Fillable Exposure To Health Risks Physical Demands Form (Page 7 of 7) in pdf

Exposure To Health Risks Physical Demands Form Page 7

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2-Acetylaminofluorene

4-Aminodiphenyl

Benzidine

Bis-chloromethyl ether

3,3'-Dichlorobenzidine (and salts)

4-Dimethylaminoazobenzene

Ethyleneimine

Methyl chloromethyl ether

Alpha-naphthylamine

Beta-naphthylamine

4-Nitrobiphenyl

N-nitrosodimethylamine

Exposure is with or without respiratory protection devices. Laboratory

workers do not routinely have significant exposures unless a spill or leak

occurs. Significant exposures can occur if fume hoods, or containment

devices fail, or if safe work practices are not followed.

Using large

quantities of volatile chemicals outside of a fume hood, or in confined or

poorly ventilated areas may result in significant exposures. For more

information, call EHS at 355-0153.

Required monitoring/training: To be determined based on evaluation by EHS and OH

10. Physically intensive job. Physical demands testing is required for any employee (except students) in a

physically intensive job BEFORE the employee may begin work.

a. Complete the PHYSICAL DEMANDS SECTION indicating the physical demands of the job.

b. Fax a copy of the completed form and a brief description of the job or posting text, to the MSU

Occupational Health Office at 355-0332.

c. Schedule the pre-placement physical demands testing by calling MSU Occupational Health

Office, 353-9137.

d. The supervisor will be notified by fax of any restrictions by Occupational Health.

e. If an employee is physically incapable in any essential function, the supervisor should review

the restriction to see if a reasonable accommodation can be made. The supervisor should call

Staffing Services in Human Resources at 353.3720 for assistance with this review. If it is

determined the candidate cannot perform the essential functions of the job with an

accommodation, the job offer should be withdrawn.

Exposure To Health Risks Physical Demands Form Page 7

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