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Occupational Medical Surveillance and Evaluation Program. OMSEP- guidance. COMDTINST M5100.47 Safety and Environmental Health Manual- Chapter 4 COMDTINST M6000.1C Medical Manual- Chapter12 See MLCA Web Site for copy to download Occupational Safety and Health Act & Specific OSHA regs.

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Presentation Transcript
omsep guidance
OMSEP- guidance
  • COMDTINST M5100.47
        • Safety and Environmental Health Manual- Chapter 4
  • COMDTINST M6000.1C
        • Medical Manual- Chapter12
        • See MLCA Web Site for copy to download
  • Occupational Safety and Health Act & Specific OSHA regs
medical surveillance purpose
Medical Surveillance- purpose
  • To identify work related diseases or conditions:
    • at a stage when modifying the exposure or providing medical intervention could potentially:
      • arrest disease progression or prevent recurrences
medical surveillance objectives
Medical Surveillance -Objectives
  • identify pre-existing health conditions
  • provide risk specific periodic screenings
  • monitor clinical laboratory tests and biologic functions
omsep exam types
OMSEP-Exam types
  • Initial/baseline
      • Civilian/military within 30 days
        • Employment
        • Reassignment (only if new exam protocols applies)
        • Only required once per career if continually enrolled
  • Periodic
      • Variable/usually annual
  • Acute exposure
      • Upon notification
  • Exit/separation
      • End of exposure
      • End of employment
        • Separation letter
omsep exam protocols
OMMP Exam Protocols (old)

