Former Worker Medical Screening Programs Under the United States Department of Energy
U.S. Department of Energy Former Worker Medical Screening Program (FWP)
Section 3162 of the Defense Authorization Act for Fiscal Year 1993 requires the U.S. Department of Energy (DOE) to establish and carry out a program in order to identify and evaluate DOE employees subject to significant health risks as a result of their exposure to hazardous or radioactive substances while employed at a DOE facility. 50 U.S.C. § 2733 (2013).
The Act also requires that the DOE provide a process to:
- Identify hazardous and/or radioactive substances that DOE employees may have been exposed to during their employment at a DOE site;
- Identify those DOE employees who may have been exposed to such hazardous and/or radioactive substances;
- Determine the number, scope, and frequency of the medical evaluations that are to be provided to exposed employees;
- Make available the evaluations and tests to the exposed employee;
- Maintain the privacy of the exposed employees; and
- Ensure that employee participation is voluntary.
Id. at § 2733(b)(1). In addition to providing evaluations, tests, and results to the exposed employees, the Act requires the DOE to collect and assemble the information to assist in preventing the exposure and illness in current and future DOE employees. Id. at § 2733(b)(5).
The purpose of FWP is to provide voluntary medical screenings to assist DOE employees in the early detection of illnesses or conditions potentially related to their employment at a DOE facility. Not only does this provide the DOE employee with information on the status of their health, but also the DOE gains valuable information about the trends on the health effects of exposure to hazardous or radioactive substances and how to reduce those effects for future employees.
In order to remain objective, the FWP uses independent occupational health experts to administer the medical screening programs. U.S. Department of Energy, Office of Environment, Health, Safety & Security, “Former Worker Medical Screening Program,” available at http://energy.gov/ehss/services/worker-health-and-safety/former-worker-medical-screening-program. The FWP is administered through both regional screening projects, with clinics in communities near DOE sites, and nationwide screening projects, with a vast network of clinics nationwide. Id.
Nationwide Screening Projects
The National Supplemental Screening Program (NSSP)
The National Supplemental Screening Program (NSSP) provides free medical screenings to eligible Department of Energy (DOE) employees. It is operated by Oak Ridge Associated Universities (ORAU) and its partners, including National Jewish Health (NJH), Comprehensive Health Services, Inc. (CHS), Axion Health, and the University of Colorado Denver. National Supplemental Screening Program (NSSP), available at http://www.orau.org/nssp/default.htm.
The NSSP provides free medical screenings to detect health issues resulting from exposure to hazardous substances and radiation while employed at a DOE facility. Eligible employees are entitled to a customized medical screening based on their work history and work site risks. In addition, special examinations are available for employees who have been exposed to beryllium (i.e. the BeLPT test), asbestos, radioactive substances, or lasers. In addition to the initial medical screening, rescreening is authorized by the DOE every three years. Initially, this rescreening was only allowed for beryllium sensitivity testing but now includes all medical testing. National Supplemental Screening Program (NSSP), “Screening Exam,” available at http://www.orau.org/nssp/nssp-screening-exam.html. Like an initial screening, rescreening is entirely voluntarily and eligible employees may elect to repeat all, some, or none of the tests available.
Former DOE employees, contractors, or subcontractors who may have been exposed to radiation and/or worked with hazardous substances are eligible for free medical screening so long as they worked at one of the covered facilities: Argonne National Laboratory, Fermi National Laboratory, or Princeton Plasma Physics Laboratory. National Supplemental Screening Program (NSSP), “Am I Eligible?” available at http://www.orau.org/nssp/am-i-eligible.html.
Former production workers are eligible if they worked at Hanford, Kansas City Plant, Pinellas Plant, Rocky Flats, or Savannah River Site. Id. Because the medical providers included under these Former Worker Programs are limited, a worker who does not meet the criteria of one of the regional FWP, as discussed below, may be referred to the NSSP if he or she no longer lives in the vicinity of a regional FWP. Id.
Building Trades National Medical Screening Program (BTNMSP)
The Building Trades National Medical Screening Program (BTNMSP) is a national screening program conducted by the CPWR – Center for Construction Research and Training in conjunction with the University of Cincinnati Medical Center, Duke University Medical Center, and Zenith American Solutions, Inc.
