Medical Surveillance Program Audit Checklist [FREE PDF]

Medical surveillance programs are required under multiple OSHA standards to detect early signs of occupational disease, track health trends in exposed worker populations, and verify the effectiveness of exposure controls. OSHA 29 CFR 1910.1020 establishes baseline requirements for medical recordkeeping, while substance-specific standards such as OSHA 1910.95 (noise) and 1910.134 (respiratory protection) mandate surveillance at defined exposure thresholds and intervals. A comprehensive annual aud

Industry: Occupational Health
Frequency: Annually
Estimated Time: 50-70 minutes
Role: Occupational Health Nurse
Total Items: 36
Compliance: OSHA 29 CFR 1910.1020 Access to Employee Exposure and Medical Records, OSHA 29 CFR 1910.95 Occupational Noise Exposure (Hearing Conservation), OSHA 29 CFR 1910.134 Respiratory Protection Standard, NIOSH Recommended Exposure Limits (RELs) – Current Intelligence Bulletins, ACGIH Threshold Limit Values (TLVs) and Biological Exposure Indices (BEIs)

Program Administration & Written Plan

Confirm the medical surveillance program is documented, assigned, and regularly reviewed.

Is a written medical surveillance program document established and available to all stakeholders?
Has the program been reviewed and updated within the past 12 months?
Is a qualified occupational health physician or licensed healthcare professional designated as program medical director?
Does the program identify all chemical, physical, and biological hazards requiring employee medical surveillance?
Are roles and responsibilities for program administration clearly assigned and documented?

Exposure Monitoring & Industrial Hygiene Data

Verify that exposure monitoring is conducted, records are maintained, and employees are notified of results.

Are exposure monitoring records for all chemical and physical hazards retained for at least 30 years?
Are employees notified in writing of individual exposure monitoring results within 15 working days of receipt?
Are noise exposure measurements conducted and documented in areas suspected of exceeding 85 dB(A) TWA?
Are exposure levels compared against applicable OSHA PELs, NIOSH RELs, and ACGIH TLVs?
Is exposure data from industrial hygiene sampling used to update medical surveillance protocols?

Hearing Conservation Surveillance

Audit audiometric testing, baseline audiograms, and follow-up procedures for noise-exposed workers.

Are all employees exposed at or above 85 dB(A) TWA enrolled in a hearing conservation program?
Has a baseline audiogram been established for each noise-exposed employee within 6 months of first exposure?
Are annual audiograms conducted for all employees in the hearing conservation program?
Are employees notified within 21 days when a Standard Threshold Shift (STS) is identified?
Are audiometric test records retained for the duration of the affected employee's employment?

Respiratory Protection Medical Evaluations

Confirm that medical evaluations for respirator users are current and conducted by a licensed healthcare professional.

Has a medical evaluation been completed for every employee required to use a respirator prior to initial use?
Was the medical evaluation completed using at minimum the OSHA Respirator Medical Evaluation Questionnaire (Appendix C)?
Are follow-up medical examinations provided when the PLHCP deems them necessary based on questionnaire responses?
Are employees re-evaluated for medical fitness to wear a respirator when changes in health status or work conditions occur?
Is the PLHCP's written recommendation regarding respirator use maintained in the employee's medical file?

Medical Records Management & Confidentiality

Assess the maintenance, retention, transfer, and employee access to occupational medical records.

Are employee medical records maintained separately from personnel files in a secure, confidential location?
Are medical records retained for at least the duration of employment plus 30 years for all exposed employees?
Are employees provided written notice of their right to access their own medical and exposure records?
Is employee access to medical records provided within 15 working days of a written or oral request?
Are procedures in place to transfer medical records to NIOSH when a business closes or the retention period would otherwise expire?

Biological Monitoring & Biomarker Surveillance

Verify that biological monitoring is conducted for applicable chemical exposures in accordance with ACGIH BEIs and OSHA standards.

Is biological monitoring conducted for all employees with exposures to substances with established ACGIH Biological Exposure Indices (BEIs)?
Are blood lead levels (BLL) monitored at the frequency required for employees with lead exposures at or above the action level?
Are biological monitoring results communicated to employees in writing and compared against reference BEI values?
Is elevated biological monitoring data used to trigger re-evaluation of engineering controls and work practices?
Are biological monitoring specimens collected, handled, and submitted to laboratories according to documented chain-of-custody procedures?

Program Effectiveness & Trend Analysis

Evaluate whether surveillance data is analyzed for trends, acted upon, and used to drive health and safety improvements.

Is aggregate medical surveillance data analyzed at least annually to identify occupational health trends across exposed groups?
Are surveillance findings formally reported to EHS management and used to drive corrective actions?
Are workers removed from exposure and placed in medically appropriate work assignments when surveillance results indicate health effects?
Are physicians or PLHCPs reviewing surveillance trends and providing recommendations for program improvement?
Are employees informed of aggregate health findings in a manner that protects individual medical confidentiality?
Is there a documented process to review and close out all corrective actions identified during the annual program audit?

Related Occupational Health Checklists

Related Medical Surveillance Checklists

Why Use This Medical Surveillance Program Audit Checklist [FREE PDF]?

This medical surveillance program audit checklist [free pdf] helps occupational health teams maintain compliance and operational excellence. Designed for occupational health nurse professionals, this checklist covers 36 critical inspection points across 7 sections. Recommended frequency: annually.

Ensures compliance with OSHA 29 CFR 1910.1020 Access to Employee Exposure and Medical Records, OSHA 29 CFR 1910.95 Occupational Noise Exposure (Hearing Conservation), OSHA 29 CFR 1910.134 Respiratory Protection Standard, NIOSH Recommended Exposure Limits (RELs) – Current Intelligence Bulletins, ACGIH Threshold Limit Values (TLVs) and Biological Exposure Indices (BEIs). Regulatory-aligned for audit readiness and inspection documentation.

Frequently Asked Questions

What does the Medical Surveillance Program Audit Checklist [FREE PDF] cover?

This checklist covers 36 inspection items across 7 sections: Program Administration & Written Plan, Exposure Monitoring & Industrial Hygiene Data, Hearing Conservation Surveillance, Respiratory Protection Medical Evaluations, Medical Records Management & Confidentiality, Biological Monitoring & Biomarker Surveillance, Program Effectiveness & Trend Analysis. It is designed for occupational health operations and compliance.

How often should this checklist be completed?

This checklist should be completed annually. Each completion takes approximately 50-70 minutes.

Who should use this Medical Surveillance Program Audit Checklist [FREE PDF]?

This checklist is designed for Occupational Health Nurse professionals in the occupational health industry. It can be used for self-assessments, team audits, and regulatory compliance documentation.

Can I download this checklist as a PDF?

Yes, this checklist is available as a free PDF download. You can also use it digitally in the POPProbe mobile app for real-time data capture, photo documentation, and automatic reporting.