(a) Initial. The health of persons doing spray coating may be injured by inhaling such substances as lead, poisonous solvents, especially benzol, or finely divided siliceous material. To render complete protection to spray operators from these hazards it is recommended that operators be given a physical examination, including X-ray examinations, previous to or within one week of employment, with the following two objects in view:

1. (1) To determine whether they have any physical defects which might be made worse by their employment.
2. (2) To obtain a record of their physical condition for comparison with succeeding examinations.

(b) Follow up. The following frequency of examinations is recommended:

1. (1) Periodic examinations of persons spraying lead or poisonous solvents should be made at least once every 6 months and should include white and red blood cell counts, differential white cell counts, and an estimation of the amount of hemoglobin.
2. (2) The periodic examinations of persons spraying vitreous enamel or other siliceous materials should be made at least once every 2 years and should include an X-ray examination of the chest.

(c) Guidelines for restricting employment. It is recommended that there be compliance with the following:

1. (1) No person should be permitted to perform the work of a spray operator or to come in contact in any way with spray coating operations if the results of an examination made of his blood show any evidence of a disturbance that would be aggravated by exposure to lead or benzol or any evidence of lead or benzol absorption as indicated by any of the following findings:

   1. (i) The presence of 70 stipple cells per 100,000.
   2. (ii) A distinct evidence of anemia as shown by hemoglobin under 12 grams per 100 cubic centimeters of blood, or red cells under 4 million per cubic millimeter for men, and 3.8 million for women.
   3. (iii) A total white cell count under 5,600 per cubic millimeter, or a total polymorphonuclear cell count under 4,000 per cubic millimeter. When a second or succeeding differential count is more than 5% lower in polymorphonuclear cells than the preceding one, the individual should be reexamined in one month, or sooner if he appears to be in poor physical condition. If the recount made on such examination shows the condition to be progressive, he should not be permitted to continue spraying, regardless of his physical condition in other respects.
2. (2) No person should be permitted to spray vitreous enamel or other siliceous materials if an X-ray examination of his chest shows the presence of fibrosis or active tuberculosis. Any evidence of developing fibrosis at subsequent examinations should call for a change of occupation. Any evidence of progressive lead absorption by such persons, as indicated by the increase of stipple cells, should likewise call for a change of occupation.