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5.0 - HEALTH SURVEILLANCE PROGRAM 5.1 Employee Medical Examinations All employees involved in work at the Site will participate in ATC's Medical Surveillance Program administered by Health Resources. Additionally, when respirators are required (as determined by the SSHO and project manager), each employee will also have current respirator clearance. A post project, follow-up exam may be required if an exposure incident is reported or an employee shows specific symptoms associated with the known or suspected hazardous chemicals. The RSC and the Project Manager will determine when post project exams are required. 5.2 Heat Stress Program This procedure applies to all employees when heat stress conditions exist at project sites. 5.2.1 Training The SSHO will have received acceptable training in first-aid and Cardiopulmonary Resuscitation (CPR), including training in heat-related illnesses. The SSHO shall also be trained on the requirements of the ATC Policy for Industrial Hygiene (Policy No. 23), which contains the requirement for Heat Stress monitoring. All workers should be capable of recognizing and treating the signs and symptoms of heat stress conditions. During potential heat stress conditions, ice should be readily available to rapidly cool victims. 5.2.2 Fluid Replacement Water will be made available at the Site for employee fluid replacement. When heat stress is determined to be a problem by the SSHO, employees will be provided with balanced, electrolyte solutions to replace fluid and electrolyte loss. Employees will be provided with replacement fluids at a minimum rate of 8 ounces every 15 to 20 minutes per person. 5.2.3 Acclimatization Acclimatization is a gradual physiological adaptation that improves an individual's ability to tolerate heat stress. Full-heat acclimatization requires up to 3 weeks of continued physical activity under heat-stress conditions similar to those anticipated for the work. Its loss begins when the work activity in the heat stress conditions is discontinued. A noticeable loss usually occurs within 3 —4 days. 5.2.4 Rest Breaks When heat stress conditions are applicable, all rest breaks should be taken out of the zone of exclusion into a cooler, shaded, rest area. If these conditions are not available, more frequent rest breaks will be taken. 5.2.5 Heat Stress Monitoring Heat Stress and heat strain are conditions resulting from environmental factors including temperature, relative humidity, radiant heat transfer, and air movement, as they are affected by clothing. The primary objective of the heat stress management program is to prevent heat stroke which is life threatening and the most serious of the heat-induced disabilities. Extra caution should be taken for workers who are not acclimated to working in the heat. The following Heat Stress Index (refer to ATC Policy No. 23) should be used as a guide to evaluate heat stress situations. If the Heat Stress exceeds 105°F, contact the RSC prior to work for detailed guidance. HASP Level III Rev. 01 — (June 11, 2007) 5-1