Approximately 2.3 million people in the United States are exposed to silica on the job.  Workers who inhale these very small crystalline silica particles are at an increased risk of developing serious diseases, which include:

  1. Silicosis, which is an incurable lung disease that can lead to disability and death;
  2. Lung cancer;
  3. Chronic obstructive pulmonary disease (COPD); and
  4. Chronic kidney disease.

To protect workers exposed to respirable crystalline silica, OSHA has issued two standards: one for the construction industry, and the other for general industry and maritime.

The occupational health team at The EI Group, Inc. can provide your company with onsite silica medical surveillance examinations to ensure OSHA compliance with respirable crystalline silica standard and protect your employees.

Medical surveillance must be offered for employees with exposure levels above the PEL for 30 or more days per year from June 23, 2018 through June 22, 2020 and for exposure at of above the action level for 30 or more days per year beginning June 23, 2020.

Employers must offer medical examinations: 1) within 30 days of initial assignment, unless the employee has had an exam that meets the requirements of the silica standard within the last 3 years; and 2) every 3 years from the last examination that met the requirements of the silica standard, or more frequently if recommended by the physician or other licensed health care provider (PLHCP), if the employee will continue to perform tasks that result in exposures for 30 or more days per year.  More frequent medical examinations might be recommended by the PLHCP based on various factors such as high exposure levels or individual medical findings.

The initial silica standard medical surveillance exams must include:

A medical and work history that focuses on the employee’s past, present, and projected future exposure to respirable crystalline silica, dust, or other agents affecting the respiratory system, a history of their respiratory problems, including signs and symptoms of respiratory diseases (for example: shortness of breath, wheezing, or cough), a history or tuberculosis, and their smoking status and smoking history;

• A physical exam by the PLHCP that focuses in-depth on the respiratory system;

• A chest x-ray (which is to be interpreted by the International Labour Office International Classification of Radiographs of Pneumoconioses by a National Institute for Occupational Health & Safety – certified B Reader; this involves a certified physician reading the x-ray according to certain procedures to determine if the x-ray shows signs of disease such as silicosis);

• A pulmonary function test, also known as a spirometry test, that is administered by a NIOSH spirometry trained technician.  The pulmonary function test must include the forced vital capacity (the total amount of air that is forcibly blow out after taking in a full breath), forced expiratory volume in one second (the amount of air forcibly blown out in the first second of the forced vital capacity), and the FEV1/FVC ratio (the speed of the air that is forcibly blown out);

• Testing for latent tuberculosis infection;

• Respiratory protection fit testing;

• Any other test that the PLHCP deems appropriate and/or medically necessary.

Periodic exams, typically every 3 years, will need to be conducted and include each of the tests above with exception of testing for latent tuberculosis; that test is only required with the initial examination.

For more information regarding crystalline silica exposure or to schedule your onsite medical surveillance exam, please contact me at
(919) 459-5275 or [email protected].

To find the complete OSHA Guide for compliance, please see documents below.

OSHA Small Entity Compliance Guide for Construction:

Small Entity Compliance Guide for the Respirable Crystalline Silica Standard for General Industry and Maritime: