title: Quality assurance audits of medical surveillance programs for hazardous waste workers.
abstract: The Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120) requires medical surveillance examinations for hazardous waste workers. We investigated the consistency and appropriateness of the services provided under OSHA 29 CFR 1910.120 as part of a quality control audit. Our study revealed that in most cases the required paperwork including fitness for duty and restrictions or limitations was completed. However, it is also apparent that many of the components of a complete occupational history were not performed. Spirometric examinations often were performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of the findings of their examinations. Our study indicated there may be a lack of education, training, and experience of occupational health providers. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers.
authors.affiliation: University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Department of Environmental and Community Medicine, Piscataway 08854.
authors.forename: I G
authors.initials: IG
authors.lastname: Udasin
authors.forename: G
authors.initials: G
authors.lastname: Buckler
authors.forename: M
authors.initials: M
authors.lastname: Gochfeld
mesh_terms: D000328:Adult; D005260:Female; D006256:Hazardous Waste / Q000009:adverse effects*; D006266:Health Education; D006801:Humans; D008297:Male; D008403:Mass Screening; D008485:Medical Audit; D009784:Occupational Diseases / Q000517:prevention & control*; D011481:Protective Clothing; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D014481:United States; D014489:United States Occupational Safety and Health Administration; D014938:Work Capacity Evaluation
chemical_list: D006256:Hazardous Waste