ACOEM Comments on OSHA's Proposed Revisions to the Beryllium Standard

February 11, 2019
OSHA Docket Office
Occupational Safety & Health Administration
U.S. Department of Labor, Room N-3653
200 Constitution Avenue, NW
Washington, DC 20210
Re:  Docket No. OSHA–2018–0003
Dear Sir/Madam:
The American College of Occupational and Environmental Medicine (ACOEM) appreciates the opportunity to comment on the Notice of Proposed Rulemaking (NPRM) for modifications to the Beryllium Standard for General Industry.   
ACOEM is a national medical society representing more than 4,000 occupational and environmental medicine physicians and other health care professionals devoted to preventing and managing occupational injuries
ACOEM has two concerns regarding the NPRM that we encourage OSHA to consider in the final regulation.
Section 1919.1024 B Confirmed PositiveOSHA’s proposed the definition of a confirmed positive “means the person tested has two abnormal BeLPT test results, an abnormal and a borderline test result, or three borderline test results obtained within the 30-day follow-up test period required after a first abnormal or borderline BeLPT test result. It also means the result of a more reliable and accurate test indicating a person has been identified as having beryllium sensitization.”
ACOEM submits that this change to define a confirmed positive to an individual meeting the stated criteria with a repeat test within 30 days is unwarranted and unsupported by the medical facts. In a beryllium worker, a single abnormal has a reasonably good positive predictive value. A 30-day window for a repeat test abnormality or borderline result is unnecessarily restrictive and will delay follow-up medical testing and other protections to at-risk workers. OSHA has stated no compelling rationale for making this change other than the concern of false positives which are less common than true positives. OSHA has given no scientific basis for proposing a 30-day repeat period which is, in many cases, difficult to achieve, especially for 3 borderline tests.
Paragraph (k)(2)(i)(B) – Under paragraph (k)(2)(i)(B), the employer must provide a medical examination within 30 days after determining that the employee shows signs or symptoms of CBD or other beryllium-related health effects or that the employee has been exposed to beryllium in an emergency. OSHA is proposing to remove the requirement for a medical examination within 30 days of exposure in an emergency and adding paragraph (k)(2)(iv) as above, which would require the employer to offer a medical examination at least one year after but no more than two years after the employee is exposed to beryllium in an emergency.
ACOEM opposes this change. Workers who are exposed to beryllium in an emergency deserve prompt medical evaluation to understand the potential health risks, receive baseline testing, if desired, and to receive medical counseling.  It would be an extremely insensitive and harsh change in policy to require exposed workers to wait more than a year to receive professional medical advice.

Thank you for your consideration of our comments. Please do not hesitate to contact Patrick O’Connor, ACOEM’s Director of Government Affairs, at 703-351-6222 with any questions.

William G. Buchta, MD, MPH, FACOEM