[Code of Federal Regulations]
[Title 29, Volume 6]
[Revised as of July 1, 2006]
From the U.S. Government Printing Office via GPO Access
[CITE: 29CFR1910.1020]

[Page 92-101]
 
                             TITLE 29--LABOR
 
CHAPTER XVII--OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT 
                                OF LABOR
 
PART 1910_OCCUPATIONAL SAFETY AND HEALTH STANDARDS (CONTINUED)--Table of 
Contents
 
                Subpart Z_Toxic and Hazardous Substances
 
Sec.  1910.1020  Access to employee exposure and medical records.

    (a) Purpose. The purpose of this section is to provide employees and 
their designated representatives a right of access to relevant exposure 
and medical records; and to provide representatives of the Assistant 
Secretary a right of access to these records in order to fulfill 
responsibilities under the Occupational Safety and Health Act. Access by 
employees, their representatives, and the Assistant Secretary is 
necessary to yield both direct and indirect improvements in the 
detection, treatment, and prevention of occupational disease. Each 
employer is responsible for assuring compliance with this section, but 
the activities involved in complying with the access to medical records 
provisions can be carried out, on behalf of the employer, by the 
physician or other health care personnel in charge of employee medical 
records. Except as expressly provided, nothing in this section is 
intended to affect existing legal and ethical obligations

[[Page 93]]

concerning the maintenance and confidentiality of employee medical 
information, the duty to disclose information to a patient/employee or 
any other aspect of the medical-care relationship, or affect existing 
legal obligations concerning the protection of trade secret information.
    (b) Scope and application. (1) This section applies to each general 
industry, maritime, and construction employer who makes, maintains, 
contracts for, or has access to employee exposure or medical records, or 
analyses thereof, pertaining to employees exposed to toxic substances or 
harmful physical agents.
    (2) This section applies to all employee exposure and medical 
records, and analyses thereof, of such employees, whether or not the 
records are mandated by specific occupational safety and health 
standards.
    (3) This section applies to all employee exposure and medical 
records, and analyses thereof, made or maintained in any manner, 
including on an in-house of contractual (e.g., fee-for-service) basis. 
Each employer shall assure that the preservation and access requirements 
of this section are complied with regardless of the manner in which the 
records are made or maintained.
    (c) Definitions. (1) Access means the right and opportunity to 
examine and copy.
    (2) Analysis using exposure or medical records means any compilation 
of data or any statistical study based at least in part on information 
collected from individual employee exposure or medical records or 
information collected from health insurance claims records, provided 
that either the analysis has been reported to the employer or no further 
work is currently being done by the person responsible for preparing the 
analysis.
    (3) Designated representative means any individual or organization 
to whom an employee gives written authorization to exercise a right of 
access. For the purposes of access to employee exposure records and 
analyses using exposure or medical records, a recognized or certified 
collective bargaining agent shall be treated automatically as a 
designated representative without regard to written employee 
authorization.
    (4) Employee means a current employee, a former employee, or an 
employee being assigned or transferred to work where there will be 
exposure to toxic substances or harmful physical agents. In the case of 
a deceased or legally incapacitated employee, the employee's legal 
representative may directly exercise all the employee's rights under 
this section.
    (5) Employee exposure record means a record containing any of the 
following kinds of information:
    (i) Environmental (workplace) monitoring or measuring of a toxic 
substance or harmful physical agent, including personal, area, grab, 
wipe, or other form of sampling, as well as related collection and 
analytical methodologies, calculations, and other background data 
relevant to interpretation of the results obtained;
    (ii) Biological monitoring results which directly assess the 
absorption of a toxic substance or harmful physical agent by body 
systems (e.g., the level of a chemical in the blood, urine, breath, 
hair, fingernails, etc) but not including results which assess the 
biological effect of a substance or agent or which assess an employee's 
use of alcohol or drugs;
    (iii) Material safety data sheets indicating that the material may 
pose a hazard to human health; or
    (iv) In the absence of the above, a chemcial inventory or any other 
record which reveals where and when used and the identity (e.g., 
chemical, common, or trade name) of a toxic substance or harmful 
physical agent.
    (6)(i) Employee medical record means a record concerning the health 
status of an employee which is made or maintained by a physician, nurse, 
or other health care personnel or technician, including:
    (A) Medical and employment questionnaires or histories (including 
job description and occupational exposures),
    (B) The results of medical examinations (pre-employment, pre-
assignment, periodic, or episodic) and laboratory tests (including chest 
and other X-

