1. Objectives
1.1 Establish complementary guidelines and parameters in the PCMSO for health surveillance of employees occupationally exposed to carcinogenic chemical substances and ionizing radiation, based on the information provided by the Risk Management Program (PGR), aiming at the prevention and detection of cancer and work-related pre-cancerous lesions and alterations.
2. Scope
2.1 This Annex applies to organizations that produce, transport, store, use, or handle carcinogenic chemical substances, with CAS registration, as indicated in the PGR Risk Inventory, liquid mixtures containing a concentration equal to or greater than 0.1% (zero point one percent) by volume of these substances, or gaseous mixtures containing these substances, and to organizations whose work processes expose their employees to ionizing radiation.
3. Guidelines
3.1 The occupational health physician responsible for the PCMSO must record in the PCMSO the activities and functions within the organization that involve occupational exposure to ionizing radiation and carcinogenic chemical substances, as identified and classified in the PGR.
3.1.1 The physician responsible for the PCMSO must guide the physicians conducting the clinical examination of these employees on the importance of identifying lesions and clinical or laboratory alterations that may be related to occupational exposure to carcinogenic chemical substances and ionizing radiation.
4. Carcinogenic Chemical Substances
4.1 The medical records of employees exposed to carcinogenic chemical substances must be kept for a minimum period of 40 (forty) years after the employee’s termination.
4.1.1 Complementary exams for employees exposed to carcinogenic chemical agents, as informed in the organization’s PGR, are mandatory when occupational exposure exceeds 10% (ten percent) of occupational exposure limits, or when there is no environmental assessment, and must be conducted and interpreted based on the criteria set forth in this NR.
4.2 Benzene
4.2.1 Health surveillance actions for employees exposed to benzene must follow the provisions of Instruction No. 2, dated December 20, 1995, of SSST/Ministry of Labor, and in the Consolidation Ordinance No. 5, Annexes LXVIII, LXIX, LXX, and LXXI, dated September 28, 2017, of the Ministry of Health.
5. Ionizing Radiation
5.1 Employees must be evaluated in the admission medical examination, return to work, or change of risk examination, regarding their fitness to perform activities in controlled or supervised areas, based on the information from the PGR and the classification of the National Nuclear Energy Commission (CNEN) (CNEN NN 3.01) for areas of work with radiation or radioactive material.
5.1.1 The information about fitness or unfitness to perform activities with exposure to radiation or radioactive material must be recorded in the employee’s Occupational Health Certificate (ASO).
5.2 In cases of occupational exposure above the annual dose limit of ionizing radiation, whether effective or equivalent, a new medical evaluation of the employee must be conducted to determine their continued activity, with a new ASO being issued.
5.3 In cases of accidental occupational exposure to high levels of ionizing radiation, a new medical evaluation must be conducted, including a complete blood count immediately and 24 hours after exposure.
5.4 The medical records of employees exposed to ionizing radiation must be kept until the employee reaches the age of 75 and for at least 30 (thirty) years after the employee’s termination.