Asbestos medical surveillance, recordkeeping and the competent person study guide
Paragraphs (m), (n) and (o) of 29 CFR 1926.1101, OSHA's asbestos standard for construction, set the employer's medical surveillance duties, the records the employer and building owner must keep, and the designation, inspections and training of the competent person. This guide sets out what the rule text states on who is covered, when examinations are given and what they include, the information given to the physician and the physician's written opinion, objective data, exposure and medical records and how long they are kept, and the competent person's inspections, duties and training by class of work. Medical content is limited to the exact words of the rule; this is not medical advice. goraedu is not an accredited training provider, and this is not a course or accreditation exam. Your State may run its own OSHA-approved plan with its own rules, so check them too. Every point links to the regulation and quotes its exact words.
Coverage and who performs examinations
1926.1101(m)(1)(i)(A) puts the duty on the employer: it must institute a medical surveillance program for all employees who, for a combined total of 30 or more days per year, are engaged in Class I, II and III work or are exposed at or above a permissible exposure limit.
“The employer shall institute a medical surveillance program for all employees who for a combined total of 30 or more days per year are engaged in Class I, II and III work or are exposed at or above a permissible exposure limit.”
Some days are not counted toward the 30 days: a day on which a worker engages in Class II or Class III operations (or a combination) on intact material for one hour or less, counting the entire time spent on the removal operation including cleanup, and while doing so adheres fully to the work practices in the standard.
“For purposes of this paragraph, any day in which a worker engages in Class II or Class III operations or a combination thereof on intact material for one hour or less (taking into account the entire time spent on the removal operation, including cleanup) and, while doing so, adheres fully to the work practices specified in this standard, shall not be counted.”
For employees otherwise required by the standard to wear a negative pressure respirator, employers shall ensure the employees are physically able to perform the work and use the equipment; this determination shall be made under the supervision of a physician.
“For employees otherwise required by this standard to wear a negative pressure respirator, employers shall ensure employees are physically able to perform the work and use the equipment. This determination shall be made under the supervision of a physician.”
The employer shall ensure that all medical examinations and procedures are performed by or under the supervision of a licensed physician, and are provided at no cost to the employee and at a reasonable time and place.
“The employer shall ensure that all medical examinations and procedures are performed by or under the supervision of a licensed physician, and are provided at no cost to the employee and at a reasonable time and place.”
Persons other than licensed physicians who administer the required pulmonary function testing shall complete a training course in spirometry sponsored by an appropriate academic or professional institution.
“Persons other than such licensed physicians who administer the pulmonary function testing required by this section shall complete a training course in spirometry sponsored by an appropriate academic or professional institution.”
Not covered here
The exposure monitoring and permissible exposure limits that the coverage test refers to are in other parts of the standard and are not repeated here. We only write what an official source states, so study these parts with your certifying program's materials.
Examination schedule
The employer shall make medical examinations and consultations available to each employee covered under (m)(1)(i) on the schedules listed in (m)(2)(i).
“The employer shall make available medical examinations and consultations to each employee covered under paragraph (m)(1)(i) of this section on the following schedules:”
One schedule point is before the employee is assigned to an area where negative-pressure respirators are worn.
“Prior to assignment of the employee to an area where negative-pressure respirators are worn;”
When the employee is assigned to an area where exposure may be at or above the permissible exposure limit for 30 or more days per year, or engages in Class I, II, or III work for a combined total of 30 or more days per year, a medical examination must be given within 10 working days following the thirtieth day of exposure.
“When the employee is assigned to an area where exposure to asbestos may be at or above the permissible exposure limit for 30 or more days per year, or engage in Class I, II, or III work for a combined total of 30 or more days per year, a medical examination must be given within 10 working days following the thirtieth day of exposure;”
Examinations follow at least annually after that.
“And at least annually thereafter.”
If the examining physician determines that any of the examinations should be provided more often than specified, the employer shall provide them to affected employees at the frequencies the physician specifies.
“If the examining physician determines that any of the examinations should be provided more frequently than specified, the employer shall provide such examinations to affected employees at the frequencies specified by the physician.”
The rule states an exception: no medical examination is required of any employee if adequate records show that the employee has been examined in accordance with this paragraph within the past 1-year period.
“Exception: No medical examination is required of any employee if adequate records show that the employee has been examined in accordance with this paragraph within the past 1-year period.”
Examination content
Medical examinations made available under the schedules in (m)(2)(i)(A) through (m)(2)(i)(C) shall include a medical and work history with special emphasis directed to the pulmonary, cardiovascular, and gastrointestinal systems.
