Specifications include, but are not limited to: The contractor shall have responsibility for performing all of the medical examinations described below. As outlined in the Guidance (MSPGuide.pdf), the MSP Coordinator shall provide a list of employees who are enrolled in the MSP to the contractor, who will make arrangements for all baseline, periodic, respiratory only and termination examinations. All medical examinations shall be performed by a licensed physician or nurse practitioner under the supervision of a physician board certified in occupational medicine. Baseline: The primary purpose of the baseline examination is to detect any medical condition that might increase risk to a MassDEP employee or others as a result of hazardous materials exposures on the job, so that an appropriate placement or accommodation can be made by DEP. The baseline exam shall consist of an interval work/exposure history, appropriate biological monitoring (i.e., testing for a chemical agent or its metabolite in the body) and other diagnostic tests, and a physical examination. The minimum content of the physical examination, as described in the Guidance, is as follows: Review of employee baseline medical history Review of employee baseline work history Complete physical examination height, weight, temperature, pulse, respiration, and blood pressure head, nose, and throat chest (heart and lungs) peripheral vascular system abdomen and rectum (including hernia exam) spine and other components of the musculoskeletal system genitourinary system skin nervous system. Complete Blood Count with differential: White blood cell count (WBC) Red cell count (RBC) Hemoglobin and Hematocrit determination Blood chemistry profile including: Blood urea nitrogen Serum Creatinine Albumin, globulin & total protein Total bilirubin Serum glutamic oxalacetic transaminase (SGOT) Lactate dehydrogenase (LDH) Alkaline phosphatase Calcium Phosphorus Uric acid Glucose Glutamyl transferase (GGT) Urinalysis including: Specific gravity pH Microscopic examination Protein Ketones Glucose Urine Heavy Metals Screen. Either (a) 24-hr specimen collection or (b) random specimen collection reported in mcg/g creatinine. Including: Arsenic Mercury Chest x-ray. 14" x 17" films taken at a distance of six feet and including a posterior-anterior and a left lateral projection by a licensed X-ray Technician and interpreted by a B-reader Radiologist. Electrocardiogram with interpretation Pulmonary function Periodic: After the baseline examination, each participating employee shall receive a periodic medical examination. Depending on actual or potential exposure risk for an employee, the examination frequency may vary. The purpose of this exam is: to discover early signs or symptoms of adverse health effects; to provide data to assist the evaluation of the personnel protection program; and to detect changes in the health of an employee after the baseline examination that might require a change in job placement or task assignment in order to reduce or eliminate potential exposure to hazardous materials. The periodic examination serves as a screening program for the purpose of discovering an adverse health indicator in an early pre-symptomatic stage when the disorder is reversible and/or treatable. The periodic exam shall consist of an interval work/exposure history, appropriate biological monitoring (i.e., testing for a chemical agent or its metabolite in the body) and other diagnostic tests, and a physical examination. The periodic work history form shall provide data concerning exposures and symptoms. The physical examination will be based upon the pathophysiology and toxicology of the specific chemicals to which the employee has been exposed and shall follow up on symptoms or conditions reported by the employee. The contractor shall assist the department in determining the appropriate recall interval for each employee's periodic exam based upon job duties and exposure potential and other relevant factors. Respiratory-Only: The primary purpose of the respiratory-only examination is to detect any medical condition that might prevent a DEP employee from being able to wear a respirator safely. The respiratory-only exam shall consist of an interval work/exposure history, a physical examination, and a pulmonary function test. The minimum content of the physical examination, as described in the Guidance, is as follows: Review of employee medical history Review of employee work history Pulmonary function Physical examination height, weight, temperature, pulse, respiration, and blood pressure head, nose, and throat chest (heart and lungs) peripheral vascular system Unscheduled: An unscheduled medical examination may be required in cases of complaint of occupationally related symptoms or employee concern. The format of this exam is at the discretion of the examining physician and shall be dependent on the specific type of exposure. Termination: This examination is available to all employees participating in the MSP who are leaving service with DEP, and those who are leaving the MSP because of a change in job placement within DEP. The purpose of this examination is to assess the cumulative effects of exposure to hazardous materials during the period of employment with DEP. As such, it should be similar in scope to the baseline examination and produce a complete report of the employee's occupational health upon termination. The panel of tests that may be ordered for an employee in the periodic, unscheduled and termination examinations is based largely on the medical judgment of the examining physician. Such tests shall not be ordered casually but must have an underlying surveillance rationale that is grounded in the work exposure and health profile of the employee. The contractor shall provide all necessary medical data to the physician of an employee seeking a second or third medical opinion. This procedure is described in the Guidance.
