+---------+---+----------+-----------------+--------------------------+
| N       |   |          | **KMI**         | 1810.1                   |
| ational |   |          |                 |                          |
| Aero    |   |          |                 |                          |
| nautics |   |          |                 |                          |
|         |   |          |                 |                          |
| and     |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Adminis |   |          |                 |                          |
| tration |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| **John  |   |          | **REVISION**    | I                        |
| F.      |   |          |                 |                          |
| Kennedy |   |          |                 |                          |
| Space   |   |          |                 |                          |
| C       |   |          |                 |                          |
| enter** |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| *       |   |          |                 | 7/20/00                  |
| *DATE** |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| **EX    |   |          |                 | 7/20/04                  |
| PIRES** |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
|         |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| **MAN   |   |          |                 |                          |
| AGEMENT |   |          |                 |                          |
| INSTRU  |   |          |                 |                          |
| CTION** |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
|         |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| **RESP  |   | \*TA/S   |                 |                          |
| ONSIBLE |   | paceport |                 |                          |
| OF      |   | Services |                 |                          |
| FICE:** |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
|         |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| **SU    | K |          |                 |                          |
| BJECT** | S |          |                 |                          |
|         | C |          |                 |                          |
|         | O |          |                 |                          |
|         | c |          |                 |                          |
|         | c |          |                 |                          |
|         | u |          |                 |                          |
|         | p |          |                 |                          |
|         | a |          |                 |                          |
|         | t |          |                 |                          |
|         | i |          |                 |                          |
|         | o |          |                 |                          |
|         | n |          |                 |                          |
|         | a |          |                 |                          |
|         | l |          |                 |                          |
|         | M |          |                 |                          |
|         | e |          |                 |                          |
|         | d |          |                 |                          |
|         | i |          |                 |                          |
|         | c |          |                 |                          |
|         | i |          |                 |                          |
|         | n |          |                 |                          |
|         | e |          |                 |                          |
|         | P |          |                 |                          |
|         | r |          |                 |                          |
|         | o |          |                 |                          |
|         | g |          |                 |                          |
|         | r |          |                 |                          |
|         | a |          |                 |                          |
|         | m |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
|         |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| Refe    |   |          |                 |                          |
| rences: |   |          |                 |                          |
| \*a)    |   |          |                 |                          |
| NPG     |   |          |                 |                          |
| 8715.1  |   |          |                 |                          |
| (as     |   |          |                 |                          |
| re      |   |          |                 |                          |
| vised), |   |          |                 |                          |
| \"NASA  |   |          |                 |                          |
| Safety  |   |          |                 |                          |
| and     |   |          |                 |                          |
| Health  |   |          |                 |                          |
| Han     |   |          |                 |                          |
| dbook - |   |          |                 |                          |
| Occup   |   |          |                 |                          |
| ational |   |          |                 |                          |
|         |   |          |                 |                          |
| Safety  |   |          |                 |                          |
| and     |   |          |                 |                          |
| Health  |   |          |                 |                          |
| Pro     |   |          |                 |                          |
| grams\" |   |          |                 |                          |
|         |   |          |                 |                          |
| b\) NPD |   |          |                 |                          |
| 8900.1  |   |          |                 |                          |
| (as     |   |          |                 |                          |
| re      |   |          |                 |                          |
| vised), |   |          |                 |                          |
| \"      |   |          |                 |                          |
| Medical |   |          |                 |                          |
| Ope     |   |          |                 |                          |
| rations |   |          |                 |                          |
| Re      |   |          |                 |                          |
| sponsib |   |          |                 |                          |
| ilities |   |          |                 |                          |
| for     |   |          |                 |                          |
| Human   |   |          |                 |                          |
| Space   |   |          |                 |                          |
|         |   |          |                 |                          |
| Flight  |   |          |                 |                          |
| Pro     |   |          |                 |                          |
| grams\" |   |          |                 |                          |
|         |   |          |                 |                          |
| c\) KMI |   |          |                 |                          |
| 3792.1  |   |          |                 |                          |
| (as     |   |          |                 |                          |
| re      |   |          |                 |                          |
