Medical Surveillance for Former Workers

Tim Takaro Jordan Firestone

关键词: ASBESTOS;    BERYLLIOSIS;    BERYLLIUM;    CONSTRUCTION;    CONTRACTORS;    DOCUMENTATION;    EMPLOYMENT;    HEALTH HAZARDS;    IMPLEMENTATION;    LYMPHOCYTES;    MEDICAL SURVEILLANCE;    MEDICINE;    MONITORING;    PERSONNEL;    PROLIFERATION;    RISK ASSESSMENT Hanford;    Former Worker;    Medical Monitoring;    Surveillance;    Asbestos;    Beryllium;    Noise;   

DOI  :  10.2172/953494
RP-ID  :  DOE/SF21258-1
PID  :  OSTI ID: 953494
Others  :  TRN: US201002%%1165

学科分类：社会科学、人文和艺术（综合）

美国|英语

来源: SciTech Connect

【 摘 要 】

The Former Hanford Worker Medical Monitoring Program, directed by the Occupational and Environmental Medicine Program at the University of Washington, served former production and other non-construction workers who were potentially exposed to workplace hazards while working for the USDOE or its contractors at Hanford. The USDOE Former Workers Program arose from Congressional action in the Defense Authorization of 1993 (Public Law 102). Section 3162 stated that, “The Secretary shall establish and carry out a program for the identification and ongoing medical evaluation of current and former Department of Energy employees who are subject to significant health risks as a result of exposure of such employees to hazardous or radioactive substances during such employment.” (This also covers former employees of USDOE contractors and subcontractors.) The key objective has been to provide these former workers with medical evaluations in order to determine whether workers have experienced significant risk due to workplace exposure to hazards. Exposures to asbestos, beryllium, and noise can produce specific medical conditions: asbestosis, berylliosis, and noise-induced hearing loss (NIHL). Each of these conditions can be identified by specific, non-invasive screening tests, which are widely available. Treatments are also available for individuals affected by these conditions. This project involved two phases. Phase I involved a needs and risk assessment, characterizing the nature and extent of workplace health hazards which may have increased the risk for long-term health effects. We categorized jobs and tasks by likelihood of exposures to specific workplace health hazards; and located and established contact with former Hanford workers. Phase II involved implementation of medical monitoring programs for former workers whose individual work history indicated significant risk for adverse health effects. We identified 118,000 former workers, employed from 1943 to 1997. After excluding current workers, construction workers, and deceased workers, the total estimated number of former workers eligible for screening was 72,611. By September, 2006, 53,010 workers had been contacted, 20,298 responded, 2,835 were eligible and authorized, and 2,773 workers were ultimately screened. The cohort was 80% male, 85% white, and had a mean age of 63 years (range 24-96 years) at the time of first exam. Participants completed an occupational health history survey prior to the medical exam. Former Hanford workers were considered eligible for an exam if they reported exposure to asbestos, beryllium, or noise, or if a review of their Hanford work history indicated possible or probable exposure to one of these three hazards. We also invited any former Hanford worker who requested an exam to participate, regardless of documentation of exposure. The screening exam included a problem-focused physical exam, along with screening tests for one or more of three specific medical conditions: asbestosis (chest X-ray and spirometry), berylliosis (chest X-ray, spirometry, and beryllium-induced lymphocyte proliferation test), and NIHL (audiometry). We assisted ill workers in filing appropriate workers’ compensation claims, and facilitated appropriate follow-up medical care. This program has made an important contribution to the health of former DOE contractor workers at the Hanford defense nuclear site.