[[Page 94]]

ray examinations taken for the purposes of establishing a base-line or 
detecting occupational illness, and all biological monitoring not 
defined as an ``employee exposure record''),
    (C) Medical opinions, diagnoses, progress notes, and 
recommendations,
    (D) First aid records,
    (E) Descriptions of treatments and prescriptions, and
    (F) Employee medical complaints.
    (ii) ``Employee medical record'' does not include medical 
information in the form of:
    (A) Physical specimens (e.g., blood or urine samples) which are 
routinely discarded as a part of normal medical practice; or
    (B) Records concerning health insurance claims if maintained 
separately from the employer's medical program and its records, and not 
accessible to the employer by employee name or other direct personal 
identifier (e.g., social security number, payroll number, etc.); or
    (C) Records created solely in preparation for litigation which are 
privileged from discovery under the applicable rules of procedure or 
evidence; or
    (D) Records concerning voluntary employee assistance programs 
(alcohol, drug abuse, or personal counseling programs) if maintained 
separately from the employer's medical program and its records.
    (7) Employer means a current employer, a former employer, or a 
successor employer.
    (8) Exposure or exposed means that an employee is subjected to a 
toxic substance or harmful physical agent in the course of employment 
through any route of entry (inhalation, ingestion, skin contact or 
absorption, etc.), and includes past exposure and potential (e.g., 
accidental or possible) exposure, but does not include situations where 
the employer can demonstrate that the toxic substance or harmful 
physical agent is not used, handled, stored, generated, or present in 
the workplace in any manner different from typical non-occupational 
situations.
    (9) Health Professional means a physician, occupational health 
nurse, industrial hygienist, toxicologist, or epidemiologist, providing 
medical or other occupational health services to exposed employees.
    (10) Record means any item, collection, or grouping of information 
regardless of the form or process by which it is maintained (e.g., paper 
document, microfiche, microfilm, X-ray film, or automated data 
processing).
    (11) Specific chemical identity means the chemical name, Chemical 
Abstracts Service (CAS) Registry Number, or any other information that 
reveals the precise chemical designation of the substance.
    (12)(i) Specific written consent means a written authorization 
containing the following:
    (A) The name and signature of the employee authorizing the release 
of medical information,
    (B) The date of the written authorization,
    (C) The name of the individual or organization that is authorized to 
release the medical information,
    (D) The name of the designated representative (individual or 
organization) that is authorized to receive the released information,
    (E) A general description of the medical information that is 
authorized to be released,
    (F) A general description of the purpose for the release of the 
medical information, and
    (G) A date or condition upon which the written authorization will 
expire (if less than one year).
    (ii) A written authorization does not operate to authorize the 
release of medical information not in existence on the date of written 
authorization, unless the release of future information is expressly 
authorized, and does not operate for more than one year from the date of 
written authorization.
    (iii) A written authorization may be revoked in writing 
prospectively at any time.
    (13) Toxic substance or harmful physical agent means any chemical 
substance, biological agent (bacteria, virus, fungus, etc.), or physical 
stress (noise, heat, cold, vibration, repetitive motion, ionizing and 
non-ionizing radiation, hypo-or hyperbaric pressure, etc.) which:

[[Page 95]]

