CHAPTER 12 - OCCUPATIONAL HEALTH AND MEDICAL SURVEILLANCE

Effective Date: July 1, 1997 (Issue No. 2)

Last Updated: December, 2014

A. Introduction

In order to ensure a safe and healthful work environment for the HKUST campus community, HSEO provides an occupational health and medical surveillance program that meets regulatory requirements and professional standards.

HSEO carries out its health mission as follows:

• Coordinates physical examinations to assure that applicants and employees are suited to their work and to foster health and diminish illness or injury arising from the work environment.

• Coordinates employee access to emergency treatment and limited medical care for occupational and non-occupational illness or injury; helps to ensure the early detection and treatment of the occupationally ill or injured employee.

• Provides training and general health education for the maintenance of optimal occupational health.

 

B. Health Examination Services

The following health examinations are required:

1.	Pre-placement Examination A pre-placement examination to evaluate overall fitness and physical ability to perform the job is required of applicants for employment at HKUST. This examination consists of a personal medical history, an occupational history, and a physical examination that includes appropriate laboratory tests.
2.	Health Examination Some work assignments at HKUST require a more detailed medical assessment and stricter occupational medical surveillance. A baseline examination may be required to determine the health status of an individual at the beginning of a period of occupational medical surveillance. These examinations will be recommended at specific intervals for employees who work in jobs involving specific physical, chemical, or biological hazards (e.g. lasers, carcinogens, infectious or radioactive agents). Supervisors of these workers, with the assistance of HSEO, are required to identify those workers at the time of initial employment and on an annual basis for purposes of updating the database. For workers requiring a baseline examination at the time of employment, a Job Requirement Form describing exposure risk must be completed as part of the hiring package. This form will be completed by the applicant or supervisor as indicated. Arrangements will be made for the candidate to take the pre-employment and the health hazard specific examinations together if possible.
3.	Visitor and Summer Student Examinations A health history may be required for visitors or students assigned to HKUST for more than 1 month who are involved in specific health hazardous activities. Based on the work assignment and review of the visitor’s health, a physical examination or laboratory tests may also be required. Contact HSEO for further information.
4.	Termination Examinations Employees terminating employment in certain high hazard areas (e.g. carcinogens, lasers, biohazards) will complete a termination interview and a physical examination as indicated. Contact HSEO for further information.

 

C. Responsibilities

Principal investigators/supervisors are responsible for assessing the work and identifying the possible type(s) of medical surveillance required for laboratory personnel. They must instruct their personnel as to the possible health effects and symptoms associated with acute and long term exposure. In case of a job/program transfer or termination, supervisors need to make arrangements for any appropriate exit medical screening or testing.

Employees and students are required to comply with any prescribed medical screening or testing. In case of suspected or confirmed exposure or relevant symptoms, the employee or student should report this condition to the supervisor.

HSEO assists supervisors, employees and students in assessing the need for medical surveillance and coordinates examinations and testing with the health care provider. HSEO participates in the interpretation of the results as well.

 

D. Diagnosing and Treating Occupational Illnesses and Injuries

HKUST Regular Employees

HKUST provides access to medical services to diagnose and treat occupational injury or disease primarily through the staff medical insurance scheme. If medical expenses resulting from a confirmed occupational injury or disease exceed the cap of the insurance scheme, the University will make special arrangement to cover the extra expenses. Employees electing to be treated by their private physician must file the physician’s name and address with HSEO.

Every injury sustained while performing HKUST assigned tasks must be reported to the employee’s supervisor and to HSEO. In addition, work-related injuries involving loss of work days must be reported to the Personnel Office for notifying the Labour Department. Prompt reporting of injury or illness will help to ensure prompt worker’s compensation payments as well as proper reporting.

Non-HKUST Employees

In the case of contract labour, contractors, consultants, students and guests, the University will not normally provide examinations or routine treatment for occupational or non-occupational illness or injuries.

Some limited services such as basic first-aid/emergency treatment may be provided on an as needed basis.

 

E. Biohazards

Biohazard workers are defined as those staff members, contract workers, long-term visitors and students who engage in the following activities:

• work with recombinant DNA vectors of all kinds,

• work with any bacteria, viruses or fungi,

• culturing of virus infected cells,

• processing of samples of tissues or body fluids (blood, serum, or semen) from humans or other primates, or

• frequent handling of laboratory animals for care or experimentation.

The principal investigator is responsible for informing HSEO in advance when any employee will be working with biohazardous materials. This will include:

• work with microorganisms: isolation, culturing, mutation testing;

• work with virus-infected cells or isolated viruses;

• all forms of genetic engineering, and

• work involving handling of animals by animal care staff and research staff.

 

A roster of biohazard workers will be maintained by HSEO. HSEO management must update this listing annually, and when new employees or current personnel begin work with biohazards.

Minimum medical surveillance for biohazard workers includes a review of medical records, a periodic examination of the employee’s health with appropriate review of activities being performed and any suspected significant exposure. Medical records should include reports of any instances of accidental ingestion, inhalation, or skin penetration of biohazardous material. Employees working with potential biohazards must report any exposures immediately to HSEO. Employees being treated with immunosuppressive drugs shall be excluded from biohazard work for the duration of treatment, and the treating physician must provide a statement that the employee’s immune status is normal prior to return to biohazardous work. Modification of work regimens during pregnancy shall be determined on a case-by-case basis.

