NEHC-TM OM-6260, MEDICAL SURVEILLANCE PROCEDURES MANUAL AND MEDICAL MATRIX (EDITION 7) (FEB 2001)

NEHC-TM OM-6260, MEDICAL SURVEILLANCE PROCEDURES MANUAL AND MEDICAL MATRIX (EDITION 7) (FEB 2001)., Published By NAVY ENVIRONMENTAL HEALTH CENTER 2510 WALMER AVENUE NORFOLK, VIRGINIA 23513-2617. 1.1 Medical screening examination as part of a medical surveillance program is one of several tools aimed at protecting workers who are exposed or potentially exposed to hazardous substances in the workplace. A medical surveillance program includes establishing exam content, performing occupational medical examinations, documenting results of examinations, informing the employee of the results of examination, following up abnormalities, counseling and education, and evaluating grouped data for trends and sub-clinical effects of exposure. Selection of personnel for medical surveillance programs is based primarily on the results of the industrial hygiene survey and is exposure driven. This is known as "hazard based" medical surveillance. In the absence of industrial hygiene data, medical personnel will make a decision on placement in medical surveillance programs based on knowledge of the workplace processes, job requirements, and occupational history. Exam content is established in the Medical Matrix for performing hazard based medical examinations and certification examinations. This document establishes the minimum requirements for medical surveillance and certification examinations. (OPNAVINST 5100.23 series.) Special attention in performing occupational medical examinations is given to those target organs or organ systems potentially subject to the untoward effects of hazardous substances whether by inhalation, absorption or ingestion. Elements of examination include specific history questions (personal and family medical history, and work history), physical examination, x-ray, biological monitoring (testing of body fluids or tissues for the toxic substance itself, a metabolite or a physiologic change), and other laboratory and ancillary tests such as EKG, PFT and audiogram. Conducting occupational medical examinations to detect early organ dysfunction or early disease to benefit individual workers is "screening" or "monitoring" and constitutes secondary prevention. An integral component of the occupational medical examination is followup. Follow-up may include notification, additional tests or evaluation, evaluation or modification of the workplace or removal from exposure. Workers who receive occupational medical examinations should be informed of any specific health risks identified on examination. Certain OSHA programs require written notification in the form of Physician’s Written Opinions. Examples are included in Appendix E.