The periodic medical examination, 29 CFR 1910.1027(l)(4)(ii) shall include:

• A detailed medical and work history, 29 CFR 1910.1027(l)(4)(ii)(A), with emphasis on:
  1. Past, present and anticipated future exposure to cadmium;
  2. Smoking history and current status; reproductive history;
  3. Current use of medications with potential nephrotoxic side-effects;
  4. History of renal, cardiovascular, respiratory, hematopoietic, and/or musculo-skeletal system dysfunction; and
  5. For employees who wear respirators, see Appendix D (questions 3-11 and 25-32).
• A complete physical examination, 29 CFR 1910.1027(l)(4)(ii)(B), with emphasis on: blood pressure, the respiratory system, and the urinary system.
• A 14 inch by 17 inch, or a reasonably standard sized posterior-anterior chest X-ray (after the initial X-ray, the frequency of chest X-rays is to be determined by the examining physician) 29 CFR 1910.1027(l)(4)(ii)(C).
• Pulmonary function tests, including forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV(1)) 29 CFR 1910.1027 (l)(4)(ii)(D).
• Biological monitoring, as required in paragraph 29 CFR 1910.1027(l)(2)(ii)(B).
• Blood analysis 29 CFR 1910.1027(l)(4)(ii)(F), in addition to the analysis required under paragraph 29 CFR 1910.1027(l)(2)(ii)(B), including blood urea nitrogen, complete blood count, and serum creatinine.
• Urinalysis 29 CFR 1910.1027(l)(4)(ii)(G), in addition to the analysis required under paragraph 29 CFR 1910.1027(l)(2)(ii)(B), including the determination of albumin, glucose, and total and low molecular weight proteins.
• For males over 40 years old, prostate palpation, or other at least as effective diagnostic test(s) 29 CFR 1910.1027(l)(4)(ii)(H).
• Any additional tests deemed appropriate by the examining physician 29 CFR 1910.1027(l)(4)(ii)(I).

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