KUMC. Medical Surveillance Program

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1 KUMC Medical Surveillance Program INTRODUCTION Employees at KUMC could potentially be exposed to safety hazards such as chemical, biological, and physical hazards. These hazards are most likely to occur in the research laboratories and animal research locations of KUMC. Other departments which may encounter hazards and are included in this program are: Facilities Maintenance, Landscaping, and KU Police. KUMC has adopted OSHA s Medical Screening and Surveillance Standards (29 CFR ) and developed a medical surveillance program to address health and safety concerns related to hazardous exposures. The primary purpose of this program is to assess and monitor employee health before, during, and at the end of employment. All KUMC employees are covered under this Medical Surveillance Program. Students who work in laboratories are not considered KUMC employees. Students are encouraged to consult with Student Health Services for all medical needs related to occupational exposures. Student fees cover medical expenses for students. The Medical Surveillance program at KUMC complies with applicable regulations and provides services for all employees at risk of exposure to occupational hazards. The elements of this program are: Roles and Responsibilities Hazard Assessment Medical Surveillance Recordkeeping and Reporting Program Evaluation These elements are used to establish a baseline of employee health and used to monitor future health.

2 ROLES AND RESPONSIBILITIES Medical surveillance is a service coordinated by the Environment, Health and Safety Office. All medical services are provided by the Occupational Health Clinic by occupational health physicians or other licensed occupational health care professional (PLHCP). A PHLCP is an individual whose legally permitted scope of practice (license, registration, or certification) allows him or her to independently provide, or be delegated the responsibility to provide, some or all of the medical surveillance listed in this Medical Surveillance Program. These services include a review of an occupational medical history, physical exams, diagnostic and performance testing, and vaccinations. Environment, Health and Safety: The Environment Health and Safety Office will administer this program by ensuring that employees are evaluated by the Occupational Health Clinic for potential Occupational exposures. EHS will: Administer Annual Medical Questionnaires. Track Employee compliance with Medical Surveillance Program. Refer employees to the Occupational Health Clinic as needed. Assist in Hazard Assessments to identify potential occupational hazards and refer employees to the Occupational Health Clinic as needed. Provide Radiation Monitoring Badges to appropriate personnel. Evaluate Medical Surveillance Program annually. University of Kansas Hospital Occupational Health Clinic The responsibilities of the University of Kansas Hospital Occupational Health Clinic are: Review medical questionnaires and conduct required medical evaluations for employees. Determine the extent of follow-up medical surveillance or treatment required. Provide written opinion to EHS, supervisors and employees within 15 business days of employee visit. Provide any vaccinations that are required or recommended. Coordinate with the State of Kansas to report worker s compensation claims. Maintain a copy of employee s records for a minimum of 30 years after employment has ended. Employees can contact the Clinic at: University of Kansas Hospital Occupational Health Clinic G110 Delp, Mailstop 4020 Fax: Phone: Hours of Operation: Monday Friday: 7:00 a.m. To 4:00 p.m.

3 Human Resources Maintain recommendation records for employees from the Occupational Health Clinic. Supervisors: Ensure employees participate in required medical surveillance. Follow and implement any recommendations that the Occupational Health Clinic prescribes. Report all occupational related injuries and illnesses to Human Resources and the Occupational Health Clinic. Employees (includes faculty, staff, and paid students): Participate in all required medical surveillance. Report all occupational related injuries and illnesses immediately to a supervisor and go to the Occupational Health Clinic for treatment and evaluation. If a workplace injury requires medical attention between 4:00 pm and 7:00 am M-F or Saturday or Sunday, report to the Hospital Emergency Department. Follow-up with the Occupational Health Clinic on the next business day.

