• Implement a lead-specific medical program supervised by a physician or licensed health care provider (PLHCP) who is knowledgeable about the Cal/OSHA occupational lead standard requirements.
  

• Conduct an initial blood lead level (BLL) test prior to assignment to lead work when worker exposure will be at or above the action level of 2 micrograms per cubic meter (μg​/m³)​​​, or the worker will perform trigger tasks and an exposure assessment has not been completed.

• Perform BLL testing at least every 2 months for the first 6 months of lead work and after any change in task resulting in higher exposure, and every 6 months thereafter. If a worker’s last BLL is at or above 10 micrograms per deciliter (μg/dl), the testing frequency must be increased to at least every two months. Maintain this frequency until two consecutive BLLs taken at least 30 days apart are less than 10 μg/dl.

• Notify workers in writing of their BLL test results within 5 working days of receipt. The PLHCP who orders the BLL test also must notify the worker of the test results and recommend follow-up testing and medical examinations.

• Temporarily remove workers from exposure to lead who have a BLL at or above 30 μg/dL or 2 BLLs at or above 20​​ μg/dl. Provide them with alternate work. Before returning to lead work, the worker must have at least 2 consecutive monthly BLL tests taken at least 30 days apart that are below 10 μg/dL.

• Implement a written BLL response plan for workers with BLLs at or above 10 μg/dl.

​Review the Cal/OSHA Occupational Lead Standards for more information about worker medical surveillance and removal protection requirements, sections (j) and (k).