    (i) Is listed in the latest printed edition of the National 
Institute for Occupational Safety and Health (NIOSH) Registry of Toxic 
Effects of Chemical Substances (RTECS), which is incorporated by 
reference as specified in Sec.  1910.6; or
    (ii) Has yielded positive evidence of an acute or chronic health 
hazard in testing conducted by, or known to, the employer; or
    (iii) Is the subject of a material safety data sheet kept by or 
known to the employer indicating that the material may pose a hazard to 
human health.
    (14) Trade secret means any confidential formula, pattern, process, 
device, or information or compilation of information that is used in an 
employer's business and that gives the employer an opportunity to obtain 
an advantage over competitors who do not know or use it.
    (d) Preservation of records. (1) Unless a specific occupational 
safety and health standard provides a different period of time, each 
employer shall assure the preservation and retention of records as 
follows:
    (i) Employee medical records. The medical record for each employee 
shall be preserved and maintained for at least the duration of 
employment plus thirty (30) years, except that the following types of 
records need not be retained for any specified period:
    (A) Health insurance claims records maintained separately from the 
employer's medical program and its records,
    (B) First aid records (not including medical histories) of one-time 
treatment and subsequent observation of minor scratches, cuts, burns, 
splinters, and the like which do not involve medical treatment, loss of 
consciousness, restriction of work or motion, or transfer to another 
job, if made on-site by a non-physician and if maintained separately 
from the employer's medical program and its records, and
    (C) The medical records of employees who have worked for less than 
(1) year for the employer need not be retained beyond the term of 
employment if they are provided to the employee upon the termination of 
employment.
    (ii) Employee exposure records. Each employee exposure record shall 
be preserved and maintained for at least thirty (30) years, except that:
    (A) Background data to environmental (workplace) monitoring or 
measuring, such as laboratory reports and worksheets, need only be 
retained for one (1) year as long as the sampling results, the 
collection methodology (sampling plan), a description of the analytical 
and mathematical methods used, and a summary of other background data 
relevant to interpretation of the results obtained, are retained for at 
least thirty (30) years; and
    (B) Material safety data sheets and paragraph (c)(5)(iv) records 
concerning the identity of a substance or agent need not be retained for 
any specified period as long as some record of the identity (chemical 
name if known) of the substance or agent, where it was used, and when it 
was used is retained for at least thirty (30) years;\1\ and
---------------------------------------------------------------------------

    \1\ Material safety data sheets must be kept for those chemicals 
currently in use that are effected by the Hazard Communication Standard 
in accordance with 29 CFR 1910.1200(g).
---------------------------------------------------------------------------

    (C) Biological monitoring results designated as exposure records by 
specific occupational safety and health standards shall be preserved and 
maintained as required by the specific standard.
    (iii) Analyses using exposure or medical records. Each analysis 
using exposure or medial records shall be preserved and maintained for 
at least thirty (30) years.
    (2) Nothing in this section is intended to mandate the form, manner, 
or process by which an employer preserves a record as long as the 
information contained in the record is preserved and retrievable, except 
that chest X-ray films shall be preserved in their original state.
    (e) Access to records--(1) General. (i) Whenever an employee or 
designated representative requests access to a record, the employer 
shall assure that access is provided in a reasonable time, place, and 
manner. If the employer cannot reasonably provide access to the record 
within fifteen (15) working days, the employer shall within the fifteen 
(15) working days apprise the employee or designated representative 
requesting the record of the reason for

[[Page 96]]