| vised), |   |          |                 |                          |
| \"KSC   |   |          |                 |                          |
| E       |   |          |                 |                          |
| mployee |   |          |                 |                          |
| Ass     |   |          |                 |                          |
| istance |   |          |                 |                          |
| Pr      |   |          |                 |                          |
| ogram\" |   |          |                 |                          |
|         |   |          |                 |                          |
| d\) 21  |   |          |                 |                          |
| CFR,    |   |          |                 |                          |
| part    |   |          |                 |                          |
| 1300,   |   |          |                 |                          |
| Con     |   |          |                 |                          |
| trolled |   |          |                 |                          |
| Sub     |   |          |                 |                          |
| stances |   |          |                 |                          |
| Act of  |   |          |                 |                          |
| 1970    |   |          |                 |                          |
|         |   |          |                 |                          |
| e\) JOP |   |          |                 |                          |
| 15      |   |          |                 |                          |
| E-3-22, |   |          |                 |                          |
| \"      |   |          |                 |                          |
| Between |   |          |                 |                          |
| 45th    |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Wing    |   |          |                 |                          |
| (45 SW) |   |          |                 |                          |
| and the |   |          |                 |                          |
| John F. |   |          |                 |                          |
| Kennedy |   |          |                 |                          |
|         |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Center  |   |          |                 |                          |
| for     |   |          |                 |                          |
| Medical |   |          |                 |                          |
| Cont    |   |          |                 |                          |
| ingency |   |          |                 |                          |
| Su      |   |          |                 |                          |
| pport\" |   |          |                 |                          |
|         |   |          |                 |                          |
| f\)     |   |          |                 |                          |
| KBM     |   |          |                 |                          |
| -ST-2.1 |   |          |                 |                          |
| (as     |   |          |                 |                          |
| re      |   |          |                 |                          |
| vised), |   |          |                 |                          |
| \"      |   |          |                 |                          |
| Medical |   |          |                 |                          |
| St      |   |          |                 |                          |
| andards |   |          |                 |                          |
| for     |   |          |                 |                          |
| John F. |   |          |                 |                          |
| Kennedy |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Center  |   |          |                 |                          |
|         |   |          |                 |                          |
| and     |   |          |                 |                          |
| Cape    |   |          |                 |                          |
| Ca      |   |          |                 |                          |
| naveral |   |          |                 |                          |
| Air     |   |          |                 |                          |
| S       |   |          |                 |                          |
| tation, |   |          |                 |                          |
| FL\"    |   |          |                 |                          |
|         |   |          |                 |                          |
| 1\.     |   |          |                 |                          |
| PURPOSE |   |          |                 |                          |
| AND     |   |          |                 |                          |
| APPLIC  |   |          |                 |                          |
| ABILITY |   |          |                 |                          |
|         |   |          |                 |                          |
| This    |   |          |                 |                          |
| Inst    |   |          |                 |                          |
| ruction |   |          |                 |                          |
| pre     |   |          |                 |                          |
| scribes |   |          |                 |                          |
| policy  |   |          |                 |                          |
| and     |   |          |                 |                          |
| assigns |   |          |                 |                          |
| re      |   |          |                 |                          |
| sponsib |   |          |                 |                          |
| ilities |   |          |                 |                          |
| for the |   |          |                 |                          |
| a       |   |          |                 |                          |
| dminist |   |          |                 |                          |
| ration, |   |          |                 |                          |
| profe   |   |          |                 |                          |
| ssional |   |          |                 |                          |
|         |   |          |                 |                          |
| def     |   |          |                 |                          |
| inition |   |          |                 |                          |
| and     |   |          |                 |                          |
| surve   |   |          |                 |                          |
| illance |   |          |                 |                          |
| of the  |   |          |                 |                          |
| Kennedy |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Center  |   |          |                 |                          |
| (KSC)   |   |          |                 |                          |
| Occup   |   |          |                 |                          |
| ational |   |          |                 |                          |
| M       |   |          |                 |                          |
| edicine |   |          |                 |                          |
| P       |   |          |                 |                          |
| rogram. |   |          |                 |                          |
|         |   |          |                 |                          |
| This    |   |          |                 |                          |
| Inst    |   |          |                 |                          |
| ruction |   |          |                 |                          |
| applies |   |          |                 |                          |
