1926.1101(m)(2)(ii): Content of Asbestos Medical Exams
Asbestos medical exams must include a medical and work history focused on the lungs, heart and digestive system, standardized questionnaires from appendix D, and a physical exam of the lungs and digestive system. That exam includes a chest X-ray at the physician's discretion and FVC and FEV1 breathing tests, plus any other tests the physician deems necessary.
Key takeaways
- 1926.1101(m)(2)(ii) is part of OSHA's construction standards (29 CFR Part 1926, Subpart Z).
- OSHA cited it 42 times in the last 3 years, in 38 inspections, with $740 in current penalties.
- Most citations: MI (42).
- Related part: 1926.1101(m) Medical surveillance— (130 citations).
- Free 5-minute toolbox talk for your crew below.
In this article
What this rule covers
29 CFR 1926.1101(m)(2)(ii) ("Content") is one requirement inside 1926.1101 Asbestos, an OSHA construction standard (Part 1926, Subpart Z). It includes 4 sub-paragraphs. The official text below is copied word for word from the Electronic Code of Federal Regulations (eCFR). The numbers, injury cases and training on this page show how OSHA enforces it on real job sites.
Official text
(ii) Content. Medical examinations made available pursuant to paragraphs (m)(2)(i)(A) through (m)(2)(i)(C) of this section shall include: 42 citations
(A) A medical and work history with special emphasis directed to the pulmonary, cardiovascular, and gastrointestinal systems.
(B) 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. 6 citations
(C) 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. Open (m)(2)(ii)(c) 8 citations
(D) Any other examinations or tests deemed necessary by the examining physician.
Source: eCFR, text current as of 2026-10-15. Read all of 1926.1101.
Where and how often it was cited
| Year | Citations |
|---|---|
| 2024 | 20 |
| 2025 | 17 |
| 2026 | 5 |
Top states: MI (42)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| ACE EXCAVATING & GRAVEL INC. | KALAMAZOO, MI | $250 |
| SAFE ENVIRONMENTAL CORPORATION | MIDLAND, MI | $240 |
| ACE EXCAVATING & GRAVEL INC. | KALAMAZOO, MI | $100 |
| ATLAS SERVICE GROUP, LLC | BURTON, MI | $100 |
| BRAD LUBAHN & SONS EXCAVATING, L.L.C. | CHASE, MI | $50 |
Free toolbox talk
A 5-minute crew talk on 1926.1101(m)(2)(ii), plus alerts when this rule changes. Free.
OSHA interpretation letters
- OSHA's position on the acceptability of digital radiography in place of traditional chest roentgenograms. (2012-09-24)
- Medical exams and chest roentgenograms (x-rays) under OSHA's Asbestos standards. (2009-08-18)
Related parts of this rule
- 1926.1101(m) Medical surveillance— 130 citations
- 1926.1101(m)(2) Medical examinations and consultations 70 citations
- 1926.1101(m)(4) Physician's written opinion 42 citations
- 1926.1101(m)(4)(i) 42 citations
- 1926.1101(m)(2)(i) Frequency 28 citations
- 1926.1101(m)(1) General 18 citations
- 1926.1101(m)(1)(i) Employees covered 18 citations
- 1926.1101(m)(1)(i)(B) 12 citations
- 1926.1101(m)(2)(ii)(C) 8 citations
Get your crew competent
Trainers on Black Belt Safety: Marc Harvey, Dana Reyes
Trainers and suppliers: feature your business on this rule for $25/month.
Frequently asked questions
What questionnaire is used?
Part 1 of appendix D on initial exam, and the abbreviated questionnaire in part 2 on annual exams.
Is a chest X-ray required?
A chest X-ray is given at the discretion of the physician, with classification per appendix E.
What breathing tests are included?
Pulmonary function tests of forced vital capacity (FVC) and forced expiratory volume at one second (FEV1).
About this page
Sources
- 29 CFR 1926.1101 (eCFR), text current as of 2026-10-15
- U.S. Department of Labor enforcement data: OSHA inspections, citations and accident records, copied nightly; data as of 2026-10-20
3-year window. Federal OSHA only; state-plan rules are not counted. Plain-language text is a summary, not legal advice; the official text controls. Black Belt Safety is not part of OSHA or the Department of Labor.