Asbestos

Benzene

Lead

Noise

Respirator Wear

Unspecified

OMSEP Exam Protocols

Asbestos

Benzene

Chromium Compounds

Hazardous Waste

Lead

Noise

Pesticides

Respirator Wear*

Respiratory Sensitizers

Solvents

Tuberculosis

Bloodborne pathogens

Radiation

OMSEP - Exam Protocols
who gets enrolled
Who gets enrolled?
  • Anyone exposed > action level for 30+ days/year
    • Documented or likely to occur for 30+ days/year
    • ACDU/Reserve/CIV/AUX
  • What is “exposed?”
who gets enrolled1
Who gets enrolled?
  • Some jobs require enrollment unless proved unnecessary
    • Marine Inspector, Pollution investigators, Marine Safety (general), Port safety, marine investigator, and fire fighters
omsep roles responsibilities
OMSEP- Roles & Responsibilities
  • Unit
    • Appoint OMSEP Coordinator
      • Note who’s exposed
      • Submit enrollments
      • maintain unit-level tracking report
      • coordinate physical exam process with clinics
      • One coord can manage >1 unit
      • “transfer” member to new unit after member PCS
    • Guides @ MLCA(kse) CGWEB and OMSEP home: http://cgweb.lant.uscg.mil/KDiv/kseOMSEPTrainingGuide.htmand http://webapps.mlca.uscg.mil/kdiv/kseOMSEP/
  • MLC(kse) Detached SEH Office
    • Worksite evaluation
    • Approve enrollment recommendations
omsep roles and responsibilities
OMSEP - Roles and Responsibilities
  • MLC (k)
      • OMSEP tracking report oversight
      • Physical exam oversight
      • Medical referral oversight
      • Maintain electronic tracking system
      • Provide guidance and training
  • Commandant (CG-1133)
      • Policy - Chapter 12 of Medical Manual
      • Overall Program Oversight- planning/expertise
      • Medical officer support on Occ. Health issues
      • Annual report of Occ. Health problems
asbestos
ASBESTOS
  • Found in floor and roof tiles, popcorn ceilings and pipe lagging
  • Okay as long as it is intact
  • Dangerous if torn, cut, crumbing or disturbed
asbestos1
ASBESTOS
  • Airborne microscopic needles
  • Once inhaled, permanent damage
  • Asbestosis, Mesothelioma
  • Cigarette smoking
asbestos protocol
Asbestos Protocol
  • Acute exposure must be documented and confirmed
  • Once confirmed, member remains on protocol for next 30 years
  • Not based on “say-so”
benzene1
BENZENE
  • Mandatory for Marine Inspectors prior to 1990
  • Otherwise must have a confirmed documented exposure
  • Long-term career monitoring
hexavalent chromium compounds
Hexavalent Chromium Compounds
  • Found in some paints, metal alloys and masonry cement
  • At Risk: paint booth operators, aircraft and boat painters
  • Can cause cancer, occupational asthma, dermatitis, skin ulcers
  • TLV 0.5 mg/m3 @ 30 Days/year
lead hazards
Lead Hazards
  • Inhaled or ingested
  • Acute anemia
  • Chronic health defects
  • Very dangerous to children under six.
  • Neurological damage
  • Action level 30mg/m3 of air
lead protocols
Lead Protocols
  • Gunner’s Mates
  • Firearms Instructors
  • Possibly LE teams
  • Painters or anyone chipping lead-based paints
  • Educate on workplace hygiene
noise2
NOISE
  • All aircrew and most boat crews
  • Cutter MKs, GMs, and ETs
  • Above 84db: 8 hr day/30 day per year
  • Impulse noise sound pressure above 140 db/30 day per year
noise3
NOISE
  • Baseline audiogram and annual audiogram
  • Can use audiogram in conjunction with another physical exam
  • If STS >25db at 500-3000 HZ is consistent, then the member will remain on the HCP even after exposure is over.
hazardous waste protocol
Hazardous Waste Protocol
  • Can be used to monitor many non-specific industrial exposures
  • Acute exposures
  • Will also monitor for Benzene
blood borne pathogens1
Blood borne Pathogens
  • Used for Acute exposures only
  • No longer automatic for Health Services Techs, EMTs or Rescue Swimmers
  • Follow treatment plans as outlined in MedMan
respirator wear1
Respirator Wear
  • Initial physical exam if not current. Initial questionnaire
  • Questionnaire review every 5 years
  • Annual Fit Test
respirator wear2
Respirator wear?
  • Start with COMDTINST M6260.2D, Resp. Protection
    • Per 62620.2D, don’t need to enroll in OMSEP just for respirator wear
      • But industrial workers may need enrollment in another protocol!
    • OMSEP protocol is suggested process for physician if unable to approve wear based on questionnaire in COMDTINST M6260.2D
respiratory sensitizers1
Respiratory Sensitizers
  • Many types of chemicals and substances
  • 2 part epoxies, wood dust, silicon sprays
  • Long term exposure could = occupational asthma, cancer, etc.
solvents1
Solvents
  • Can be inhaled or absorbed through skin
  • Commonly used by MKs, DCs, ETs and painters.
  • Can cause rashes, neurological disorders and possibly birth defects in pregnant women
potential exposure
Potential Exposure
  • Medical/Dental Personnel
  • Boarding Teams
  • Marine Inspectors
  • MSSTs
acute exposure1
Acute Exposure
  • Document exposure
  • May require medical evaluation
    • Specified in each protocol
  • Might not trigger OMSEP enrollment
    • See particular protocol, including form in back of chapter
  • OOD/CDO/SDO/CC/OpCen should have a quick reference to know what to do, what forms to fax to hospital
unit coordinator
Unit Coordinator
  • Check in/Check out sheet
  • Coordinate with supervisors, safety officers, HAZMAT coordinators, RPC, medical
  • Keep database current
  • Use reports to keep program on track
unit coordinator1
Unit Coordinator
  • Identifies occupational risks
  • Identifies potential enrollees
  • Request enrollment
  • Maintains database
  • Transfers files or request dis-enrollment as needed
enrollment
Enrollment
  • Prior to exposure
  • Upon notification of acute exposure under direction of MO
  • Unit Coordinator requests enrollment
  • SEHO approves/disapproves
enrollment1
Enrollment
  • Member remains enrolled until
  • Job change eliminates exposure
  • Retires, relads, dies
  • Protocols may be added or subtracted as needed
dis enrollment
Dis-enrollment
  • Unit Coordinator requests, SEHO approves
  • When exposure ends
  • When member retires, relads or dies
  • Not when member PCS!
pcs to non exposed jobs
PCS to non-exposed jobs?
  • Put OMSEP coordinator on check-out sheet. 60 days recommended.
  • If PCS to non-exposed job, conduct end-of-exposure physical and disenroll
    • If PCS again to exposed job, re-enroll in required protocols (periodic), baseline physical for new protocols
  • If PCS to exposed job, transfer, stay enrolled, keep periodic physicals current
  • If departed already, or if exposure at next unit not known, “transfer” to new unit for action
transfer
Transfer
  • When member PCS
  • Unit Coordinator transfers file
  • Allows member to stay in OMSEP until new Unit Coordinator evaluates if he should be dis-enrolled.
  • Keeps Baseline PE current
make it easy
Make it Easy
  • Check in/check out
  • Work with supervisors
  • Enrollment tool
  • Check pending files to see if member is already enrolled
  • Schedule the physical
make it easy1
Make it Easy
  • Keep the Database current by keeping track of transfers, relads
  • Run a monthly report to see who is due
  • Make sure supervisors tell you when an enrollee’s job changes
medical coordinator
Medical Coordinator
  • Ensures proper PE is done
  • Ensures member is advised of findings by MO
  • Ensures PE is filed in MR
  • Ensures PE date is in database
medical coordinator1
Medical Coordinator
  • Has access to unit data based on AOR
  • Can do everything Unit Coordinator can except transfer, add, or delete.
  • Has access to all unit reports
physicals
Physicals
  • Baseline : for new enrollees
  • Periodic: usually annual
  • Acute Exposure: as needed
  • Exit: when disenrolling from OMSEP program
exit physicals
EXIT Physicals
  • Gives verification of physical status at the time OMSEP is discontinued.
  • Needed if member is dis-enrolled due to job change, retirement, or relad.
  • If RELAD, Exit PE is needed even if no Separation PE is required
  • OMSEP should be an item on the unit’s transition check sheet
slide70