the delay and the earliest date when the record can be made available.
    (ii) The employer may require of the requester only such information 
as should be readily known to the requester and which may be necessary 
to locate or identify the records being requested (e.g. dates and 
locations where the employee worked during the time period in question).
    (iii) Whenever an employee or designated representative requests a 
copy of a record, the employer shall assure that either:
    (A) A copy of the record is provided without cost to the employee or 
representative,
    (B) The necessary mechanical copying facilities (e.g., photocopying) 
are made available without cost to the employee or representative for 
copying the record, or
    (C) The record is loaned to the employee or representative for a 
reasonable time to enable a copy to be made.
    (iv) In the case of an original X-ray, the employer may restrict 
access to on-site examination or make other suitable arrangements for 
the temporary loan of the X-ray.
    (v) Whenever a record has been previously provided without cost to 
an employee or designated representative, the employer may charge 
reasonable, non-discriminatory administrative costs (i.e., search and 
copying expenses but not including overhead expenses) for a request by 
the employee or designated representative for additional copies of the 
record, except that
    (A) An employer shall not charge for an initial request for a copy 
of new information that has been added to a record which was previously 
provided; and
    (B) An employer shall not charge for an initial request by a 
recognized or certified collective bargaining agent for a copy of an 
employee exposure record or an analysis using exposure or medical 
records.
    (vi) Nothing in this section is intended to preclude employees and 
collective bargaining agents from collectively bargaining to obtain 
access to information in addition to that available under this section.
    (2) Employee and designated representative access--(i) Employee 
exposure records. (A) Except as limited by paragraph (f) of this 
section, each employer shall, upon request, assure the access to each 
employee and designated representative to employee exposure records 
relevant to the employee. For the purpose of this section, an exposure 
record relevant to the employee consists of:
    (1) A record which measures or monitors the amount of a toxic 
substance or harmful physical agent to which the employee is or has been 
exposed;
    (2) In the absence of such directly relevant records, such records 
of other employees with past or present job duties or working conditions 
related to or similar to those of the employee to the extent necessary 
to reasonably indicate the amount and nature of the toxic substances or 
harmful physical agents to which the employee is or has been subjected, 
and
    (3) Exposure records to the extent necessary to reasonably indicate 
the amount and nature of the toxic substances or harmful physical agents 
at workplaces or under working conditions to which the employee is being 
assigned or transferred.
    (B) Requests by designated representatives for unconsented access to 
employee exposure records shall be in writing and shall specify with 
reasonable particularity:
    (1) The records requested to be disclosed; and
    (2) The occupational health need for gaining access to these 
records.
    (ii) Employee medical records. (A) Each employer shall, upon 
request, assure the access of each employee to employee medical records 
of which the employee is the subject, except as provided in paragraph 
(e)(2)(ii)(D) of this section.
    (B) Each employer shall, upon request, assure the access of each 
designated representative to the employee medical records of any 
employee who has given the designated representative specific written 
consent. Appendix A to this section contains a sample form which may be 
used to establish specific written consent for access to employee 
medical records.
    (C) Whenever access to employee medical records is requested, a 
physician representing the employer may

[[Page 97]]

recommend that the employee or designated representative:
    (1) Consult with the physician for the purposes of reviewing and 
discussing the records requested,
    (2) Accept a summary of material facts and opinions in lieu of the 
records requested, or
    (3) Accept release of the requested records only to a physician or 
other designated representative.
    (D) Whenever an employee requests access to his or her employee 
medical records, and a physician representing the employer believes that 
direct employee access to information contained in the records regarding 
a specific diagnosis of a terminal illness or a psychiatric condition 
could be detrimental to the employee's health, the employer may inform 
the employee that access will only be provided to a designated 
representative of the employee having specific written consent, and deny 
the employee's request for direct access to this information only. Where 
a designated representative with specific written consent requests 
access to information so withheld, the employer shall assure the access 
of the designated representative to this information, even when it is 
known that the designated representative will give the information to 
the employee.
    (E) A physician, nurse, or other responsible health care personnel 
maintaining medical records may delete from requested medical records 
the identity of a family member, personal friend, or fellow employee who 
has provided confidential information concerning an employee's health 
status.
    (iii) Analyses using exposure or medical records. (A) Each employee 
shall, upon request, assure the access of each employee and designated 
representative to each analysis using exposure or medical records 
concerning the employee's working conditions or workplace.
    (B) Whenever access is requested to an analysis which reports the 
contents of employee medical records by either direct identifier (name, 
address, social security number, payroll number, etc.) or by information 
which could reasonably be used under the circumstances indirectly to 
identify specific employees (exact age, height, weight, race, sex, date 
of initial employment, job title, etc.), the employer shall assure that 
personal identifiers are removed before access is provided. If the 
employer can demonstrate that removal of personal identifiers from an 
analysis is not feasible, access to the personally identifiable portions 
of the analysis need not be provided.
    (3) OSHA access. (i) Each employer shall, upon request, and without 
derogation of any rights under the Constitution or the Occupational 
Safety and Health Act of 1970, 29 U.S.C. 651 et seq., that the employer 
chooses to exercise, assure the prompt access of representatives of the 
Assistant Secretary of Labor for Occupational Safety and Health to 
employee exposure and medical records and to analyses using exposure or 
medical records. Rules of agency practice and procedure governing OSHA 
access to employee medical records are contained in 29 CFR 1913.10.
    (ii) Whenever OSHA seeks access to personally identifiable employee 
medical information by presenting to the employer a written access order 
pursuant to 29 CFR 1913.10(d), the employer shall prominently post a 
copy of the written access order and its accompanying cover letter for 
at least fifteen (15) working days.
    (f) Trade secrets. (1) Except as provided in paragraph (f)(2) of 
this section, nothing in this section precludes an employer from 
deleting from records requested by a health professional, employee, or 
designated representative any trade secret data which discloses 
manufacturing processes, or discloses the percentage of a chemical 
substance in mixture, as long as the health professional, employee, or 
designated representative is notified that information has been deleted. 
Whenever deletion of trade secret information substantially impairs 
evaluation of the place where or the time when exposure to a toxic 
substance or harmful physical agent occurred, the employer shall provide 
alternative information which is sufficient to permit the requesting 
party to identify where and when exposure occurred.
    (2) The employer may withhold the specific chemical identity, 
including the chemical name and other specific