| to all  |   |          |                 |                          |
| NASA    |   |          |                 |                          |
| organiz |   |          |                 |                          |
| ational |   |          |                 |                          |
| e       |   |          |                 |                          |
| lements |   |          |                 |                          |
| at the  |   |          |                 |                          |
| Kennedy |   |          |                 |                          |
| Space   |   |          |                 |                          |
| Center, |   |          |                 |                          |
| Cape    |   |          |                 |                          |
|         |   |          |                 |                          |
| Ca      |   |          |                 |                          |
| naveral |   |          |                 |                          |
| Air     |   |          |                 |                          |
| Force   |   |          |                 |                          |
| Station |   |          |                 |                          |
| (       |   |          |                 |                          |
| CCAFS), |   |          |                 |                          |
| Van     |   |          |                 |                          |
| denberg |   |          |                 |                          |
| Air     |   |          |                 |                          |
| Force   |   |          |                 |                          |
| Base,   |   |          |                 |                          |
| and     |   |          |                 |                          |
| te      |   |          |                 |                          |
| mporary |   |          |                 |                          |
| sites   |   |          |                 |                          |
| where   |   |          |                 |                          |
| KSC     |   |          |                 |                          |
|         |   |          |                 |                          |
| has     |   |          |                 |                          |
| jurisdi |   |          |                 |                          |
| ctional |   |          |                 |                          |
| r       |   |          |                 |                          |
| esponsi |   |          |                 |                          |
| bility, |   |          |                 |                          |
| and to  |   |          |                 |                          |
| their   |   |          |                 |                          |
| ass     |   |          |                 |                          |
| ociated |   |          |                 |                          |
| cont    |   |          |                 |                          |
| ractors |   |          |                 |                          |
| and     |   |          |                 |                          |
| tenants |   |          |                 |                          |
| in      |   |          |                 |                          |
| acc     |   |          |                 |                          |
| ordance |   |          |                 |                          |
| with    |   |          |                 |                          |
| the     |   |          |                 |                          |
|         |   |          |                 |                          |
| pro     |   |          |                 |                          |
| visions |   |          |                 |                          |
| of      |   |          |                 |                          |
| their   |   |          |                 |                          |
| res     |   |          |                 |                          |
| pective |   |          |                 |                          |
| con     |   |          |                 |                          |
| tracts. |   |          |                 |                          |
|         |   |          |                 |                          |
| 2\.     |   |          |                 |                          |
| AU      |   |          |                 |                          |
| THORITY |   |          |                 |                          |
|         |   |          |                 |                          |
| b\. NPD |   |          |                 |                          |
| 1800.2  |   |          |                 |                          |
| (as     |   |          |                 |                          |
| re      |   |          |                 |                          |
| vised), |   |          |                 |                          |
| \"NASA  |   |          |                 |                          |
| Occup   |   |          |                 |                          |
| ational |   |          |                 |                          |
| Health  |   |          |                 |                          |
| Pr      |   |          |                 |                          |
| ogram\" |   |          |                 |                          |
|         |   |          |                 |                          |
| b\.     |   |          |                 |                          |
| NASA    |   |          |                 |                          |
| FAR     |   |          |                 |                          |
| Sup     |   |          |                 |                          |
| plement |   |          |                 |                          |
| (NFS)   |   |          |                 |                          |
| Subpart |   |          |                 |                          |
| 1       |   |          |                 |                          |
| 823.70, |   |          |                 |                          |
| \       |   |          |                 |                          |
| "Safety |   |          |                 |                          |
| and     |   |          |                 |                          |
| H       |   |          |                 |                          |
| ealth\" |   |          |                 |                          |
|         |   |          |                 |                          |
| \*      |   |          |                 |                          |
| Denotes |   |          |                 |                          |
| Change  |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+
| KSC     |   |          |                 |                          |
| FORM    |   |          |                 |                          |
| 2-92    |   |          |                 |                          |
| (REV    |   |          |                 |                          |
| 9/97)   |   |          |                 |                          |
| P       |   |          |                 |                          |
| REVIOUS |   |          |                 |                          |
| E       |   |          |                 |                          |
| DITIONS |   |          |                 |                          |
| ARE     |   |          |                 |                          |
| O       |   |          |                 |                          |
| BSOLETE |   |          |                 |                          |
+---------+---+----------+-----------------+--------------------------+