“Medical examinations made available pursuant to paragraphs (m)(2)(i)(A) through (m)(2)(i)(C) of this section shall include: (A) A medical and work history with special emphasis directed to the pulmonary, cardiovascular, and gastrointestinal systems.”
On initial examination it includes the standardized questionnaire in part 1 of appendix D, and on annual examination the abbreviated standardized questionnaire in part 2 of appendix D.
“On initial examination, the standardized questionnaire contained in part 1 of appendix D to this section, and, on annual examination, the abbreviated standardized questionnaire contained in part 2 of appendix D to this section.”
They shall include a physical examination directed to the pulmonary and gastrointestinal systems, including a 14- by 17-inch or other reasonably-sized standard film or digital posterior-anterior chest X-ray to be administered at the discretion of the physician, and pulmonary function tests of forced vital capacity (FVC) and forced expiratory volume at one second (FEV1). Classification of all chest X-rays shall be conducted in accordance with appendix E.
“A physical examination directed to the pulmonary and gastrointestinal systems, including a 14- by 17-inch or other reasonably-sized standard film or digital posterior-anterior chest X-ray to be administered at the discretion of the physician, and pulmonary function tests of forced vital capacity (FVC) and forced expiratory volume at one second (FEV1). Classification of all chest X-rays shall be conducted in accordance with appendix E to this section.”
The examination also includes any other examinations or tests deemed necessary by the examining physician.
“Any other examinations or tests deemed necessary by the examining physician.”
Not covered here
The questionnaires in appendix D and the X-ray classification in appendix E are appendices and are not covered here. We only write what an official source states, so study these parts with your certifying program's materials.
Physician information and written opinion
The employer shall provide information to the examining physician, including a copy of the standard and Appendices D, E, and I to the section.
“The employer shall provide the following information to the examining physician: (i) A copy of this standard and Appendices D, E, and I to this section;”
That information also includes a description of the affected employee's duties as they relate to the employee's exposure.
“A description of the affected employee's duties as they relate to the employee's exposure;”
It also includes the employee's representative exposure level or anticipated exposure level.
“The employee's representative exposure level or anticipated exposure level;”
It also includes information from previous medical examinations of the affected employee that is not otherwise available to the examining physician.
“Information from previous medical examinations of the affected employee that is not otherwise available to the examining physician.”
The employer shall obtain a written opinion from the examining physician; the opinion shall contain the results of the medical examination and shall include the items listed in (m)(4)(i).
“The employer shall obtain a written opinion from the examining physician. This written opinion shall contain the results of the medical examination and shall include:”
The written opinion includes the physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos.
“The physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos;”
The written opinion also includes any recommended limitations on the employee or on the use of personal protective equipment such as respirators.
“Any recommended limitations on the employee or on the use of personal protective equipment such as respirators”
It includes a statement that the employee has been informed by the physician of the results of the medical examination and of any medical conditions that may result from asbestos exposure.
“A statement that the employee has been informed by the physician of the results of the medical examination and of any medical conditions that may result from asbestos exposure.”
It includes a statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure.
“A statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure.”
The employer shall instruct the physician not to reveal, in the written opinion given to the employer, specific findings or diagnoses unrelated to occupational exposure to asbestos.
“The employer shall instruct the physician not to reveal in the written opinion given to the employer specific findings or diagnoses unrelated to occupational exposure to asbestos.”
The employer shall provide a copy of the physician's written opinion to the affected employee within 30 days from its receipt.
“The employer shall provide a copy of the physician's written opinion to the affected employee within 30 days from its receipt.”
Not covered here
Not every item of information the employer gives the physician under 1926.1101(m)(3) is listed above; follow the source link for the full list. We only write what an official source states, so study these parts with your certifying program's materials.
Objective data and exposure records
Where the employer has relied on objective data showing that products made from or containing asbestos, or the activity involving such products or material, are not capable of releasing asbestos fibers at or above the permissible exposure limit and/or excursion limit under the expected conditions of processing, use, or handling, to satisfy paragraph (f), the employer shall establish and maintain an accurate record of the objective data reasonably relied upon in support of the exemption.
“Where the employer has relied on objective data that demonstrates that products made from or containing asbestos or the activity involving such products or material are not capable of releasing fibers of asbestos in concentrations at or above the permissible exposure limit and/or excursion limit under the expected conditions of processing, use, or handling to satisfy the requirements of paragraph (f), the employer shall establish and maintain an accurate record of objective data reasonably relied upon in support of the exemption.”
Among the information that record includes is a description of the operation exempted and how the data support the exemption.
“A description of the operation exempted and how the data support the exemption;”
The employer shall maintain the objective data record for the duration of the employer's reliance upon the data.