[[Page 98]]

identification of a toxic substance from a disclosable record provided 
that:
    (i) The claim that the information withheld is a trade secret can be 
supported;
    (ii) All other available information on the properties and effects 
of the toxic substance is disclosed;
    (iii) The employer informs the requesting party that the specific 
chemical identity is being withheld as a trade secret; and
    (iv) The specific chemical identity is made available to health 
professionals, employees and designated representatives in accordance 
with the specific applicable provisions of this paragraph.
    (3) Where a treating physician or nurse determines that a medical 
emergency exists and the specific chemical identity of a toxic substance 
is necessary for emergency or first-aid treatment, the employer shall 
immediately disclose the specific chemical identity of a trade secret 
chemical to the treating physician or nurse, regardless of the existence 
of a written statement of need or a confidentiality agreement. The 
employer may require a written statement of need and confidentiality 
agreement, in accordance with the provisions of paragraphs (f)(4) and 
(f)(5), as soon as circumstances permit.
    (4) In non-emergency situations, an employer shall, upon request, 
disclose a specific chemical identity, otherwise permitted to be 
withheld under paragraph (f)(2) of this section, to a health 
professional, employee, or designated representative if:
    (i) The request is in writing;
    (ii) The request describes with reasonable detail one or more of the 
following occupational health needs for the information:
    (A) To assess the hazards of the chemicals to which employees will 
be exposed;
    (B) To conduct or assess sampling of the workplace atmosphere to 
determine employee exposure levels;
    (C) To conduct pre-assignment or periodic medical surveillance of 
exposed employees;
    (D) To provide medical treatment to exposed employees;
    (E) To select or assess appropriate personal protective equipment 
for exposed employees;
    (F) To design or assess engineering controls or other protective 
measures for exposed employees; and
    (G) To conduct studies to determine the health effects of exposure.
    (iii) The request explains in detail why the disclosure of the 
specific chemical identity is essential and that, in lieu thereof, the 
disclosure of the following information would not enable the health 
professional, employee or designated representative to provide the 
occupational health services described in paragraph (f)(4)(ii) of this 
section:
    (A) The properties and effects of the chemical;
    (B) Measures for controlling workers' exposure to the chemical;
    (C) Methods of monitoring and analyzing worker exposure to the 
chemical; and,
    (D) Methods of diagnosing and treating harmful exposures to the 
chemical;
    (iv) The request includes a description of the procedures to be used 
to maintain the confidentiality of the disclosed information; and,
    (v) The health professional, employee, or designated representative 
and the employer or contractor of the services of the health 
professional or designated representative agree in a written 
confidentiality agreement that the health professional, employee or 
designated representative will not use the trade secret information for 
any purpose other than the health need(s) asserted and agree not to 
release the information under any circumstances other than to OSHA, as 
provided in paragraph (f)(7) of this section, except as authorized by 
the terms of the agreement or by the employer.
    (5) The confidentiality agreement authorized by paragraph (f)(4)(iv) 
of this section:
    (i) May restrict the use of the information to the health purposes 
indicated in the written statement of need;
    (ii) May provide for appropriate legal remedies in the event of a 
breach of the agreement, including stipulation of a reasonable pre-
estimate of likely damages; and,
    (iii) May not include requirements for the posting of a penalty 
bond.
    (6) Nothing in this section is meant to preclude the parties from 
pursuing

