1. (a) Purpose. This section implements the Texas Occupational Conditions Reporting Act, Health and Safety Code, Chapter 84, House Bill 2091, 69th Legislature, 1985, which authorizes the Texas Board of Health to adopt rules concerning the reporting and control of occupational conditions.

2. (b) Definitions. The following words and terms, when used in these sections, shall have the following meanings unless the context clearly indicates otherwise.

   1. (1) Case--A person in whom an occupational condition is diagnosed by a physician based upon clinical evaluation, interpretation of laboratory and/or roentgenographic findings, and an appropriate occupational history.
   2. (2) Commissioner--The commissioner of health.
   3. (3) Department--The Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756.
   4. (4) Local health authority--The chief administrative officer of a public health district or a local health department, or the physician who is to administer state and local laws relating to public health.
   5. (5) Occupational conditions--Those diseases, abnormal health conditions or laboratory findings that are caused by or are related to exposures in the workplace.
   6. (6) Reportable occupational condition--Any occupational disease, condition or laboratory finding for which an official report is required. See subsection (d) of this section.
   7. (7) Report of occupational condition--The notification to the appropriate authority of the occurrence of a specific occupational disease in a human, including all information required by the procedures established by the Board of Health.
   8. (8) Suspected case--A case in which an occupational condition is suspected, but the final diagnosis is not yet made.

3. (c) Reporting requirements.

   1. (1) It is the duty of every physician holding a license to practice in the State of Texas to report promptly to the local health authority each patient she or he shall examine and who has or is suspected of having any reportable occupational condition. The local health authority may authorize a staff member to transmit reports.
   2. (2) It is the duty of every person who is in charge of a clinical or hospital laboratory, blood bank, mobile unit, or other facility in which a laboratory examination of any specimen derived from a human body yields microscopical, cultural, serological, chemical, or other evidence suggestive of a reportable condition to report promptly that information to the local health authority.
   3. (3) The reporting physician or laboratory director shall make the report in writing. A local health authority may authorize one or more employees under his or her supervision to receive the report from the physician or laboratory director by telephone; use of this alternative, if authorized, is at the option of the reporter. The local health authority shall implement a method for verifying the identity of the telephone caller when that person is unfamiliar to the employee.

   4. (4) The local health authority shall collect the reports and transmit the information at weekly intervals to the Environmental Epidemiology and Toxicology Division, Bureau of Epidemiology, Texas Department of Health, 1100 West 49th Street, Austin, Texas 78756. Transmission may be made by mail, courier, or electronic transfer.

      1. (A) If by mail or courier, the reports shall be placed in a sealed envelope addressed to the attention of the Environmental Epidemiology and Toxicology Division, Bureau of Epidemiology, Texas Department of Health, 1100 West 49th Street, Austin, Texas, 78756, and marked "Confidential Medical Records."
      2. (B) If by electronic transmission, including facsimile transmission by telephone, it shall be in a manner and form authorized by the commissioner or his or her designee in each instance. Any electronic transmission of the reports must provide at least the same degree of protection against unauthorized disclosure as those of mail or courier transmission. The commissioner or his or her designee shall, before authorizing such transmission, establish guidelines for establishing and conducting such transmission.
   5. (5) When an occupational condition is reported to a local health authority, and the person diagnosed as having the condition resides outside his or her area of local health jurisdiction, the local health authority receiving the report shall notify the appropriate local health authority where the person or persons reside. The department shall assist the local health authority in providing such notifications if requested.
4. (d) List of reportable occupational conditions. Occupational conditions reportable by name, address, age, sex, race/ethnicity, method of diagnosis, and relevant occupation(s) and employer(s) of the case, and identity of the reporter, are: asbestosis, silicosis, blood lead levels at or above 25 micrograms lead/100 milliliters of blood in persons 15 years of age or older, and acute occupational pesticide poisoning.

5. (e) General control measures for reportable occupational conditions. The commissioner or his or her duly authorized representative shall, as circumstances may require, proceed as follows:

   1. (1) investigation shall be made for the purpose of verifying the diagnosis, ascertaining the source of the causative agent, obtaining an occupational and employment history and discovering unreported cases;
   2. (2) collection of specimens of the body tissues, fluids, or discharges and of materials directly or indirectly associated with the case, as may be necessary in confirmation of the diagnosis, and their submission to a laboratory for examination;
   3. (3) obtaining samples of air or materials from the current or former business or place of employment of a case, as may be necessary to ascertain if a public health hazard exists. If a hazard is found the commissioner or his/her designee shall make appropriate recommendations concerning the hazard.

6. (f) Confidential nature of case reporting.

   1. (1) All case reports received by the local health authority or the Texas Department of Health are confidential records and not public records. These records will be held in a secure location and accessed only by authorized personnel.
   2. (2) The department may use information obtained from reports or health records for statistical and epidemiological studies which may be public information as long as an individual is not identifiable.

Source Note:The provisions of this §99.1 adopted to be effective October 11, 1985, 10 TexReg 3766; amended to be effective March 1, 1998, 23 TexReg 1581; amended to be effective May 23, 2002, 27 TexReg 4357.