“The employer shall maintain this record for the duration of the employer's reliance upon such objective data.”
The employer shall keep an accurate record of all measurements taken to monitor employee exposure to asbestos as prescribed in paragraph (f).
“The employer shall keep an accurate record of all measurements taken to monitor employee exposure to asbestos as prescribed in paragraph (f) of this section.”
A note says the employer may utilize the services of competent organizations such as industry trade associations and employee associations to maintain the records required by the section.
“NOTE: The employer may utilize the services of competent organizations such as industry trade associations and employee associations to maintain the records required by this section.”
Among the information the exposure measurement record includes is the name and exposure of the employees whose exposures are represented.
“Name and exposure of the employees whose exposures are represented.”
The employer shall maintain the exposure measurement record for at least thirty (30) years, in accordance with § 1910.1020.
“The employer shall maintain this record for at least thirty (30) years, in accordance with § 1910.1020 of this chapter”
Not covered here
The full list of items each record must include is in 1926.1101(n)(1)(ii) and (n)(2)(ii); follow the source link for every item. We only write what an official source states, so study these parts with your certifying program's materials.
Medical, training and building records
The employer shall establish and maintain an accurate record for each employee subject to medical surveillance under paragraph (m), in accordance with § 1910.1020.
“The employer shall establish and maintain an accurate record for each employee subject to medical surveillance by paragraph (m) of this section, in accordance with § 1910.1020 of this chapter.”
That record includes a copy of the employee's medical examination results, including the medical history, questionnaire responses, results of any tests, and physician's recommendations.
“A copy of the employee's medical examination results, including the medical history, questionnaire responses, results of any tests, and physician's recommendations.”
It also includes any employee medical complaints related to exposure to asbestos.
“Any employee medical complaints related to exposure to asbestos;”
The employer shall ensure the medical surveillance record is maintained for the duration of employment plus thirty (30) years, in accordance with § 1910.1020.
“The employer shall ensure that this record is maintained for the duration of employment plus thirty (30) years, in accordance with § 1910.1020 of this chapter.”
The employer shall maintain all employee training records for one (1) year beyond the last date of employment by that employer.
“The employer shall maintain all employee training records for one (1) year beyond the last date of employment by that employer.”
Where the building owner and employer have relied on data to demonstrate that PACM is not asbestos-containing, that data shall be maintained for as long as it is relied upon to rebut the presumption.
“Where the building owner and employer have relied on data to demonstrate that PACM is not asbestos-containing, such data shall be maintained for as long as they are relied upon to rebut the presumption.”
Where the building owner has communicated and received information on the identification, location and quantity of ACM and PACM, the building owner shall maintain written records of those notifications and their content for the duration of ownership and shall transfer them to successive owners of the buildings/facilities.
“Where the building owner has communicated and received information concerning the identification, location and quantity of ACM and PACM, written records of such notifications and their content shall be maintained by the building owner for the duration of ownership and shall be transferred to successive owners of such buildings/facilities.”
Upon written request, the employer shall make all records required by the section available to the Assistant Secretary and the Director for examination and copying.
“The employer, upon written request, shall make all records required to be maintained by this section available to the Assistant Secretary and the Director for examination and copying.”
For transfer of records, the employer must comply with the requirements set forth in 29 CFR 1910.1020(h).
“The employer must comply with the requirements concerning transfer of records set forth in 29 CFR 1910.1020(h).”
Not covered here
Not every item the medical surveillance record must include under 1926.1101(n)(3)(ii) is listed above; follow the source link for the full list. The detailed availability and transfer requirements of 29 CFR 1910.1020 are a separate section and are not covered here. We only write what an official source states, so study these parts with your certifying program's materials.
Competent person and inspections
On all construction worksites covered by the standard, the employer shall designate a competent person having the qualifications and authorities for ensuring worker safety and health required by subpart C (29 CFR 1926.20 through 1926.32).
“On all construction worksites covered by this standard, the employer shall designate a competent person, having the qualifications and authorities for ensuring worker safety and health required by subpart C, General Safety and Health Provisions for Construction (29 CFR 1926.20 through 1926.32).”
Section 1926.20(b)(2), which requires health and safety prevention programs to provide for frequent and regular inspections of the job sites, materials, and equipment to be made by competent persons, is incorporated.
“Section 1926.20(b)(2) which requires health and safety prevention programs to provide for frequent and regular inspections of the job sites, materials, and equipment to be made by competent persons, is incorporated.”
In addition, the competent person shall make frequent and regular inspections of the job sites in order to perform the duties in (o)(3)(i); for Class I jobs, on-site inspections shall be made at least once during each work shift, and at any time at employee request.