[[Page 99]]

non-contractual remedies to the extent permitted by law.
    (7) If the health professional, employee or designated 
representative receiving the trade secret information decides that there 
is a need to disclose it to OSHA, the employer who provided the 
information shall be informed by the health professional prior to, or at 
the same time as, such disclosure.
    (8) If the employer denies a written request for disclosure of a 
specific chemical identity, the denial must:
    (i) Be provided to the health professional, employee or designated 
representative within thirty days of the request;
    (ii) Be in writing;
    (iii) Include evidence to support the claim that the specific 
chemical identity is a trade secret;
    (iv) State the specific reasons why the request is being denied; 
and,
    (v) Explain in detail how alternative information may satisfy the 
specific medical or occupational health need without revealing the 
specific chemical identity.
    (9) The health professional, employee, or designated representative 
whose request for information is denied under paragraph (f)(4) of this 
section may refer the request and the written denial of the request to 
OSHA for consideration.
    (10) When a heath professional employee, or designated 
representative refers a denial to OSHA under paragraph (f)(9) of this 
section, OSHA shall consider the evidence to determine if:
    (i) The employer has supported the claim that the specific chemical 
identity is a trade secret;
    (ii) The health professional employee, or designated representative 
has supported the claim that there is a medical or occupational health 
need for the information; and
    (iii) The health professional, employee or designated representative 
has demonstrated adequate means to protect the confidentiality.
    (11)(i) If OSHA determines that the specific chemical identity 
requested under paragraph (f)(4) of this section is not a bona fide 
trade secret, or that it is a trade secret but the requesting health 
professional, employee or designated representatives has a legitimate 
medical or occupational health need for the information, has executed a 
written confidentiality agreement, and has shown adequate means for 
complying with the terms of such agreement, the employer will be subject 
to citation by OSHA.
    (ii) If an employer demonstrates to OSHA that the execution of a 
confidentiality agreement would not provide sufficient protection 
against the potential harm from the unauthorized disclosure of a trade 
secret specific chemical identity, the Assistant Secretary may issue 
such orders or impose such additional limitations or conditions upon the 
disclosure of the requested chemical information as may be appropriate 
to assure that the occupational health needs are met without an undue 
risk of harm to the employer.
    (12) Notwithstanding the existence of a trade secret claim, an 
employer shall, upon request, disclose to the Assistant Secretary any 
information which this section requires the employer to make available. 
Where there is a trade secret claim, such claim shall be made no later 
than at the time the information is provided to the Assistant Secretary 
so that suitable determinations of trade secret status can be made and 
the necessary protections can be implemented.
    (13) Nothing in this paragraph shall be construed as requiring the 
disclosure under any circumstances of process or percentage of mixture 
information which is trade secret.
    (g) Employee information. (1) Upon an employee's first entering into 
employment, and at least annually thereafter, each employer shall inform 
current employees covered by this section of the following:
    (i) The existence, location, and availability of any records covered 
by this section;
    (ii) The person responsible for maintaining and providing access to 
records; and
    (iii) Each employee's rights of access to these records.
    (2) Each employer shall keep a copy of this section and its 
appendices, and make copies readily available, upon request, to 
employees. The employer

