Page 45 - Occupational Health & Safety, January/February 2020

Table 1. U.S. Workers Currently Exposed to Silica above Permissible Exposure Limit
Industry Sector
Number Currently Exposed above PEL
Ready-mix concrete
32,110
Foundries, rock drilling
24,658
Concrete products
19,204
Oil & gas industry support (e.g., fracking)
16,056
Cut stone (e.g., countertops)
7,441
Railroads (e.g., maintenance of way)
5,629
Pottery
4,777
Jewelry
4,600
Structural clay products
4,377
Shipyards (e.g., abrasive blasting)
3,250
Asphalt roofing materials
1,963
Reference: https://www.osha.gov/silica/factsheets/OSHA_FS-3683_Silica_Overview.html
The physical exam should include vital signs (blood pressure, pulse, temperature); careful examination of the chest (observa- tion of breathing, chest structure, signs of cardio-pulmonary disease, listening to the chest for decreased breath sounds, rales, rhonchi, etc.); and observation of the fin- gers for cyanosis, edema, clubbing or other joint abnormalities.
Challenges of New
OSHA Regulations
As with all new OSHA regulations, there is often confusion and uncertainty during planning and implementation. However, the silica standard raises more than a dozen significant challenges for employers, em- ployees, and medical professionals. The fol- lowing challenges have emerged from ex- perience performing more than 2,000 silica medical exams for dozens of employers.
Here are seven challenges you may face when working with OSHA’s silica standard. Challenge 1. Understanding the silica regulations: Safety managers frequently express confusion with OSHA’s new silica standard, as it differs significantly from
■ Other Tests as determined by the PLHCP, e.g., kidney function, CT scan of lung if chronic exposure
■ Two written medical reports issued within 30 days, one tailored to the employ- ee, the second tailored to the employer
The medical and work history should address questions such as 1) prior, cur- rent and anticipated exposure to respirable
silica, dust, or other respiratory irritants; 2) durations and levels of exposure, 3) use of personal protective equipment, 4) prior respiratory system dysfunction (e.g., short- ness of breath, cough, asthma), 5) smoking status and history 6) history of tuberculosis or exposure, 7) prior positive TBC skin test, 8) history of kidney or autoimmune disease, and 9) availability of prior medical records.
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