Safety Beyond the Suit: HazMat and HAZWOPER Health

Andrew Berry

HazMat and HAZWOPER employees face dangerous situations as a part of their job descriptions. These employees, typically differentiated by their full-body protective suits and, in many cases, respirators, are often on the front lines of emergencies and disasters. Their work is defined by its frequently strenuous tasks and a strong commitment to safety, governed by employers’ standards and government regulations. While HazMat suits and respirators keep workers safe in the moment, HazMat and HAZWOPER physicals help employees and their employers monitor for exposures and the potential health impacts of hazardous materials and chemicals. At Concentra®, our HazMat and HAZWOPER physicals are designed to ensure the efficacy of employers’ environmental controls as well as help employers stay compliant with state and national regulations.

The hazardous in HazMat and HAZWOPER

In the United States, hazardous materials are defined and regulated by four government agencies – the Occupational Safety and Health Administration (OSHA), the Department of Transportation (DOT), the Environmental Protection Agency (EPA), and the United States Nuclear Regulatory Commission (U.S.NRC).1 In the occupational health space, most employers are held to the standards set by DOT for transportation of hazardous materials and OSHA for employees who interact with hazardous materials. DOT defines hazardous materials as “any chemical or item that is a risk to public safety or the environment when being transported or moved in commerce” but does not extend to the health of the employees transporting such materials.2

OSHA’s definition for hazardous materials covers “any substance or chemical which is hazardous to people’s health or is physically hazardous.”3 Substances that typically fall into this definition include chemicals that can be categorized as carcinogens, irritants, corrosives, toxic agents, sensitizers, and chemicals that can combust, explode, or become reactive. OSHA maintains a Hazard Communication Standard to ensure that employees who handle hazardous materials can access information about the chemicals and toxic substances in their workplace as well as the standards put in place to protect them. State and local government employees in states without OSHA-approved State Plans are governed by the EPA, which largely shares its hazardous materials definition with OSHA.4

What is the difference between HazMat and HAZWOPER?

HazMat and HAZWOPER are often used interchangeably, but this is inaccurate and can be confusing when it comes to the standards set by OSHA. HazMat is an abbreviation for “hazardous materials” and is most often used as an umbrella term for all work with hazardous materials, from transportation to disaster cleanup. HAZWOPER is an abbreviation for “Hazardous Waste Operations and Emergency Response.” HAZWOPER is an OSHA standard and requires employers to protect workers and enable them to handle hazardous substances safely and effectively. The HAZWOPER standard applies to employees in the following general work categories:5

  • Hazardous waste site cleanup operations
  • Operations involving hazardous waste that are conducted at treatment, storage, and disposal facilities
  • Emergency response operations involving hazardous substance releases

The HAZWOPER standard brings clarity to employers, emergency response workers, and any other employees who may be exposed to hazardous materials, which, in turn helps improve workplace safety and health and reduce workplace injuries and illnesses that could occur from exposures to hazardous substances.6

Preventive health for hazardous work

Employees who fall under the HAZWOPER standard often work in emergency response jobs that involve the uncontrolled release of a hazardous substance. These emergencies are tightly defined by OSHA and include the below situational criteria:7

  • High concentration of toxic substances 
  • Environments that may be immediately dangerous to life or health
  • Situations that present an oxygen deficient atmosphere
  • Conditions that pose a fire or explosion hazard
  • Situations that require evacuation of an area
  • Situations that require immediate attention because of dangers posed to employees in the area

Such dangerous situations have the potential to expose these employees to a host of health challenges, illnesses, and injuries. OSHA mandates employers offer their employees working in potentially hazardous and toxic environments medical evaluations to screen for early health-related effects. Depending on the exposure, health effects can include skin and mucous membrane irritation, reproductive disorders, bone marrow changes, impaired liver and/or kidney function, and changes in the neurological, respiratory, and cardiovascular systems.8 The machinery utilized in HazMat and HAZWOPER environments often emit high decibel levels of noise with associated auditory risks, and may additionally pose risk of exposure to heat stress. Both noise and heat exposure can compound the risk of injury and illness in a hazardous work environment.

HazMat and HAZWOPER exams

HazMat medical surveillance falls under the HAZWOPER OSHA standard for general industry, 29 CFR 1910.120; and construction 29 CFR 1926.65.

A HazMat exam conducted by an established occupational health provider, like Concentra, will use a baseline physical exam similar to a basic employee physical. HazMat medical evaluations should be based on the required physical demands of the job assignment, personal protective equipment to be worn, the individual employee’s previous exposure, and current level of exposure. Recommended testing can include:9

  • Blood and urine samples to check for signs of exposure
  • Audiometry
  • Spirometry (lung function)
  • Chest X-ray
  • Electrocardiogram
  • Hepatitis B vaccine and testing (for employees falling under the Bloodborne Pathogen Standard)

HAZWOPER exams are more structured – the OSHA HAZWOPER standard mandates that employees must receive a HAZWOPER exam if they meet certain criteria:10

  • Are exposed to hazardous substances or health hazards at or above the permissible exposure levels (PELs) (or, if there is no PEL, above the published exposure levels for these substances), without regard to the use of respirators, for 30 days or more a year.
  • Wear a respirator for 30 days or more a year
  • Become sick or develop signs or symptoms due to possible overexposure
  • Work on a HAZMAT response team

A medical surveillance physical under the HAZWOPER standard must be completed before an employee starts the work assignment that falls under OSHA Standard 29 CFR 1910.120. Periodic exams are performed annually during the assignment, and an exit exam is performed at the conclusion of their assignment.11 The OSHA standard requires that the physical include a review of the employee’s medical and work history, with a special emphasis on symptoms related to the handling of hazardous substances and exposure to health hazards.12 The employee also must be certified as fit for duty, meaning they can perform the duties of the job while wearing any required personal protective equipment necessary due to the conditions expected at the worksite; this is typically a respirator but can extend to any equipment required by the work assignment. The HAZWOPER physical will also assess any abnormalities in function, agility, and strength as appropriate to the role’s demand.

Beyond the above requirements, the content of exam is left to the discretion of the clinician. A Concentra HAZWOPER exam may include any of the following diagnostic components:

  • Vision screening
  • Spirometry (lung function)
  • Chest X-ray
  • Audiometry
  • Liver and kidney function tests
  • Complete blood count
  • Urinalysis
  • Hepatitis B vaccine and testing (for employees falling under the Bloodborne Pathogen Standard)

Location matters

The experience and capabilities of an established occupational health provider are essential to an effective HazMat or HAZWOPER exam. A strong provider will have clinicians on staff who are well-versed in the demands and regulatory requirements of OSHA’s HAZWOPER standard. They will create an exam to fit the unique job site and assignment of every employee. Learn how you can protect and maintain the health of your HazMat employees by contacting a medical surveillance expert today.


  1. What Defines a Hazardous Material?,” MLI Environmental, 2017.
  2. How to Comply with Federal Hazardous Materials Regulations,” FMSCA, 2022.
  3. Ibid.
  4. Mandatory elements of a HAZWOPER baseline physical examination,” OSHA, 2012.
  5. Hazardous Waste Operations and Emergency Response (HAZWOPER),” OSHA, n.d.
  6. Ibid.
  7. Ibid.
  8. HazMat Physicals,” Vanderbilt University Medical Center, 2022.
  9. Workers’ Health,” National Institutes of Environmental Health Sciences, 2022.
  10. HazMat and HAZWOPER Physicals,” Concentra, n.d.
  11. Ibid.
  12. “1910.1020 - Access to Employee Exposure and Medical Records,” OSHA, 2011.