Armed Forces Epidemiology Board Integrity Service Excellence USAF

Armed Forces Epidemiology Board Integrity - Service - Excellence USAF Medical Service Occupational Health Program Lt Col Kenneth L. Cox, USAF, MC, SFS Chief, Risk Assessment Division Kenneth. Cox@brooks. af. mil Phone: 210/536 -1788 17 April 2002

Overview Definition Occupational Health Program and Drivers Occupational Health Basic Strategy Occupational Health Team and Functions l BEE, Public Health, Physician, Support Staff Occupational Health Working Group (OHWG) Data Collection and Analyses Special Occupational Studies Initiatives and Future Projects Integrity - Service - Excellence

Occupational Health Definition “. . . Promotion and maintenance of the highest degree of physical, mental and social well-being of workers. . . Prevention among workers of departures from health caused by their working conditions. . . Protection of workers. . . from risk. . . World Health Organization (1950) Integrity - Service - Excellence

Occupational Health Program Policy Directives and Drivers “The Air Force will ensure the occupational health of its people by identifying work-site health hazards, recommending control measures, assessing fitness for work, conducting medical surveillance, educating workers, and providing clinical services. ” AFPD 48 -1, Aerospace Medical Program Components outlined in AFI 48 -145, Occupational Health Program, 1 Apr 99 AFMAM 48 -146, Occupational Health Information Management (under development, to replace AFOSH Std 161 -17) Integrity - Service - Excellence

Occupational Health Surveillance Strategy Integrity - Service - Excellence

Occupational Health Team Occupational health consultant physician Public health specialists Bioenvironmental engineer Support specialists Other, depending on local assets/needs l l l Safety Audiology Primary Care Mgr l. Health promotions l. Civilian personnel l. Union representative Integrity - Service - Excellence

Bioenvironmental Engineer Responsibilities/Functions Conduct l industrial workplace surveys Workplace categorization by potential health risk — 1 -High; requires annual assessment — 2 -Medium; requires assessment every 2 years — 3 -Low; assessment as needed l Special surveillance assessment matrix Confidence in Hazard Assessment Confidence in Existing Controls Low Medium High Low A A B Medium A B C High B C D

Bioenvironmental Engineer Responsibilities/Functions (cont) Goal l l is to protect the worker Hazard elimination – substitute, stop process Engineering control – ventilation, acoustical material Administrative control – signs, restricted areas Personal protective equipment Investigate occupational illnesses, incidents, and reproductive health hazards Fit-test respirators Ergonomic assessments Thermoluminescent dosimetry program Integrity - Service - Excellence

Documentation AF Form 2755, Workplace Exposure Data Summary

Public Health Responsibilities/Functions Propose medical surveillance exam requirements based on BEE survey results Perform epidemiological trend analysis Investigate & document occupational illnesses/incidents Identify worker educational requirements Integrity - Service - Excellence

Occupational Health Consultant Responsibilities/Functions Review BEE survey data Visit workplaces, with BEE and/or Public Health l Health survey, workplace survey, summary report Determine l medical surveillance requirements Modify and approve public health recommendations Perform occupational health examinations Accomplish fitness-for-duty evaluations Establish/review pregnancy profiles Assess quality of local occupational health program Integrity - Service - Excellence

Support Staff Responsibilities/Functions Schedule periodic occupational exams Validate/update workshop personnel rosters Track no shows Communicate results of exam to worker Schedule required follow-ups and monitor until done Integrity - Service - Excellence

Occupational Health Working Group Sample Agenda and Products Review l recent surveys Establish medical surveillance exam requirements Identify ergonomics issues Report occupational illness/injury trends Monitor the Hearing Conservation Program l Significant threshold shift log Calculate completion rate for occupational exams Quality control of exams and procedures Oversees all aspects of occupational health at the base level. Integrity - Service - Excellence

Documentation AF Form 2766, Clinical Occupational Health Examination Requirements

Event or Exposure Yes AF Injury/Illness Reporting Algorithm Symptoms or +biomonitoring? No Yes Not Recordable No Work Related? Yes Ground Safety (Line) Injury Illness or Injury? AF Safety Center Public Health Illness (Medics) AFIERA Recordable

Data Reporting & Enterprise-level Analyses OSHA-mandated l injury reporting via safety offices Base, MAJCOM, AF summary reports Occupational illness reporting by base public health via AF Reportable Events Surveillance System to AFIERA l Data sent to AF Safety Center for combined reporting Audiometric data transmitted directly to Defense Occupational and Environmental Health and Readiness System (DOEHRS) l Data currently inaccessible due to technical problems Shop l survey data entered into Command Core Base level only, no central collection/access Integrity - Service - Excellence

Special Occupational Studies JP-8 Acute Effects Study Anthrax Vaccine and Vision in Aviators Kelly AFB Worker Mortality Study Investigations of diverse cancer cluster alarms, e. g. , l l Thyroid cancer in aviators at a training base Diverse cancers in an ANG admin building Mesothelioma in a HQ building Lymphoma in a missile squadron Note: topics usually brought to AFIERA’s attention by concerned field staff or workers Integrity - Service - Excellence

Initiatives and Future Projects Improve l l l occupational injury/illness reporting New web-based reportable events system Use ambulatory visit codes to identify possible cases Real-time reports re lost duty days Computerized occ exams via PIMR Establish an AF repository for Command Core IH data at AFIERA with centralized trend analysis Continue developing the Global Expeditionary Medical System (GEMS) to ensure proper reporting of occupational/environmental exposures that occur in deployed settings Assist in development of Automated Civil Engineer System (ACES) for environmental management data Integrity - Service - Excellence

Integrity - Service - Excellence Questions? ? ?

Integrity - Service - Excellence Backup Slides

Current Instructions/Guides Do. D 6055. 5 -M, Occupational Medical Surveillance Manual AFOSH 48 -119, Hazardous Noise Program AFOSH 48 -9, Radio Frequency Radiation Safety Program AFI 48 -125, Personnel Dosimetry Program AFOSH 48 -8, Controlling Exposures to Hazardous Materials Integrity - Service - Excellence

Current Instructions/Guides (cont) AFJI 48 -110, Immunizations and Chemoprophylaxis AFOSH 48 -139, Laser Radiation Protection Program; ANSI 136. 1 -2000 NFPA 1582, 2000 ed, Medical Requirements for Fire Fighters AFOSH 48 -137, Respiratory Protection Program Interim Guidance for 48 -20, Hearing Protection Program – Do. DI 6055. 12 Integrity - Service - Excellence

Keeping Current Internet Reference Sources Requires team approach Internet sites l l l l www. osha. gov www. denix. osd. mil afpubs. hq. af. mil sg-www. disa. mil/moasgoa www-4 afia. saia. af. mil wwwsam. brooks. af. mil www. afms. mil/afiera/rsh/Occ. Med Integrity - Service - Excellence