1910.1026(k): Chromium (VI) Medical Surveillance
Employers must offer free medical surveillance, at a reasonable time and place, to employees exposed to chromium (VI) at or above the action level for 30 or more days a year, those with signs or symptoms, and those exposed in an emergency. Exams must be done by or under a PLHCP, at set times including within 30 days of initial assignment, annually, and at termination, and include work history and a skin and respiratory exam.
Key takeaways
- 1910.1026(k) is part of OSHA's general industry standards (29 CFR Part 1910).
- OSHA cited it 23 times in the last 3 years, in 22 inspections, with $88,424 in current penalties.
- 1 death is linked to inspections that cited this rule.
- Most citations: MI (7), WI (4), TN (2).
- Related part: 1910.1026(k)(1) General (18 citations).
- Free 5-minute toolbox talk for your crew below.
In this article
What this rule covers
29 CFR 1910.1026(k) ("Medical surveillance") is one requirement inside 1910.1026 Chromium (VI), an OSHA general industry standard (Part 1910). It includes 29 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
(k) Medical surveillance — 23 citations
(1) General. Open (k)(1) 18 citations
(i) The employer shall make medical surveillance available at no cost to the employee, and at a reasonable time and place, for all employees: Open (k)(1)(i) 18 citations
(A) Who are or may be occupationally exposed to chromium (VI) at or above the action level for 30 or more days a year; 8 citations
(B) Experiencing signs or symptoms of the adverse health effects associated with chromium (VI) exposure; or 1 citations
(C) Exposed in an emergency.
(ii) The employer shall assure that all medical examinations and procedures required by this section are performed by or under the supervision of a PLHCP.
(2) Frequency. The employer shall provide a medical examination: Open (k)(2) 4 citations
(i) Within 30 days after initial assignment, unless the employee has received a chromium (VI) related medical examination that meets the requirements of this paragraph within the last twelve months; Open (k)(2)(i) 1 citations
(ii) Annually; 3 citations
(iii) Within 30 days after a PLHCP's written medical opinion recommends an additional examination;
(iv) Whenever an employee shows signs or symptoms of the adverse health effects associated with chromium (VI) exposure;
(v) Within 30 days after exposure during an emergency which results in an uncontrolled release of chromium (VI); or
(vi) At the termination of employment, unless the last examination that satisfied the requirements of paragraph (k) of this section was less than six months prior to the date of termination.
(3) Contents of examination. A medical examination consists of:
(i) A medical and work history, with emphasis on: Past, present, and anticipated future exposure to chromium (VI); any history of respiratory system dysfunction; any history of asthma, dermatitis, skin ulceration, or nasal septum perforation; and smoking status and history;
(ii) A physical examination of the skin and respiratory tract; and
(iii) Any additional tests deemed appropriate by the examining PLHCP.
(4) Information provided to the PLHCP. The employer shall ensure that the examining PLHCP has a copy of this standard, and shall provide the following information:
(i) A description of the affected employee's former, current, and anticipated duties as they relate to the employee's occupational exposure to chromium (VI);
(ii) The employee's former, current, and anticipated levels of occupational exposure to chromium (VI);
(iii) A description of any personal protective equipment used or to be used by the employee, including when and for how long the employee has used that equipment; and
(iv) Information from records of employment-related medical examinations previously provided to the affected employee, currently within the control of the employer.
(5) PLHCP's written medical opinion. 1 citations
(i) The employer shall obtain a written medical opinion from the PLHCP, within 30 days for each medical examination performed on each employee, which contains: 1 citations
(A) The PLHCP's opinion as to whether the employee has any detected medical condition(s) that would place the employee at increased risk of material impairment to health from further exposure to chromium (VI);
(B) Any recommended limitations upon the employee's exposure to chromium (VI) or upon the use of personal protective equipment such as respirators;
(C) A statement that the PLHCP has explained to the employee the results of the medical examination, including any medical conditions related to chromium (VI) exposure that require further evaluation or treatment, and any special provisions for use of protective clothing or equipment.
(ii) The PLHCP shall not reveal to the employer specific findings or diagnoses unrelated to occupational exposure to chromium (VI).
(iii) The employer shall provide a copy of the PLHCP's written medical opinion to the examined employee within two weeks after receiving it.
Source: eCFR, text current as of 2026-10-15. Read all of 1910.1026.
Injuries linked to this rule
1 death is linked to inspections where OSHA cited 1910.1026(k).
At 10:00 a.m. on February 23, 2024, an employee working as a machine operator for an aircraft parts manufacturer was working in the fabrication department. The employee inhaled plastic dust which led to the employee developing pneumonia. At 9:00 a.m. on May 2, 2024, the…
Where and how often it was cited
| Year | Citations |
|---|---|
| 2023 | 1 |
| 2024 | 7 |
| 2025 | 10 |
| 2026 | 5 |
Top states: MI (7), WI (4), TN (2), PA (2), IL (2)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| KEWAUNEE FABRICATIONS, L.L.C. | KEWAUNEE, WI | $13,005 |
| AERSALE COMPONENTS SOLUTIONS | RIO RANCHO, NM | $9,643 |
| CENTURION INDUSTRIES, INC. DBA A-LERT CONSTRUCTION SERVICES | DECATUR, IL | $9,457 |
| 161081 - IMET ALLOYS INC. | MONROE, NC | $7,530 |
| UNIVERSAL STAINLESS AND ALLOY PRODUCTS, INC. | BRIDGEVILLE, PA | $7,093 |
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A 5-minute crew talk on 1910.1026(k), plus alerts when this rule changes. Free.
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Related parts of this rule
- 1910.1026(k)(1) General 18 citations
- 1910.1026(k)(1)(i) 18 citations
- 1910.1026(k)(2) Frequency 4 citations
- 1910.1026(k)(2)(i) 1 citations
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Frequently asked questions
Who must be offered chromium (VI) medical surveillance?
Employees exposed at or above the action level for 30 or more days a year, those with signs or symptoms, and those exposed in an emergency.
How often are exams given?
Within 30 days after initial assignment (unless a qualifying exam was done in the last twelve months), annually, and at other listed times such as after an emergency exposure and at termination.
What does the exam include?
A medical and work history and a physical exam of the skin and respiratory tract, among other items.
About this page
Sources
- 29 CFR 1910.1026 (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.