1926.62(j)(3)(i)-(ii) and 1926.62(j)(3)(iii).

  • Annual exams are required for employees with a blood lead ≥ 40 µg/dl in the preceding 12 months per 1926.62(j)(3)(i)(A).
  • If the employer selects the initial physician, the employee may have a second physician review and perform additional tests as needed per 1926.62(j)(3)(iii)(A).
  • Employers must notify employees of the right to seek a second opinion and may set conditions for payment or participation as described in 1926.62(j)(3)(iii)(B).

Under 1926.62(j)(3)(iii)(D), what must an employer and employee do if two physicians disagree about an employee's lead-related medical findings?

The employer and employee must first try to have the two physicians resolve the disagreement, and if they cannot quickly do so they must jointly designate a third physician to review the prior findings and perform any additional exams or tests the third physician deems necessary; the employer must follow the third physician’s findings unless the employer and employee agree on an alternative that is consistent with at least one of the three physicians. See 1926.62(j)(3)(iii)(C) and 1926.62(j)(3)(iii)(D).

Practical steps and key points:

  • Try to resolve the disagreement: The two physicians should make efforts to resolve their differing findings or recommendations as required by 1926.62(j)(3)(iii)(C).
  • Designate a third physician if needed: If they cannot quickly resolve the issue, the employer and employee (through their physicians) must designate a third physician to review the prior physicians’ findings and to "conduct such examinations, consultations, laboratory tests and discussions" as the third physician deems necessary, per 1926.62(j)(3)(iii)(D)(1) and 1926.62(j)(3)(iii)(D)(2).
  • Employer must follow the third physician unless there is an agreement: The employer shall act consistent with the third physician’s findings unless the employer and employee reach an agreement that is consistent with the recommendations of at least one of the three physicians, per 1926.62(j)(3)(iii)(E).
  • Provide information and records on request: Employers are required to provide physicians with relevant information (copy of the lead regulation, job duties, exposure levels, PPE used, prior blood lead results, and prior medical opinions) to the initial physician and must provide that information to a second or third physician upon request, as described in 1926.62(j)(3)(iv)(A) and 1926.62(j)(3)(iv)(B).
  • Written medical opinions and confidentiality: The employer must obtain and give the employee a copy of the written medical opinion that contains only the items listed in 1926.62(j)(3)(v)(A), and physicians must not disclose unrelated diagnoses per 1926.62(j)(3)(v)(B).
  • Alternate mechanisms allowed if equivalent: The employer and employee may agree to use an alternate physician-determination mechanism instead of the multiple-physician process, but only if it is as expeditious and protective as the multiple-physician mechanism, per 1926.62(j)(3)(vi).

Action items for employers: promptly facilitate physician communication, provide requested medical and exposure records to the consulting physicians, designate a qualified third physician if needed, and implement the third physician’s recommendations (or a mutually agreed alternative consistent with at least one physician) while documenting the process.