[[Page 100]]

shall also distribute to current employees any informational materials 
concerning this section which are made available to the employer by the 
Assistant Secretary of Labor for Occupational Safety and Health.
    (h) Transfer of records. (1) Whenever an employer is ceasing to do 
business, the employer shall transfer all records subject to this 
section to the successor employer. The successor employer shall receive 
and maintain these records.
    (2) Whenever an employer is ceasing to do business and there is no 
successor employer to receive and maintain the records subject to this 
standard, the employer shall notify affected current employees of their 
rights of access to records at least three (3) months prior to the 
cessation of the employer's business.
    (3) Whenever an employer either is ceasing to do business and there 
is no successor employer to receive and maintain the records, or intends 
to dispose of any records required to be preserved for at least thirty 
(30) years, the employer shall:
    (i) Transfer the records to the Director of the National Institute 
for Occupational Safety and Health (NIOSH) if so required by a specific 
occupational safety and health standard; or
    (ii) Notify the Director of NIOSH in writing of the impending 
disposal of records at least three (3) months prior to the disposal of 
the records.
    (4) Where an employer regularly disposes of records required to be 
preserved for at least thirty (30) years, the employer may, with at 
least (3) months notice, notify the Director of NIOSH on an annual basis 
of the records intended to be disposed of in the coming year.
    (i) Appendices. The information contained in appendices A and B to 
this section is not intended, by itself, to create any additional 
obligations not otherwise imposed by this section nor detract from any 
existing obligation.

   Appendix A to Sec.  1910.1020--Sample Authorization Letter for the 
     Release of Employee Medical Record Information to a Designated 
                     Representative (Non-Mandatory)

    I, ---------- (full name of worker/patient), hereby authorize ------
------ (individual or organization holding the medical records) to 
release to ------------ (individual or organization authorized to 
receive the medical information), the following medical information from 
my personal medical records:
________________________________________________________________________
________________________________________________________________________
(Describe generally the information desired to be released)
    I give my permission for this medical information to be used for the 
following purpose:
________________________________________________________________________
________________________________________________________________________
but I do not give permission for any other use or re-disclosure of this 
information.

    Note: Several extra lines are provided below so that you can place 
additional restrictions on this authorization letter if you want to. You 
may, however, leave these lines blank. On the other hand, you may want 
to (1) specify a particular expiration date for this letter (if less 
than one year); (2) describe medical information to be created in the 
future that you intend to be covered by this authorization letter; or 
(3) describe portions of the medical information in your records which 
you do not intend to be released as a result of this letter.)

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

________________________________________________________________________
Full name of Employee or Legal Representative
________________________________________________________________________
Signature of Employee or Legal Representative
________________________________________________________________________
________________________________________________________________________
Date of Signature

 Appendix B to Sec.  1910.1020--Availability of NIOSH Registry of Toxic 
         Effects of Chemical Substances (RTECS) (Non-Mandatory)

    The final regulation, 29 CFR 1910.20, applies to all employee 
exposure and medical records, and analyses thereof, of employees exposed 
to toxic substances or harmful physical agents (paragraph (b)(2)). The 
term toxic substance or harmful physical agent is defined by paragraph 
(c)(13) to encompass chemical substances, biological agents, and 
physical stresses for which there is evidence of harmful health effects. 
The regulation uses the latest printed edition of the National Institute 
for Occupational Safety and Health (NIOSH) Registry of Toxic Effects of 
Chemical Substances (RTECS) as one of the chief sources of information 
as to whether evidence of harmful health effects exists. If a substance 
is listed in the latest printed RTECS, the regulation applies to 
exposure and medical records (and analyses of these

