BY ORDER OF THE
SECRETARY OF THE AIR FORCE
DEPARTMENT OF THE AIR FORCE
MANUAL 48-146
1 DECEMBER 2022
Aerospace Medicine
OCCUPATIONAL HEALTH PROGRAM
MANAGEMENT
COMPLIANCE WITH THIS PUBLICATION IS MANDATORY
ACCESSIBILITY: Publications and forms are available for downloading or ordering on the e-
Publishing website at www.e-publishing.af.mil/
RELEASABILITY: There are no releasability restrictions on this publication.
OPR: AFMRA/SG3PB Certified by: AF/SG3/4
(Maj Gen Sharon R. Bannister)
Supersedes: AFMAN48-146, 15 October 2018 Pages: 113
This manual implements requirements of Department of the Air Force Instruction (DAFI) 48-145,
Occupational and Environmental Health and is consistent with Air Force Policy Document
(AFPD) 48-1, Aerospace & Operational Medicine Enterprise. It provides procedures for
successful management and operation of an Air Force installation occupational health (OH)
program. This publication applies to the entire Department of Air Force (DAF), including all
civilian employees and uniformed members of the Regular Air Force, the United States Space
Force, Air Force Reserve, and the Air National Guard and those with a contractual obligation to
abide by the terms of DAF issuances, except where noted otherwise. This instruction does not
apply to DAF units receiving OH support from other military services under joint basing
agreements. The lead service under the joint basing agreement will provide OH support according
to their regulations and guidance. The supported unit is responsible for ensuring compliance with
the tracking and completion of occupational health exams and training requirements. This manual
does not apply to DAF contractor personnel and contractor operations. The contractor is directly
responsible for safety and health risks to their personnel and the protection of the public, except
where DAF has contractually agreed to assume responsibility for the protection of contract
employee’s health and/or compliance with Occupational Safety and Health Administration
(OSHA) requirements. This instruction does not prohibit providing workplace sampling and
survey information to contractors subject to local arrangements. This manual follows guidelines
for exposure health strategies as described in the American Industrial Hygiene Association’s A
Strategy for Assessing and Managing Occupational Exposures (4th Edition). It also incorporates
risk management (RM) principles into the OH program. Additionally, it specifies the exposure
limits and hierarchy of controls that will be used in DAF workplaces. Compliance with the
