USDA - ARS Occupational Medical Surveillance Program

1. USDA - ARS Occupational Medical Surveillance Program Medical Surveillance Issues OMSP - Changes & Improvements Selected Findings Ensuring Program Success

2. Medical Surveillance • Purposes • establish baselines • meet regulatory requirements • secondary prevention strategy • assess efficacy of existing controls • identify problems and determine what changes may be necessary

3. Purpose of OMSP Program • Individuals who work with, or are in the vicinity of, qualifying hazards • Establish baseline health status • Identify harmful effects • Determine unusual susceptibility to exposures • Establish trends over time

4. Medical Surveillance Is- • Based Upon Job Activity • Based Upon Workplace Exposure Potential • a Cooperative effort among Management, Employees and Health Professionals

5. Determine Exposures Position Descriptions Employee Interview Supervisor Interview Safety, IH input Walk-through Survey: IH, Safety, MD/RN IH Data Exposure Analysis Medical Matrix Determination Medical Examination History & Physical Vision, Hearing Chest X-ray Spirometry Laboratory Tests Toxicology Exam Data Analysis Trend Analysis Assess Efficacy of Existing Controls Medical Surveillance Program Flow Chart

6. “….But my employees are not over-exposed….” • Most Standards NOT based on human experience • one-third ACGIH criteria based on human experience • only 58% of these had quantitative data • of human studies in industry, only 8 had >200 participants • Meant to protect most workers

7. Medical Surveillance Is Not- • a substitute for sound hygienic practices • to be confused with employee wellness programs or primary health care • a ‘Problem Employee’ evaluation

8. Success Depends Upon- • Full employee participation • Standardized Testing • Standard Interpretation of Tests • Full understanding of job activities • Good communication between Safety Office, Human Resources and Medical Team

9. Accomplishments FY97-00 • Set Up Relational Database • Summary of Findings and Recommendations to Improve OHMP • Met with Area Safety Managers (12/98) • Revised ALL USDA-ARS Forms • Exposure Form Streamlined • Baseline History Form Expanded on Cancer and Reproductive History • Developed Interval History Form 182C(2)

10. Cancer & Reproductive History

11. Link to IH Data

12. Accomplishments FY97-00 • Initiated Interagency Agreement with Plum Island • Revised P&P • Issued ARS 182 Forms • distributed in INFORMS • also available in PDF (Acrobat) Format • Developed Electronic Matrix • Beta tested Spring, 2000

13. Revised Medical Matrix Available on CD-ROM or Hard Copy Incorporates over 3600 Hazards chemical, physical and biological Electronic Matrix in Microsoft Access Prints Individualized ARS 182A/B Forms Prints Lists of Recommended Tests and Instructions to Examiner

14. Medical Matrix - OMSP 182 B Exposure Form

16. Status of ARS Database • Physically over 9.5 MB data • Over 8000 exams entered • Variety of Reports available • Occupational Diagnoses • Exposure Reporting by Classification • Trend Analyses • CQI Reports (Exam and Letter Turn-around)

17. Occupational Findings FY 97-00

18. Selected Hazards Reported - FY 1997 to 2000

19. Selected Hazards Reported - FY 1997 to 2000

20. Ability to Track Trends

21. Lung Volumes: Trend Analysis 1986 - 1999

22. Peak Flow Analysis: Pre- and Post-Exposure Season

23. Turn Around Time - Exams Received  Letter Sent

24. Success of OMSP Depends Upon Full Participation of Eligible Employees Standardization of Program Elements Adequate Turn-Around Times Trend Analyses of good quality data Communication Among ARS Staff, Safety Office and Medical Review Team