Like the other screening programs, the BTNMSP provides free medical screening to eligible DOE employees. First, employees will undergo a comprehensive work history interview to help determine whether they have been exposed to hazardous and/or radioactive substances. Building Trades National Medical Screening Program, “Program Benefits,” available at https://www.btmed.org/benefits.cfm. Next, eligible employees are given a free medical screening examination. Id. The screening may help with the early detection of health problems and will also be used for informational purposes to better protect the health of current and former DOE employees. Id.
To be eligible under the BTNMSP, the employee must have performed construction work, either as a contractor or subcontractor, at any time in the past for the Atomic Energy Commission (AEC) or a DOE site associated with the research or production of nuclear weapons. Building Trades National Medical Screening Program, “Who Is Eligible?” available at https://www.btmed.org/eligible.cfm. In addition, the employee must have potentially been exposed to a health hazard, such as radiation, beryllium, asbestos, silica, mercury, cadmium, nickel, lead, uranium, plutonium, and etcetera or think that he or she has developed serious health problems as a result of his or her DOE employment. Id.
Covered DOE Sites
To be eligible under the BTNMSP, the employee must have performed construction work at one of the following sites:
- Hanford Nuclear Reservation
- Argonne National Laboratories (West)
- Idaho National Laboratory
- Amchitka Island Nuclear Explosion Site
- Rocky Flats Plant
- Waste Isolation Pilot Plant
- Kansas City Plant
- Mallinckrodt Chemical Company
- Weldon Spring Site
- Paducah Gaseous Diffusion Plant
- Piqua Organic Moderated Reactor
- Mount Plant
- GE Evendale
- Fernald Feed Materials Center
- Oak Ridge Reservation (K-25, X-10, Y-12)
- Savannah River Site
- Brush Luckey
- Battelle Laboratories (King Avenue and West Jefferson)
- Ashtabula (Reactive Metals Extrusion Plant)
- Shippingport Atomic Power Plant
- Brookhaven National Laboratory
- National Energy Technology Plant
- Portsmouth Gaseous Diffusion Plant
- Huntington Pilot Plant
- Pinellas Plant
Regional Screening Projects
Worker Health Protection Program (WHPP)
The Worker Health Protection Program (WHPP) provides free medical screening for former and some current employees at thirteen participating Department of Energy (DOE) facilities. The WHPP seeks to detect work-related illnesses at an early stage and assist employees in determining whether a current health condition is the result of their exposure to hazardous materials while employed at a DOE facility. The program is funded by a contract with the DOE and is led by the Queens College of the City of New York, in collaboration with the United Steel Workers (USW), Atomic Trades and Labor Council (ATLC), and the former Fernald Atomic Trades and Labor Council (FATLC). The Worker Health Protection Program, available at http://www.worker-health.org/index.html.
The WHPP provides medical screening examinations for chronic lung diseases, kidney disease, liver disease, and hearing loss. The tests that accompany the physical examination include:
- Spirometry, used to diagnose chronic obstructive pulmonary disease (COPD) and other chronic lung conditions;
- Chest x-ray;
- Audiometry, used to diagnose hearing loss;
- Urinalysis, used to diagnose kidney disease;
- Blood test;
- Beryllium sensitivity test (BeLPT) for eligible employees who were possibly exposed to beryllium as a result of their employment at a DOE facility;
- Low-dose CT scan, used to diagnose lung cancer, for eligible former Nevada Test Site, Mound Plant, and Fernald Plant employees as well as current and former Oak Ridge National Laboratory, Y-12 Plant, and Gaseous Diffusion Plant employees; and
- Medical and occupational exposure questionnaires.
While only available to eligible workers, a beryllium lymphocyte proliferation test (BeLPT) is used to determine whether a former employee has developed an allergic reaction or sensitivity to beryllium or is at risk for developing Chronic Beryllium Disease (CBD). The Worker Health Protection Program, “Beryllium Testing,” available at http://www.worker-health.org/berylliumtesting.html. In the event that an employee receives abnormal results from his or her BeLPT test, he or she is eligible to participate in follow-up medical tests, which are used to diagnose CBD. CBD can be compensated under Parts B and/or E of the Energy Employee Occupational Illness Compensation Program Act (EEOICPA).
