Medical Surveillance Update

1. Medical Surveillance Update Peter D. Lichty, MD MOH FACOEM April, 2012

2. Medical Surveillance at LBNL • This update (driven by CHESS implementation) primarily consists of automation and record-keeping changes • There are no changes to the underlying requirements – no new requirements in initial implementation (some under development) • Most of the exams are voluntary (but must be offered) • Declination will now be documented (required by regulation) • Electronic declination option is now available • Types of exams • Voluntary • Mandatory • Under development

3. Division Safety Coordinator Meeting

4. Division Safety Coordinator Meeting

5. Mandatory Offer (Voluntary) Exams This list is not exhaustive

6. Mandatory Required Exams This list is not exhaustive

7. New Surveillance Groups under Development • Animal researchers, colony maintenance staff. • Nanoparticle workers • Pre-Placement • These new requirements will go through formal policy development and be implemented later.

8. Surveillance Program Numbers • Surveillance Enrollments: • About 1200 people currently enrolled in surveillance • About 2200 people-groups (many people in multiple groups) • Roughly 15% of these people are affiliates • About 70 to 110 people have exams currently due, which is slightly above the normal monthly rate • Changes due to improved assignment & recordkeeping (to be phased in over 4-6 months): • About 10% of the people included in the numbers listed above have newly due exams (missed before for either inclusion or repeat) • About 8% of the people who were originally in mandatory surveillance are either no longer in surveillance or are now in voluntary surveillance

9. Key Changes:Surveillance Group Reports • New access to reports: • Examinee List by Division – specify division at whatever level you wish • Examinee list by Supervisor – specify supervisor • Group members by Job Title – specify job title • Individual Status Report – Medical Surveillance Group enrollment and exam status by individual • Individual can look up information about their enrollments in Medical Surveillance Group(s).

10. Other Key Changes • Email notification of initial enrollment to employee and supervisor to allow verification of “correctness” of placement • Exam credit given for “equivalent exams” – reduces the number of times must visit the clinic • Declinations of exams must be signed via either electronic or physical signature (legal requirement not enforced before) • Formal escalation process for people who decline a mandatory required exam (including removal from group and work if not resolved)

11. Stakeholder Participation • Process Approach was reviewed & approved in early May 2011 by a group which included: • Two Facilities supervisors • Two Division Safety Coordinators • Three Medical Surveillance Group leads • Three clinic staff (in addition to senior EHS staff) Division Safety Coordinator Meeting

12. Demonstration of CHESS Randy Roig, PhD EHS Division Office SME Training Class 3.25.12

13. Key Demonstration Points • Typical Declination Screen • Reports • Individual • Division • Supervisor • Notification Email Division Safety Coordinator Meeting

14. Notification Email to Individual • You have been enrolled in the following medical surveillance program:Program: Hearing ConservationPlease contact the health clinic at (510) 486-6266 to schedule your appointment. If you feel that this enrollment is in error, please contact the following person to discuss it with them:Subject Matter Expert/Program Manager: Herb ToorPhone: 510-486-5918 SME Training Class 3.25.12