Presentation on theme: "The Model for Medical Surveillance Program for Caribbean Upstream Oil/Gas Producer Businesses including international upstream oil and gas producers rely."— Presentation transcript:
11 Medical Surveillance Program Standard Medical History and Examination FormThe individual to be examined is to complete the shaded medical history portions of this form prior to his/her appointment.Name, address, and phone number (including fax) of physician/ health center performing examination:New Applicants ONLY:Your Current Occupation:____Your Current Employer:Time in Current Position (in years/months):Name of Department:Examinee’s Name:Position/Job Title:SS#Address:Work Location:Region:Home Phone:Work Phone:Date of Scheduled Exam:Date of Birth:Gender: Male Female REPSOL PROGRAM MANAGEREXAMINING PHYSICIAN (Please Note - Core Exam Must Always be Completed, Plus All Function-Specific ServicesTYPE OF EXAMINATIONo Pre-placement/Baseline/Exit o Periodic o ExitSPECIFY FUNCTION AND/OR CLEARANCES REQUESTED (Check ALL That Apply) Respirator User [complete Request for Respirator Clearanceform] Health, Safety, and Environmental Subsurface Reservoir Development Commercial Drivers License Facilities and Construction Diver and Diving Team Well Maintenance, Deck, Inspection, and Construction Crane/Derrick/Aerial Lift Operator/Rigger Commercial Vehicle Operator Security E&P Operated Asset – TSP Laboratory/Chemical Worker Well Drill and Oil/Gas ProductionPRE-PLACEMENT/BASELINE CORE EXAMRequired Services: (Check those services completed) Authorization for Disclosure Form General Medical History General Physical Examination Chemistry Panel (including Glucose, Bilirubin (total),Cholesterol, HDL-C, LDL-C, Triglycerides, GGTP, LDH,SGOT, SGPT), Complete Blood Count, and Urinalysis Urinalysis Audiometry (including noise exposure history) Electrocardiogram Spirometry Vision Screening (Corrected and Uncorrected Near and Far;Color; Peripheral; Depth Perception) Drug/Alcohol screen (cocaine/marijuana) Plus other Function or Clearance-required services (see thefollowing page) ANNUAL/PERIODIC/EXIT CORE EXAM Chemistry Panel (including Glucose, Bilirubin (total), Plus other Function or Clearance-required services (seethe following page)Note: For Respirator User exams, the General Physical Examination may be a brief, limited exam or a more extensive exam, depending on the health of the examinee and the judgment of the examiner. Also, laboratory tests (e.g., chemistry panel, blood count, and urinalysis) and procedures (e.g., electrocardiograms) are intended to be at the discretion of the examiner, rather than required services. Refer to the Occupational Medicine Surveillance Program for further guidance. For all Respirator User exams, completion of the Request for Respirator Clearance form must precede this exam and be attached to this exam form when completed.Outline of pre-placement and annual or exit physical exam requirements.It is important to collect occupational and medical histories since the worker may changed jobs or reassigned to other work tasks that may be more or less hazardous.The type of physical should be changed to reflect the work being performed.
12 Medical Surveillance Program Upstream Oil/Gas Respirator UsersPre-Placement/Baseline Core Exam Services, plus::Request for Respirator Clearance form(Limited Exam based on respirator use)(Use above for any Respirator User exam) Regional Control and ResourcesNo additional clearance specific requirements Finance and Accounting Health, Safety, and EnvironmentalAdditional requirements applies to offshore field personnel.Pre-Placement/Baseline Core Exam Services, plus:Vision (Cor/Uncor. Near/Far; Color; Peripheral; Depth )Chest X-Ray – PA/LatBlood lead and Zinc Protoporphyrin (for firearms users)Mercury urine (pre-placement for baseline)Cholinesterase (RBC/Plasma)Serum, 5cc, labeled, frozen, and storedImmunizations and ScreeningAudiometry (including noise exposure history)Spirometry (respirator use)Periodic Core Exam Services, plus:Audiometry (noise exposure) Subsurface Reservoir DevelopmentNo additional clearance specific requirements for either the administrative and managerial staff. Requirements apply to field geologist, petro- physicist, geophysicist, and engineersBlood lead (offshore personnel)Mercury urine (prior to shift) or blood (end of work week) for offshore personnelOther ACGIH BEI indicators based on exposure risk)Exit Core Exam Services, plus:Audiometry(For age 40 and over) Multiple Risk Factor Assessment (age lipid profile, blood pressure, diabetic screening)Audiogram (5 years) based on noise exposure history)Vision (Cor. and Uncor. Near and Far)Chest X-Ray (PA/Lat) (every 2 years after age 40)Electrocardiogram (every year after age 35) Facilities and ConstructionNo additional clearance specific requirements for either the administrative and managerial staff. Requirements apply to field engineers and topside refurbishment workforce.Other ACGIH BEI indicators based on exposure risk\24 hour Urine Heavy Metal ScreenExample of the types of exams provided for each business unit.As you can see, the physical exam requirements are structured differently for leadership and managers as compared to the workforce.The elements of the pre-placement, annual, and exit physical also as somewhat different as well.