4 JOB HAZARD ASSESSMENT A job hazard assessment has been developed to identify possible occupational hazards of various positions within KUMC. Employees or supervisors are required to complete a job hazard assessment. The EHS office will review the questionnaire and make recommendations of needed surveillance to employees and the Occupational Health Clinic. The Occupational Health Clinic will ultimately decide which medical testing and treatment is required. Appendix A provides guidelines for hazards and the medical surveillance needs. Appendix B provides guidelines on OSHA Medical Surveillance Requirements. Job Hazard Assessments are used to: 1. Make a complete and accurate description of tasks. 2. Identify all the hazards that may require protection such as chemical, biological, radiological, and physical hazards. Please note: for chemical hazards, it is important to refer to the safety data sheet (SDS). 3. Estimate exposure risk by evaluating factors such as: length of time, type of exposure, and available exposure control methods. 4. Make recommendations on PPE and additional medical monitoring. The Hazard Risk Assessment can be found online at: and in Appendix D. Once the form is filled out, submit to MEDICAL SURVEILLANCE Medical Surveillance consists of risk assessments, medical physicals, and vaccinations as needed. The EHS office will recommend services to the Occupational Health Clinic. The Occupational Health Clinic will ultimately determine what services are required. The risk assessment will be used to identify which hazards the employee is likely to encounter. Titers for communicable diseases and physical screenings may be required. Annual risk assessments may be required for some employees. There are specific medical surveillance requirements for the different types of work (Appendix A). In general, the medical surveillance program encompasses: Biological Hazards Chemical Hazards Physical Hazards Respiratory Hazards

5 Appendix A Medical Surveillance Flow Charts

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8 Appendix B OSHA Medical Surveillance Requirements: Asbestos (General Industry) (I) Examinations Pre-placement Periodic (Annual) Termination within ± 30 days Medical History Medical History Questionnaire Required for all exams Exam Elements Emphasis on Respiratory, cardiovascular, gastrointestinal: Chest x-ray (in accordance with (I)(3)(8)) Pulmonary Function Test (PFT) Other Requirements Evaluation of ability to wear respirator Physicians written opinion to include: o Limitations regarding a medical conditions that would place employee at risk from exposure o Limitations regarding PPE o Any recommendations physician deems necessary o Statement that employee has been informed of exam results o Statement that employee has been informed by physician of increased risk of lung cancer if employee is a smoker Bloodborne Pathogens (f) Examinations No pre-placement exam required, but must be offered Hepatitis B Vaccine o Declination of hepatitis B vaccine Post-exposure monitoring Medical History Medical History Questionnaire Required at the beginning of employment Exam Elements N/A Other Requirements Post-exposure incident; follow U.S. Public Health Service (USPHS) postexposure protocols. Physicians written opinion to include: o Counseling (HBV vaccine) and post-exposure follow-up o Whether hepatitis B vaccination is indicated and was received

9 Noise (g); Examinations Pre-placement within 6 months of first exposure at or above 85dB Periodic (Annual) Medical History Initial and Annual hearing questionnaire Exam Elements Baseline Audiogram Annual Audiometric exam: comparison of annual and baseline Other Requirements Employee counseling when there is a threshold shift or suspected ear pathology Respiratory Protection (e); Examinations Pre-placement evaluation questionnaire or exam Periodic evaluation questionnaire or exam Medical History Respiratory fit for duty questionnaire Exam Elements Chest x-ray: As determined by physician or other licensed healthcare professional Pulmonary Function Test (PFT): As determined by physician or other licensed healthcare professional Other Requirements Questionnaire or exam required before being fit tested Follow-up exams for any employee giving positive response to questionnaire Physicians written opinion to include: o Limitations on respirator use o The need for any follow-up medical evaluations o Any recommendations physician deems necessary o Statement that employee has been informed of exam results Hazwoper (f); Examinations Pre-placement evaluation questionnaire or exam Periodic (Annual) evaluation questionnaire or exam Post-exposure monitoring Termination exam if no exam within 6 months of termination/reassignment Medical History Medical History questionnaire Exam Elements Emphasis on symptoms related to handling hazardous substances and health hazards, fitness for duty and ability to wear PPE Evaluation of ability to wear respirator (If needed) Other Requirements Questionnaire or exam required before being fit tested Physicians written opinion to include: o Limitations on work o Any recommendations physician deems necessary o Statement that employee has been informed of exam results