Staff who work with potentially pathogenic microorganisms, with human cells or other samples that may contain infectious agents, and those who care for, or work with, experimental animals, are requested to have a serum sample banked by HSEO as a baseline for future assay in the event of accidental exposure. Additional samples will be obtained for assay in the event of a suspected exposure. Blood samples will be drawn and serum prepared for storage in a labelled container in a -70°C freezer. Contact HSEO for further information.

Staff who work with human samples of any kind will be offered a course of vaccine (3 injections over 6 months) against hepatitis B virus to prevent illness in the event of accidental infection. Vaccination will be given after a pre-screen serum sample shows absence of hepatitis B antibodies. Success of immunization will be determined by post screening (one month after the last injection).

Immunization services for other infectious agents such as tetanus, tuberculosis and other diseases are provided to high risk employees working with biological agents as needed. Staff may elect to waive the right to the immunization services provided by the University with consent from the health care provider. A waiver form must be properly filled-in and signed by the concerned staff.

 

F. Respirator User Examinations

Respirator users must receive a medical examination prior to use of a respirator and once annually thereafter. HSEO provides quantitative fit-testing for negative pressure air-purifying respirator users. Contact HSEO (ext. 6512) for an appointment. Those requesting SCBA clearance or approval are required to have additional annual tests (e.g. pulmonary function examination, complete blood count (CBC), and EKG as needed ). SCBA training requires prior medical approval.

 

G. Laser Eye Examinations

All individuals who will work in areas where they may be exposed to laser radiation from a Class 3b or Class 4 laser are required to have an eye examination prior to the work assignment and following any confirmed or suspected eye exposure to the laser beam. In instances where eye disease is found at the time of the examination, the employee/student will be referred to an ophthalmologist. An eye examination is also recommended when the employee/student terminates from HKUST. To schedule a laser eye examination, the supervisor or the employee/student shall contact HSEO.

Short term visitors for whom arrangements for an eye examination are not feasible may have this requirement waived by the Department Head upon evaluation of experience, level of involvement and work supervision at HKUST.

 

H. Radiation User Examinations

Individuals who work with unsealed radioactive materials are required to attend a medical examination and once annually thereafter in compliance with the regulatory requirement.  Users can either make appointment for a free medical examination offered by the Department of Health at a specified clinic or attend a paid medical examination arranged by HSEO on campus.  In either case, users will be notified for medical checkup annually.

 

I. Hazardous Chemical Users

Laboratory researchers frequently use hazardous chemicals in the course of performing their research. Persons using hazardous chemicals should contact HSEO to have their operations evaluated for potential exposures. Where quantities, monitoring, and/or handling practices relative to hazardous chemicals indicate the potential for exposure, biological monitoring shall be performed and results compared with the biological exposure indices (BEI). Urine, exhaled air, and blood are the types of biological specimens which are commonly collected for analysis and comparison with the appropriate BEIs. The type of specimen and the biological indicator to be screened for are determined by the specific hazardous material.

 

J. Hearing Conservation

Various working environments at HKUST have been observed to have relatively high noise levels associated with them. Workers in areas which have been identified as having elevated noise levels will be monitored to determine their work shift exposure level. Persons who have exposures at or above the 85 dB(A) action level will be placed in a hearing conservation program which will include audiometric testing and hearing protection as well as periodic exposure monitoring.

 

K. Pregnant Employees

Any employee who plans a pregnancy, suspects a pregnancy, or has a positive diagnosis of pregnancy are advised to contact HSEO (ext. 6512) so that an evaluation can be made of her work environment. This notification helps to ensure that the employee is afforded the maximum amount of protection against toxic substances, radiation, mutagens, and carcinogens. Proper protective measures should be instituted before pregnancy or as early as possible in the first trimester. Disclosure of any information on pregnancy is subject to the employees' own discretion.

 

L. Work Restrictions

Restrictions regarding work assignments are recommended by HSEO for the following situations:

• Temporary restrictions are issued to facilitate convalescence and rehabilitation from injury or illness or to return the employee to work as soon as reasonably possible.

• Permanent restrictions are issued whenever the work assignment could produce serious disability or death, damage to HKUST equipment, or injury to fellow employees.

Written work restrictions will identify the restricted activity only, and will not reveal medically confidential information. Supervisors with questions or who would like assistance should contact HSEO.

 

M. Medical Records

Complete medical records are maintained for each employee from the time of the pre-employment examination until termination of employment. These records are confidential and will be retained indefinitely in the custody and control of HKUST. Information from an employee’s health records will be handled as medically privileged information and will only be transferred on receipt of a signed request from the employee. The results of medical examinations will be reported to the employee, and if any significant health defects are found, the health care providers will offer the employee appropriate recommendations for care or treatment.

 

N. Other Services

1.	Program Liaison HSEO provides certain education programs targeted at specific occupational hazards or other concerns in the work place. Contact HSEO at ext. 6512 for more information.
2.	Worksite Evaluations HSEO personnel perform worksite health and safety evaluations periodically and in response to special requests.