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records) relevant to employees exposed to the substance.
    It is appropriate to note that the final regulation does not require 
that employers purchase a copy of RTECS, and many employers need not 
consult RTECS to ascertain whether their employee exposure or medical 
records are subject to the rule. Employers who do not currently have the 
latest printed edition of the NIOSH RTECS, however, may desire to obtain 
a copy. The RTECS is issued in an annual printed edition as mandated by 
section 20(a)(6) of the Occupational Safety and Health Act (29 U.S.C. 
669(a)(6)).
    The Introduction to the 1980 printed edition describes the RTECS as 
follows:
    ``The 1980 edition of the Registry of Toxic Effects of Chemical 
Substances, formerly known as the Toxic Substances list, is the ninth 
revision prepared in compliance with the requirements of Section 
20(a)(6) of the Occupational Safety and Health Act of 1970 (Public Law 
91-596). The original list was completed on June 28, 1971, and has been 
updated annually in book format. Beginning in October 1977, quarterly 
revisions have been provided in microfiche. This edition of the Registry 
contains 168,096 listings of chemical substances: 45,156 are names of 
different chemicals with their associated toxicity data and 122,940 are 
synonyms. This edition includes approximately 5,900 new chemical 
compounds that did not appear in the 1979 Registry. (p. xi)
    ``The Registry's purposes are many, and it serves a variety of 
users. It is a single source document for basic toxicity information and 
for other data, such as chemical identifiers ad information necessary 
for the preparation of safety directives and hazard evaluations for 
chemical substances. The various types of toxic effects linked to 
literature citations provide researchers and occupational health 
scientists with an introduction to the toxicological literature, making 
their own review of the toxic hazards of a given substance easier. By 
presenting data on the lowest reported doses that produce effects by 
several routes of entry in various species, the Registry furnishes 
valuable information to those responsible for preparing safety data 
sheets for chemical substances in the workplace. Chemical and production 
engineers can use the Registry to identify the hazards which may be 
associated with chemical intermediates in the development of final 
products, and thus can more readily select substitutes or alternative 
processes which may be less hazardous. Some organizations, including 
health agencies and chemical companies, have included the NIOSH Registry 
accession numbers with the listing of chemicals in their files to 
reference toxicity information associated with those chemicals. By 
including foreign language chemical names, a start has been made toward 
providing rapid identification of substances produced in other 
countries. (p. xi)
    ``In this edition of the Registry, the editors intend to identify 
``all known toxic substances'' which may exist in the environment and to 
provide pertinent data on the toxic effects from known doses entering an 
organism by any route described. (p xi)
    ``It must be reemphasized that the entry of a substance in the 
Registry does not automatically mean that it must be avoided. A listing 
does mean, however, that the substance has the documented potential of 
being harmful if misused, and care must be exercised to prevent tragic 
consequences. Thus, the Registry lists many substances that are common 
in everyday life and are in nearly every household in the United States. 
One can name a variety of such dangerous substances: prescription and 
non-prescription drugs; food additives; pesticide concentrates, sprays, 
and dusts; fungicides; herbicides; paints; glazes, dyes; bleaches and 
other household cleaning agents; alkalies; and various solvents and 
diluents. The list is extensive because chemicals have become an 
integral part of our existence.''
    The RTECS printed edition may be purchased from the Superintendent 
of Documents, U.S. Government Printing Office (GPO), Washington, DC 
20402 (202-783-3238).
    Some employers may desire to subscribe to the quarterly update to 
the RTECS which is published in a microfiche edition. An annual 
subscription to the quarterly microfiche may be purchased from the GPO 
(Order the ``Microfiche Edition, Registry of Toxic Effects of Chemical 
Substances''). Both the printed edition and the microfiche edition of 
RTECS are available for review at many university and public libraries 
throughout the country. The latest RTECS editions may also be examined 
at the OSHA Technical Data Center, Room N2439--Rear, United States 
Department of Labor, 200 Constitution Avenue, NW., Washington, DC 20210 
(202-523-9700), or at any OSHA Regional or Area Office (See, major city 
telephone directories under United States Government-Labor Department).

[53 FR 38163, Sept. 29, 1988; 53 FR 49981, Dec. 13, 1988, as amended at 
54 FR 24333, June 7, 1989; 55 FR 26431, June 28, 1990; 61 FR 9235, Mar. 
7, 1996. Redesignated at 61 FR 31430, June 20, 1996, as amended at 71 FR 
16673, Apr. 3, 2006]