Process

  • Supervisor knows who’s doing what job
  • OMSEP Coord. enters member info
    • System sends to SEHO
  • SEHO approves (or disapproves w/ explanation)
  • OMSEP Coord. arranges physical
  • Member goes to physical
  • Medical administrator enters date in database
  • OMSEP Coord. tracks due dates in database for next phys.
slide71

Info path

  • Exam results go directly in member’s CG medical record, marked “OMSEP”
    • Not to HQ!
    • Not in OMSEP database!
  • OMSEP Coord. tracks dates in database
  • Need OPFAC, SSN or Last Name to initially enroll
    • Once enrolled, lists only last 4 of SSN
slide72

Privacy

  • So....
  • Medical info in medical record
    • Privacy Act, HIPPA protections
  • Significant Event Exposure Tracking tool may have HIPAA-protected information
best work practices
Best work practices
  • Clinics recommend arriving extra early or arriving with 5447 or 5447A form filled out
    • save time: do it once in Adobe and update as needed
  • Don’t send member “for OMSEP physical;” instead, send member with knowledge of which protocols (use database, or just send relevant exam protocols from MedMan)
hands on practice
HANDS ON PRACTICE
  • Grab a computer
  • Log into the OMSEP Database
  • http://cgweb.lant.uscg.mil/KDiv/kseHomePage.htm
  • If you don’t already have an account, click “request an account”
submit request to seho
Submit Request to SEHO

SEHO validates the information to verify if unit personnel are at risk. E-mail will be sent to coordinator indicating approval or disapproval (and why)

updating profile page
Updating profile page

When personnel return from physical the following information is required to update profile date of physical and hearing test if done

reports available
Reports available

Coming to MRS someday

slide89

Questions?   LCDR J.S. Clark HSC T. C. Anderson MLCA(kse) Det NOLAJeffery.S.Clark@uscg.milTyrone.C.Anderson@uscg.mil (504) 253-6512/6514