To obtain free medical screening under the WHPP, an employee must first be deemed eligible. If a former employee was employed at one of the participating DOE sites, listed below, for thirty days or more, he or she is eligible for free medical screening. In the event that the former employee was employed at Nevada Test Site, Lawrence Livermore National Laboratory, Lawrence Berkeley National Laboratory, or Sandia National Laboratories, the period of employment must be one year or more. While the program only covers former employees for a majority of the DOE facilities, current employees at the Paducah or Portsmouth Gaseous Diffusion Plants are also eligible for free screening. The Worker Health Protection Program, “What We Do,” available at http://www.worker-health.org/whatwedo.html.
Covered DOE Sites
The participating DOE facilities under the WHPP include:
- Sandia/CA National Lab in Livermore, CA;
- Lawrence Livermore National Lab (LLNL) in Livermore, CA;
- Lawrence Berkeley National Lab (LBNL) in Berkeley, CA;
- Nevada Test Site in Las Vegas, NV;
- Idaho National Laboratory (INL) in Idaho Falls, ID;
- Mound Plant in Miamisburg, OH;
- Fernald Plant in Harrison, OH;
- Paducah Gaseous Diffusion Plant in Paducah, KY;
- K-25 Complex in Oak Ridge, TN;
- Y-12 Plant/Oak Ridge National Laboratory (ORNL) in Oak Ridge, TN; and
- Portsmouth Gaseous Diffusion Plant in Piketon, OH.
The WHPP contracts with medical facilities to provide free medical screenings near all of the covered DOE facilities. A list of participating medical facilities is provided at http://www.worker-health.org/whatwedo.html.
Pantex Former Worker Program
Former employees, who are at risk for illness due to their exposure to hazardous and/or radioactive substances while employed at Pantex Plant in Amarillo, TX, are entitled to a free medical screening. The program is administered by Drexel University School of Public Health and the University of Texas Health Science Center at Tyler. U.S. Department of Energy, Office of Environment, Health, Safety & Security, “Pantex, Former Production Workers Screening Projects,” available at http://www.energy.gov/ehss/pantex-former-production-workers-screening-projects.
Medical Exam Program for Former Workers from Los Alamos and Sandia National Laboratories
The Medical Exam Program for Former Workers from Los Alamos (LANL) and Sandia National Laboratories (SNL) was established to determine whether the health of former employees from either DOE facility was affected due to their employment and exposure to hazardous substances.
The Medical Exam Program for former LANL employees focuses on exposure to asbestos, beryllium, lead, noise, radiation, and solvents. John Hopkins Bloomberg School of Public Health, “Medical Exam Program,” available at http://www.jhsph.edu/research/affiliated-programs/medical-exam-program-for-former-workers-at-los-alamos-national-laboratory/. The Medical Exam Program for SNL employees focuses on the same substances as well as silica.
The initial medical screening includes an exam and selected tests, depending on which substances the employee was exposed to. Employees are eligible for a rescreening every three years if they had past exposure to asbestos and/or beryllium. Id.
To be eligible for a free medical screening exam, former LANL employees must have worked at the LANL site anytime after 1943, been significantly exposed to one of the substances listed above, and been employed by the University of California, Zia, Pan Am World Services, Johnson Controls International, Johnson Controls of Northern New Mexico, or another subcontractor. Id.
To be eligible for a free medical screening exam, former SNL employees must have worked at the SNL site anytime after 1949, been significantly exposed to one of the substances listed above, and been employed by Z-Division Sandia Laboratories, Sandia Corporation (Western Electric), Sandia Corporation (Lockheed Martin), or Sandia National Laboratories (SNL).
Former Worker Medical Screening Program for Line 1/Division B Iowa Army Ammunition Plant and Ames Laboratory
The Former Worker Medical Screening Program provides free medical screenings to all employees of Line 1/Division B of the Iowa Army Ammunition Plant from 1949 to 1975 and Ames Laboratory in Ames, IA. The program is administered by the University of Iowa College of Public Health. The University of Iowa College of Public Health, “Former Worker Medical Screening Program (FWP),” available at http://cph.uiowa.edu/IowaFWP/line1/screening.html.
The Former Worker Medical Screening Program provides free medical screenings to eligible employees, which include a chest x-ray, a Pulmonary Function Test (PFT), a Beryllium Lymphocyte Proliferation Test (BeLPT), and general laboratory tests. Id. For those living in Iowa, medical screenings are offered in Burlington, Mt. Pleasant, Iowa City, or Ames. Id. For those not residing in Iowa, the Former Medical Screening Program refers employees to the NSSP. Id.
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