18 Medical Surveillance Program Male Reproductive HazardsObserved EffectsType of ExposureLowered Number of SpermAbnormal Sperm ShapeAltered Sperm ShapeAltered Hormones/Sexual PerformanceInorganic LeadXDibromochloropropaneCarbaryl (Sevin )Toluenediamine and DinitrotolueneEthylene DibromideStyrene and Acetone)Ethylene Glycol Monoethyl EtherWeldingPerchloroethyleneMercury VaporHeatMicrowaves from RadarKepone**Bromine Vapor**Radiation** (Chernobyl)Carbon Disulfide2,4-Dichlorophenoxy Acetic Acid (2,4-D)Examples of some male reproductive hazardsSome of the chemical contaminants were identified in the TBRAs.
19 Medical Surveillance Program Female Reproductive Hazards Observed EffectsType of ExposureAgent Observed EffectsPotentially Exposed WorkersCancer treatment drugs (e.g.,Methotrexate)Infertility, miscarriage, birth defects, low birth weightHealth care workers,pharmacistsCertain ethylene glycol ethers such as 2-ethoxyethanol (2EE) and 2-methoxyethanol (2ME)MiscarriagesElectronic and semiconductor workersCarbon disulfide (CS2)Menstrual cycle changesViscose rayon workersInorganic LeadInfertility, miscarriage, low birth weight, developmental disordersBattery makers, solderers, welders,radiator repairers, bridge painters,firing range workers, home remodelersIonizing radiation (e.g., X-rays and gamma rays)Infertility, miscarriage, birth defects, low birth weight, developmental disorders, childhood cancersHealth care workers, dental personnel,atomic workersStrenuous physical labor (e.g., prolonged standing, heavy lifting)Miscarriage late inpregnancy, premature deliveryMany types of workersCytomegalovirus (CMV)Birth defects, low birth weight,Developmental disordersHealth care workers, workers in contact with infants and childrenHepatitis B virusLow birth weightHealth care workersHuman immunodeficiency virus (HIV)Low birth weight, childhoodcancerHuman parvovirus B19MiscarriageRubella (German measles)Birth defects, low birth weightToxoplasmosisMiscarriage, birth defects, developmental disordersAnimal care workers, veterinariansVaricella zoster virus(chicken pox)Examples of female reproductive hazardsSome of the chemical and biological contaminants were identified in the TBRAs.
20 Medical Surveillance Program ASTDR Minimum Risk Levels (MRLs) NAMEROUTEDURATION OF EXPOSUREMRLUNCERTAINTY FACTORENDPOINTSTATUSCOVER DATECAS NUMBERACETONEInh.Acute26 ppm9Neurol.Final05/94Int.13 ppm100Chr.Oral2 mg/kg/dayHemato.ACROLEIN0.003 ppmResp.08/07ppm3000.004 mg/kg/dayGastro.ACRYLAMIDE0.01 mg/kg/day30Repro.12/120.001 mg/kg/dayACRYLONITRILE0.1 ppm1012/900.1 mg/kg/dayDevelop.10000.04 mg/kg/dayALDRIN0.002 mg/kg/day09/02mg/kg/dayHepaticALUMINUM1.0 mg/kg/day09/0890AMERICIUMRad.4 mSv310/041 mSv/yrOtherAMMONIA1.7 ppmANTHRACENE10 mg/kg/day08/95Dura-UncertaintyCoverCASRoutetionMRLFactorsEndpointStatusDateNumberOralInt.0.6 mg/kg/day300HepaticFinal08/95Examples of ASTDR minimal risk levels based on route and duration of exposureInformation was supplied to Medical Director as guidance on chemical exposure.