1926.1101(m)(4)(i): Contents of the Asbestos Written Opinion
Employers must obtain a written opinion from the examining physician that contains the exam results, whether the worker has conditions placing them at increased risk from asbestos, any recommended limits on the worker or on respirator use, and statements that the worker was informed of the results and of the increased lung cancer risk from smoking combined with asbestos exposure.
Key takeaways
- 1926.1101(m)(4)(i) is part of OSHA's construction standards (29 CFR Part 1926, Subpart Z).
- OSHA cited it 42 times in the last 3 years, in 42 inspections, with $670 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)(4)(i) 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
(i) The employer shall obtain a written opinion from the examining physician. This written opinion shall contain the results of the medical examination and shall include: 42 citations
(A) The physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos;
(B) Any recommended limitations on the employee or on the use of personal protective equipment such as respirators; and
(C) A statement that the employee has been informed by the physician of the results of the medical examination and of any medical conditions that may result from asbestos exposure.
(D) A statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure.
Source: eCFR, text current as of 2026-10-15. Read all of 1926.1101.
Where and how often it was cited
| Year | Citations |
|---|---|
| 2024 | 18 |
| 2025 | 16 |
| 2026 | 8 |
Top states: MI (42)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| ATLAS SERVICE GROUP, LLC | BURTON, MI | $250 |
| MID-MICHIGAN MANAGEMENT, L.L.C. | OKEMOS, MI | $120 |
| ATLAS SERVICE GROUP, LLC | BERKLEY, MI | $100 |
| BOLLE CONTRACTING, LLC | FLINT, MI | $100 |
| ACE EXCAVATING & GRAVEL INC. | KALAMAZOO, MI | $100 |
Free toolbox talk
A 5-minute crew talk on 1926.1101(m)(4)(i), plus alerts when this rule changes. Free.
OSHA interpretation letters
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)(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
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Frequently asked questions
Who must get the written opinion?
The employer, from the examining physician.
Does it include respirator limits?
Yes, any recommended limitations on the employee or on the use of PPE such as respirators.
What does it say about smoking?
It must state the employee was informed of the increased lung cancer risk from the combined effect of smoking and asbestos exposure.
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 2026-10-19
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.