1926.1101(m)(2): Asbestos Medical Exams
Employers must make medical exams and consultations available to covered asbestos workers before assignment to areas where negative-pressure respirators are worn, within 10 working days after the thirtieth day of exposure when exposure or Class I, II or III work reaches 30 or more days per year, and at least annually after that, or more often if the physician says so.
Key takeaways
- 1926.1101(m)(2) is part of OSHA's construction standards (29 CFR Part 1926, Subpart Z).
- OSHA cited it 70 times in the last 3 years, in 59 inspections, with $1,640 in current penalties.
- Most citations: MI (68), MD (1), TN (1).
- 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) ("Medical examinations and consultations") is one requirement inside 1926.1101 Asbestos, an OSHA construction standard (Part 1926, Subpart Z). It includes 11 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
(2) Medical examinations and consultations — 70 citations
(i) Frequency. The employer shall make available medical examinations and consultations to each employee covered under paragraph (m)(1)(i) of this section on the following schedules: Open (m)(2)(i) 28 citations
(A) Prior to assignment of the employee to an area where negative-pressure respirators are worn;
(B) When the employee is assigned to an area where exposure to asbestos may be at or above the permissible exposure limit for 30 or more days per year, or engage in Class I, II, or III work for a combined total of 30 or more days per year, a medical examination must be given within 10 working days following the thirtieth day of exposure; 1 citations
(C) And at least annually thereafter. 2 citations
(D) If the examining physician determines that any of the examinations should be provided more frequently than specified, the employer shall provide such examinations to affected employees at the frequencies specified by the physician.
(E) Exception: No medical examination is required of any employee if adequate records show that the employee has been examined in accordance with this paragraph within the past 1-year period.
(ii) Content. Medical examinations made available pursuant to paragraphs (m)(2)(i)(A) through (m)(2)(i)(C) of this section shall include: Open (m)(2)(ii) 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 | 31 |
| 2025 | 27 |
| 2026 | 12 |
Top states: MI (68), MD (1), TN (1)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| QUALITY NRG SOLUTIONS LLC | NEWBERRY, MI | $400 |
| ACE EXCAVATING & GRAVEL INC. | KALAMAZOO, MI | $250 |
| SAFE ENVIRONMENTAL CORPORATION | MIDLAND, MI | $240 |
| DETROIT ENVIRONMENTAL SOLUTIONS, LLC | FLINT, MI | $200 |
| ENVIRONMENTAL CONSTRUCTION SPECIALISTS - MICHIGAN LLC | GARDEN CITY, MI | $200 |
Free toolbox talk
A 5-minute crew talk on 1926.1101(m)(2), 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)(4) Physician's written opinion 42 citations
- 1926.1101(m)(4)(i) 42 citations
- 1926.1101(m)(2)(ii) Content 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
When is the first asbestos medical exam due?
Prior to assignment to an area where negative-pressure respirators are worn, and within 10 working days following the thirtieth day of exposure when the 30-day threshold is met.
How often after that?
At least annually thereafter, or more often if the examining physician determines it is needed.
Is an exam needed if one was done recently?
No exam is required if adequate records show the employee was examined under this paragraph within the past 1-year period.
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.