Location of Medical Supervision Records

Medical supervision is addressed in Title 3, California Code of Regulations (3CCR) section 6728. Subsection (c)(3) lists the records the employer is required to keep:

• The agreement (with the medical supervisor).
• The use (exposure) records.
• Recommendations from the medical supervisor.
• The results of cholinesterase (ChE) tests performed.

The section starts by requiring the employer to keep these records. It goes on to additionally require that they be maintained for three years and be made available for inspection by specified officials. Department of Pesticide Regulation (DPR) has historically interpreted this section to require that these records be retained at the employer´s headquarters location. We have been asked if the medical supervisor could retain the records, on behalf of the employer. The need for confidentiality of personal medical information is cited as a reason for having the doctor hold the records.

With the exception of the ChE test results, there should be no confidentiality issues generated by retention of these records. It is DPR’s interpretation that these records must be retained by the employer at a business location within the State, with the exception of ChE test results. The employer must maintain a record identifying the employee and the dates of tests when having the actual test results retained by the medical supervisor.

When this section was originally adopted in 1973, confidentiality was not the issue that it is today. As you are aware, there have been several State and federal laws adopted in recent years protecting the confidentiality of personal information. The interpretation and application of 3CCR section 6728 must be reevaluated in light of these more recent laws. It is reasonable for the employer to have the medical supervisor retain the confidential medical information (the test results).

Enforcement of medical supervision requirements should focus first on it being in place when required and secondly on the employer implementing the recommendations of the medical supervisor. The other required records should allow you to effectively enforce this section without routinely reviewing the actual ChE test results. If you have concerns about the completeness of the employer´s records, follow-up with the medical supervisor may be necessary. The identity of the medical supervisor can be obtained from available records (the contract).

If you or other officials have a need to review the actual test results, the records can be obtained from the medical supervisor through legally provided procedures. The Worker Health and Safety Branch can provide guidance in this area.

If you have further questions about retention of medical supervision records, contact the Enforcement Branch Liaison assigned to your county.

Sincerely,