An OSHA-compliant silica physical exam requires a medical and work history review, a focused physical examination, and specific diagnostic tests including a chest X-ray and lung function test.

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Exam Schedule

• Initial Exam: Given when first hiring or before starting work that involves silica exposure.

• Periodic Exams: Required at least every 3 years thereafter, or more frequently if recommended by the examining medical professional. 

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Required Components

• Medical & Work History: Focuses on past and present silica or dust exposure, respiratory symptoms (cough, shortness of breath), smoking history, and tuberculosis history. 

• Physical Exam: A clinical check with a strong focus on the respiratory and cardiovascular systems. 

• Chest X-Ray: A single posteroanterior view at full inspiration, interpreted and classified by a NIOSH-certified "B" reader using International Labor Office (ILO) standards. 

• Pulmonary Function Test (PFT): Spirometry testing measuring forced vital capacity (FVC) and forced expiratory volume (FEV1), run by a certified technician.

• Tuberculosis Test: Screening for latent TB (skin test or IGRA blood test), which is only required on the initial exam. 

• Written Opinion: The healthcare professional must provide the employer and employee with a written medical report detailing clearance and limitations.