1910.1027(l)(2): Initial Cadmium Medical Exam
Employers must give an initial (preplacement) medical exam to all employees in the cadmium medical surveillance program within 30 days after initial assignment to a job with cadmium exposure, or no later than 90 days after the section's effective date, whichever is later. The exam includes a detailed medical and work history and biological monitoring of cadmium in urine, beta-2 microglobulin in urine and cadmium in blood.
Key takeaways
- 1910.1027(l)(2) is part of OSHA's general industry standards (29 CFR Part 1910).
- OSHA cited it 2 times in the last 3 years, in 2 inspections, with $13,643 in current penalties.
- 1 death is linked to inspections that cited this rule.
- Related part: 1910.1027(l) Medical surveillance (5 citations).
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In this article
What this rule covers
29 CFR 1910.1027(l)(2) ("Initial examination") is one requirement inside 1910.1027 Cadmium, an OSHA general industry standard (Part 1910). It includes 5 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) Initial examination. 2 citations
(i) The employer shall provide an initial (preplacement) examination to all employees covered by the medical surveillance program required in paragraph (l)(1)(i) of this section. The examination shall be provided to those employees within 30 days after initial assignment to a job with exposure to cadmium or no later than 90 days after the effective date of this section, whichever date is later. Open (l)(2)(i) 1 citations
(ii) The initial (preplacement) medical examination shall include: 1 citations
(A) A detailed medical and work history, with emphasis on: Past, present, and anticipated future exposure to cadmium; any history of renal, cardiovascular, respiratory, hematopoietic, reproductive, and/or musculo-skeletal system dysfunction; current usage of medication with potential nephrotoxic side-effects; and smoking history and current status; and
(B) Biological monitoring that includes the following tests: 1 citations
(1) Cadmium in urine (CdU), standardized to grams of creatinine (g/Cr);
(2) Beta-2 microglobulin in urine (β2-M), standardized to grams of creatinine (g/Cr), with pH specified, as described in appendix F to this section; and
(3) Cadmium in blood (CdB), standardized to liters of whole blood (lwb).
(iii) Recent Examination: An initial examination is not required to be provided if adequate records show that the employee has been examined in accordance with the requirements of paragraph (l)(2)(ii) of this section within the past 12 months. In that case, such records shall be maintained as part of the employee's medical record and the prior exam shall be treated as if it were an initial examination for the purposes of paragraphs (l)(3) and (4) of this section.
Source: eCFR, text current as of 2026-10-15. Read all of 1910.1027.
Export the list: 2 inspections cited 1910.1027(l)(2) in the last 3 years, with employer, location, penalty and date.
Purple Belt, $59/moInjuries linked to this rule
1 death is linked to inspections where OSHA cited 1910.1027(l)(2).
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
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OSHA interpretation letters
None exist. OSHA has not published a letter of interpretation for 1910.1027(l)(2).
Related parts of this rule
- 1910.1027(l) Medical surveillance 5 citations
- 1910.1027(l)(2)(i) 1 citations
- 1910.1027(l)(4)(ii)(C)
- 1910.1027(l)(4)(ii)
- 1910.1027(l)(4) Periodic medical surveillance
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Frequently asked questions
When must the initial exam be given?
Within 30 days after initial assignment to a job with cadmium exposure, or no later than 90 days after the effective date, whichever is later.
What tests are included?
Cadmium in urine, beta-2 microglobulin in urine and cadmium in blood.
Can a recent exam count?
Yes, if adequate records show the employee was examined as required within the past 12 months.
About this page
Sources
- 29 CFR 1910.1027 (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 2026-11-06
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.