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50 7.0 MEDICAL SURVEILLANCE 7.1 GENERAL ICS employees visit sites and locations where exposure to hazardous substances may exist. Repeated exposure 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 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 substantial threats of hazardous substances without regard to the location of the hazard. This requirement aims to ensure that the health of employees working where dangerous chemicals and substances exist is 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 employee exposure and medical conditions documentation is provided and maintained in 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.