“In addition, the competent person shall make frequent and regular inspections of the job sites, in order to perform the duties set out below in paragraph (o)(3)(i) of this section. For Class I jobs, on-site inspections shall be made at least once during each work shift, and at any time at employee request.”
For Class II, III, and IV jobs, on-site inspections shall be made at intervals sufficient to assess whether conditions have changed, and at any reasonable time at employee request.
“For Class II, III, and IV jobs, on-site inspections shall be made at intervals sufficient to assess whether conditions have changed, and at any reasonable time at employee request.”
On all worksites where employees are engaged in Class I or II asbestos work, the competent person designated under paragraph (e)(6) shall perform or supervise the duties listed in (o)(3)(i), as applicable.
“On all worksites where employees are engaged in Class I or II asbestos work, the competent person designated in accordance with paragraph (e)(6) of this section shall perform or supervise the following duties, as applicable:”
One of those duties is to ensure, by on-site inspection, the integrity of the enclosure or containment.
“Ensure (by on-site inspection) the integrity of the enclosure or containment;”
Another is to supervise all employee exposure monitoring required by the section and ensure that it is conducted as required by paragraph (f).
“Supervise all employee exposure monitoring required by this section and ensure that it is conducted as required by paragraph (f) of this section;”
Another is to ensure that employees use the hygiene facilities and observe the decontamination procedures specified in paragraph (j).
“Ensure that employees use the hygiene facilities and observe the decontamination procedures specified in paragraph (j) of this section;”
Not covered here
The remaining competent person duties are in 1926.1101(o)(3)(i); follow the source link for the full text. The text of 29 CFR 1926.20(b)(2) itself is a separate section and is not covered here. We only write what an official source states, so study these parts with your certifying program's materials.
Competent person training
For Class I and II asbestos work, the competent person shall be trained in all aspects of asbestos removal and handling, including abatement, installation, removal and handling; the contents of the standard; the identification of asbestos; removal procedures, where appropriate; and other practices for reducing the hazard.
“For Class I and II asbestos work the competent person shall be trained in all aspects of asbestos removal and handling, including: abatement, installation, removal and handling; the contents of this standard; the identification of asbestos; removal procedures, where appropriate; and other practices for reducing the hazard.”
That training shall be obtained in a comprehensive course for supervisors that meets the criteria of EPA's Model Accreditation Plan (40 CFR part 763, subpart E, appendix C), such as a course conducted by an EPA-approved or state-approved training provider, certified by EPA or a state, or a course equivalent in stringency, content, and length.
“Such training shall be obtained in a comprehensive course for supervisors that meets the criteria of EPA's Model Accreditation Plan (40 CFR part 763, subpart E, appendix C), such as a course conducted by an EPA-approved or state-approved training provider, certified by EPA or a state, or a course equivalent in stringency, content, and length.”
For Class III and IV asbestos work, the competent person shall be trained in aspects of asbestos handling appropriate for the nature of the work, to include procedures for setting up glove bags and mini-enclosures, practices for reducing asbestos exposures, use of wet methods, the contents of the standard, and the identification of asbestos.
“For Class III and IV asbestos work, the competent person shall be trained in aspects of asbestos handling appropriate for the nature of the work, to include procedures for setting up glove bags and mini-enclosures, practices for reducing asbestos exposures, use of wet methods, the contents of this standard, and the identification of asbestos.”
That training shall include successful completion of a course consistent with EPA requirements for training of local education agency maintenance and custodial staff as set forth at 40 CFR 763.92(a)(2), or its equivalent in stringency, content and length.
“Such training shall include successful completion of a course that is consistent with EPA requirements for training of local education agency maintenance and custodial staff as set forth at 40 CFR 763.92(a)(2), or its equivalent in stringency, content and length.”
Competent persons for Class III and IV work may also be trained under the Class I and II requirements of paragraph (o)(4)(i).
“Competent persons for Class III and IV work, may also be trained pursuant to the requirements of paragraph (o)(4)(i) of this section.”
Not covered here
The content of EPA's Model Accreditation Plan and of 40 CFR 763.92(a)(2) is not covered here. We only write what an official source states, so study these parts with your certifying program's materials.
Sources
- eCFR: 29 CFR 1926.1101, Asbestos (as of Nov 4, 2026)Checked November 6, 2026
Other Asbestos study guides: Scope, definitions, classes of work and exposure limits, Regulated areas and exposure monitoring, Methods of compliance, Respirators, protective clothing and hygiene facilities, Communication of hazards, training and housekeeping, Schools (AHERA): responsibilities, inspections, sampling and assessment, Schools (AHERA): response actions, O&M, management plans and records