WAC 296-37-525   Medical requirements.  (1) General.

     (a) The employer shall determine that dive team members who are, or are likely to be, exposed to hyperbaric conditions are medically fit to perform assigned tasks in a safe and healthful manner.

     (b) The employer shall provide each dive team member who is, or is likely to be, exposed to hyperbaric conditions with all medical examinations required by this standard.

     (c) All medical examinations required by this standard shall be performed by, or under the direction of, a physician at no cost to the employee.

     (2) Frequency of medical examinations. Medical examinations shall be provided:

     (a) Prior to initial hyperbaric exposure with the employer, unless an equivalent medical examination has been given within the preceding 12 months and the employer has obtained the results of the examination and an opinion from the examining physician of the employee's medical fitness to dive or to be otherwise exposed to hyperbaric conditions;

     (b) At one year intervals from the date of initial examination or last equivalent examination; and

     (c) After an injury or illness requiring in-patient hospitalization.

     (3) Information provided to examining physician. The employer shall provide the following information to the examining physician:

     (a) A copy of the medical requirements of this standard; and

     (b) A summary of the nature and extent of hyperbaric conditions to which the dive team member will be exposed, including diving modes and types of work to be assigned.

     (4) Content of medical examinations.

     (a) Medical examinations conducted initially and annually shall consist of the following:

     (i) Medical history;

     (ii) Diving-related work history;

     (iii) Basic physical examination;

     (iv) The tests required by Table I; and

     (v) Any additional tests the physician considers necessary.

     (b) Medical examinations conducted after an injury or illness requiring in-patient hospitalization shall be appropriate to the nature and extent of the injury or illness as determined by the examining physician.


TABLE I


TESTS FOR DIVING MEDICAL EXAMINATION



Test		 Initial

Examination		 Annual

Reexamination
Chest X ray . . . . . . . . . . . . x  
Visual acuity . . . . . . . . . . . . x x
Color blindness . . . . . . . . . . . . x  
EKG: Standard 12L1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hearing test . . . . . . . . . . . . x x
Hematocrit or . . . . . . . . . . . . x x
hemoglobin.    
Sickle cell index . . . . . . . . . . . . x  
White blood count . . . . . . . . . . . . x x
Urinalysis . . . . . . . . . . . .
x
 x

1To be given to the employee once, at age 35 or over.

     (5) Physician's written report.

     (a) After any medical examination required by this standard, the employer shall obtain a written report prepared by the examining physician containing:

     (i) The results of the medical examination; and

     (ii) The examining physician's opinion of the employee's fitness to be exposed to hyperbaric conditions, including any recommended restrictions or limitations to such exposure (see WAC 296-37-585).

     (b) The employer shall provide the employee with a copy of the physician's written report.

     (6) Determination of employee fitness.

     (a) The employer shall determine the extent and nature of the dive team member's fitness to engage in diving or be otherwise exposed to hyperbaric conditions consistent with the recommendations in the examining physician's report.

     (b) If the examining physician has recommended a restriction or limitation on the dive team member's exposure to hyperbaric conditions, and the affected employee does not concur, a second physician selected by the employee shall render a medical opinion on the nature and extent of the restriction or limitation, if any.

     (c) If the recommendation of the second opinion differs from that of the examining (first) physician, and if the employer and employee are unable to agree on the nature and extent of the restriction or limitation, an opinion from a third physician selected by the first two physicians shall be obtained. The employer's determination of the dive team member's fitness shall be consistent with the medical opinion of the third physician, unless the employer and employee reach an agreement which is otherwise consistent with the recommendation or opinion of at least two of the physicians involved.

     (d) Nothing in this procedure shall be construed to prohibit either a dive team member from accepting, or an employer from offering, an assignment which is otherwise consistent with at least one medical opinion while a final determination on the employee's fitness is pending.



[Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. 09-01-158, § 296-37-525, filed 12/23/08, effective 3/1/09. Statutory Authority: RCW 49.17.040, 49.17.050, 49.17.240, and chapters 42.30 and 43.22 RCW. 78-10-094 (Order 78-18), § 296-37-525, filed 10/2/78.]