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nnovative onstruction olutions 7 . 0 MEDICAL SURVEILLANCE 7 . 1 GENERAL ICS employees, through the course of their work, visit sites and locations where exposure to hazardous substances may exist . Repeated exposures to health hazards can result in serious health problems . Therefore , it is essential that an ICS employee ' s state of health be determined at the time of initial exposure and then be monitored periodically to detect the first signs of a health problem . This medical surveillance program is required by T8 CCR § 5192 for emergency response operations for releases of, or the substantial threats of releases of, hazardous substances without regard to the location of the hazard . The purpose of this requirement is to assure the health of employees working where hazardous chemicals and substances exist are monitored and documented before placement, during employment, and at termination . 7 . 2 SCOPE The ICS Medical Surveillance Program covers employees who are visitors to sites and facilities where hazardous substances may exist . The medical surveillance program requirements include , but are not limited to , the following medical examinations : o Baseline or pre - assignment, o Annual medical monitoring, and o Termination . The ICS Medical Surveillance Program has been designed to : • Establish the baseline medical condition of employees and fitness for duty, • Determine the ability to work while wearing protective equipment ( e . g . respirator ) , • Track the physiological conditions of employees on an established schedule and at termination of the project or employment, and • Ensure documentation of employee exposure and medical conditions is provided and maintained as a part of the employee ' s medical record . Contractors not contractually related to ICS , ( Subcontractors/Vendors ) will assume responsibility for obtaining the necessary medical monitoring for their employees and shall provide a medical clearance letter as requested . 53