Occupational Medical Surveillance and Evaluation Program

1. Occupational Medical Surveillance and Evaluation Program

2. OMSEP- guidance • COMDTINST M5100.47 • Safety and Environmental Health Manual- Chapter 4 • COMDTINST M6000.1C • Medical Manual- Chapter12 • See MLCA Web Site for copy to download • Occupational Safety and Health Act & Specific OSHA regs

3. Medical Surveillance- purpose • To identify work related diseases or conditions: • at a stage when modifying the exposure or providing medical intervention could potentially: • arrest disease progression or prevent recurrences

4. Medical Surveillance -Objectives • identify pre-existing health conditions • provide risk specific periodic screenings • monitor clinical laboratory tests and biologic functions

5. OMSEP-Exam types • Initial/baseline • Civilian/military within 30 days • Employment • Reassignment (only if new exam protocols applies) • Only required once per career if continually enrolled • Periodic • Variable/usually annual • Acute exposure • Upon notification • Exit/separation • End of exposure • End of employment • Separation letter

6. OMMP Exam Protocols (old) Asbestos Benzene Lead Noise Respirator Wear Unspecified OMSEP Exam Protocols Asbestos Benzene Chromium Compounds Hazardous Waste Lead Noise Pesticides Respirator Wear* Respiratory Sensitizers Solvents Tuberculosis Bloodborne pathogens Radiation OMSEP - Exam Protocols

7. Who gets enrolled? • Anyone exposed > action level for 30+ days/year • Documented or likely to occur for 30+ days/year • ACDU/Reserve/CIV/AUX • What is “exposed?”

8. Who gets enrolled? • Some jobs require enrollment unless proved unnecessary • Marine Inspector, Pollution investigators, Marine Safety (general), Port safety, marine investigator, and fire fighters

9. OMSEP- Roles & Responsibilities • Unit • Appoint OMSEP Coordinator • Note who’s exposed • Submit enrollments • maintain unit-level tracking report • coordinate physical exam process with clinics • One coord can manage >1 unit • “transfer” member to new unit after member PCS • Guides @ MLCA(kse) CGWEB and OMSEP home: http://cgweb.lant.uscg.mil/KDiv/kseOMSEPTrainingGuide.htmand http://webapps.mlca.uscg.mil/kdiv/kseOMSEP/ • MLC(kse) Detached SEH Office • Worksite evaluation • Approve enrollment recommendations

10. OMSEP - Roles and Responsibilities • MLC (k) • OMSEP tracking report oversight • Physical exam oversight • Medical referral oversight • Maintain electronic tracking system • Provide guidance and training • Commandant (CG-1133) • Policy - Chapter 12 of Medical Manual • Overall Program Oversight- planning/expertise • Medical officer support on Occ. Health issues • Annual report of Occ. Health problems

11. ASBESTOS • Found in floor and roof tiles, popcorn ceilings and pipe lagging • Okay as long as it is intact • Dangerous if torn, cut, crumbing or disturbed

12. ASBESTOS • Airborne microscopic needles • Once inhaled, permanent damage • Asbestosis, Mesothelioma • Cigarette smoking

13. ASBESTOS

14. ASBESTOS

15. ASBESTOS

16. ASBESTOS

17. Asbestos Protocol • Acute exposure must be documented and confirmed • Once confirmed, member remains on protocol for next 30 years • Not based on “say-so”

18. BENZENE

19. BENZENE • Mandatory for Marine Inspectors prior to 1990 • Otherwise must have a confirmed documented exposure • Long-term career monitoring

20. BENZENE

21. BENZENE

22. CHROMATES

23. Hexavalent Chromium Compounds • Found in some paints, metal alloys and masonry cement • At Risk: paint booth operators, aircraft and boat painters • Can cause cancer, occupational asthma, dermatitis, skin ulcers • TLV 0.5 mg/m3 @ 30 Days/year

24. LEAD

25. LEAD

26. Lead Hazards • Inhaled or ingested • Acute anemia • Chronic health defects • Very dangerous to children under six. • Neurological damage • Action level 30mg/m3 of air

27. Lead Protocols • Gunner’s Mates • Firearms Instructors • Possibly LE teams • Painters or anyone chipping lead-based paints • Educate on workplace hygiene

28. NOISE

29. NOISE

30. NOISE • All aircrew and most boat crews • Cutter MKs, GMs, and ETs • Above 84db: 8 hr day/30 day per year • Impulse noise sound pressure above 140 db/30 day per year

31. NOISE • Baseline audiogram and annual audiogram • Can use audiogram in conjunction with another physical exam • If STS >25db at 500-3000 HZ is consistent, then the member will remain on the HCP even after exposure is over.

32. HAZARDOUS WASTE

33. HAZARDOUS WASTE

34. Hazardous Waste Protocol • Can be used to monitor many non-specific industrial exposures • Acute exposures • Will also monitor for Benzene

35. Blood-borne Pathogens

36. Blood borne Pathogens • Used for Acute exposures only • No longer automatic for Health Services Techs, EMTs or Rescue Swimmers • Follow treatment plans as outlined in MedMan

37. RESPIRATOR WEAR • WHY?

38. Respirator Wear • Initial physical exam if not current. Initial questionnaire • Questionnaire review every 5 years • Annual Fit Test

39. Respirator wear? • Start with COMDTINST M6260.2D, Resp. Protection • Per 62620.2D, don’t need to enroll in OMSEP just for respirator wear • But industrial workers may need enrollment in another protocol! • OMSEP protocol is suggested process for physician if unable to approve wear based on questionnaire in COMDTINST M6260.2D

40. Respiratory Sensitizers

41. Respiratory Sensitizers • Many types of chemicals and substances • 2 part epoxies, wood dust, silicon sprays • Long term exposure could = occupational asthma, cancer, etc.

42. Solvents

43. Solvents • Can be inhaled or absorbed through skin • Commonly used by MKs, DCs, ETs and painters. • Can cause rashes, neurological disorders and possibly birth defects in pregnant women

44. Pesticides

45. Tuberculosis

46. Tuberculosis

47. Ionizing Radiation

48. Potential Exposure • Medical/Dental Personnel • Boarding Teams • Marine Inspectors • MSSTs

49. OTHER

50. Acute exposure