10 Formaldehyde (I); ; Examinations Pre-placement evaluation questionnaire or exam Occupational exposure 0.5ppm 8hr TWA. Periodic (Annual) evaluation questionnaire or exam Post-exposure monitoring Medical History Work and Medical History questionnaire required Exam Elements Emphasis on symptoms related to handling formaldehyde such as irritation or sensitization of skin, respiratory system, eyes; shortness of breath Other Requirements Questionnaire or exam required before being fit tested Baseline and Annual PFT (if required to wear respirator) Physicians written opinion to include: o Limitations on work o Any recommendations physician deems necessary o Statement that employee has been informed of exam results

11 Appendix C CDC Adult Immunization Recommendations

12 Appendix D Job Hazard Assessment Job Hazard Screening Please complete the form below. Thank you! Medical Surveillance is the ongoing comprehensive review of worker's health. As an employee of the University of Kansas Medical Center, certain job functions may necessitate annual or periodic review of your health status. The following screening survey has been established to define the hazards an employee is exposed to and to determine appropriate Medical Surveillance. Please complete the following survey in its entirety. If you have any questions, please contact the Environment, Health and Safety Office (EHS) at or First Name of Employee Last Name of Employee Employee's Supervisor Employee's Supervisor's KUMC Employee ID# Office Phone # Address Job Title Department Location (building & room #) Will this position work in a research lab? Will the employee work in an area where animal research Yes No reset

13 experiments are conducted? What type of Biological Hazards will this position encounter? What type of Clinical interaction will this position encounter? What type of interaction with Chemical / Environmental Hazards will this position encounter? What type of interaction with Radiological Hazards will this position encounter? Yes No Select Agents and/or Toxins Human Material (Blood, Tissue or Cells) Etiological Agents Biosafety Level 2 Lab Work Biosafety Level 3 Lab Work Work in a clinic setting Perform blood draws Work directly with patients Asbestos Dusty Environments Formaldehyde Isoflurane Flammable Chemicals Corrosive Chemicals Toxic Chemicals Oxidizing Chemicals Organic Peroxide Chemicals Spontaneously Combustible Chemicals Water Reactive Chemicals Air Reactive Chemicals Radiation Producing Devices Radioisotopes Lasers reset

14 What type of Physical Hazards will this position encounter? Cage Wash Areas HVAC Areas Operating Landscaping equipment (mowers, blowers etc.) Loud noises above 85 db: Lifting > 50 lbs Performing Lockout/Tagout Working in Confined Spaces Operating a Forklift or other Specialized Units Working on Scaffolding > 10 ft Working on Ladders Operating Metalworking machines (Lathe) Please list any other hazards the employee may encounter. Expand Please select the Biological Preventative Measures that are relevant to the safety of this position. Please select the Chemical Preventive Measures that are relevant to the safety of this position. Please select the Personnel Protective Equipment Preventative Measures that are relevant to the safety of this position. Utilize Biological Safety Cabinet Utilize Laminar Flow Hood Autoclave Utilize chemical fume hood Gloves Laboratory Coat Eye and face protection N-95 respirator Hearing Protectors Hard Hats

15 Please select the Radiological Exposure Preventative Measures that are relevant to the safety of this position. Steel Toed Boots Half Face or Full Face Respirator Lead Shielding Lead apron Laser Safety glasses/goggles Dosimetry Badge Please list any other preventative measures that the employee may encounter I have answered the above survey to the best of my knowledge. I understand that if the duties or responsibilities of this position change, and the employee may be exposed to additional hazards or exposure to hazards may decrease, I will resubmit this form to EHS for re-evaluation of Medical Surveillance Requirements. Expand By checking the button, you acknowledge and agree to the aforementioned terms.

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