3\. [POLICY]{.underline}

> It is KSC policy to provide occupational medicine services consistent
> with NASA directives, standards, and the objectives of Federal
> Regulatory Agencies, e.g., the Department of Labor's implementing
> directives of the Occupational Safety and Health Administration
> (OSHA). Visitors are afforded only emergency medical services and
> first-aid care.

4\. [DEFINITIONS]{.underline} (None)

5.  [SPECIAL HEADINGS AS REQUIRED]{.underline} (None)

6.  [RESPONSIBILITIES]{.underline}

> Following is a statement of major responsibilities. Detailed
> responsibilities are set forth in Attachment A.

\*a. The KSC Chief Medical Officer is responsible for directing the
overall KSC Occupational Medicine Program.

\*b. The managers of program and project offices are responsible for
specifying medical requirements for their respective programs/projects
and coordinating such projects with Spaceport Services.

c\. Heads of primary organizations are responsible for ensuring
compliance from their respective organizations and contractors with
occupational medicine regulations as prescribed by law, NASA, and KSC
management issuances.

d\. The Director, Procurement Office, is responsible for assuring
appropriate Contracting Officer coordination with KSC Safety and Health
officials prior to solicitation of the procurements and for inclusion of
the appropriate provisions and clauses in accordance with NASA FAR
Supplement 1823.70.

e\. The Joint Performance Management Office (JPMO) is

> responsible for contract management and administration of the Joint
> Base Operations Contract (J-BOSC) Occupational Medicine and
> Environmental Health Contractor.

f\. An employee who has been unable to report to duty for medical
reasons for a period of five or more consecutive workdays is responsible
for obtaining medical clearance from one of the KSC/CCAFS Occupational
Health Facilities. This provision applies to contractor employees as
permitted by terms of their contracts and deemed advantageous to the
Government. The number of absent days may vary for contractor employees.

\*Denotes change.

2 of 3

g.  The Chairperson, NASA Exchange Council, is responsible for ensuring
    the Emergency Medical Services (EMS) are available for the KARS
    Recreation Areas. KSC and/or Brevard County EMS may be the first
    responder to KARS I, depending upon the telephone from which the
    call to 911 is initiated, and under the provisions of the
    KSC/Brevard County mutual aid agreements. KSC EMS is the first
    responder to KARS II requests for medical assistance.

6\. [SUPERSESSION]{.underline}

> This Instruction supersedes KMI 1810.1H.
>
> Roy D. Bridges, Jr.
>
> Director

Attachments:

A)  Responsibilities

B)  General Provisions

# KSC Civil Service Workers' Compensation Medical Policy

\*D) KSC Skin Cancer Prevention Program

DISTRIBUTION:

Tech Doc Library

\*Denotes Change

3 of 3

# [RESPONSIBILITIES]{.underline} {#responsibilities .unnumbered}

\*1. The KSC Chief Medical Officer is responsible for:

> a\. Planning, directing, and managing the overall KSC Occupational
> Medicine Program.

b\. Establishing the requirements for, and determining the constituents
of, job-related medical examinations and preventive programs, and
assuring publication of appropriate occupational medicine documents to
implement the procedural details of the respective activity or program.

c\. Providing professional medical consultation to the Center Director,
and to heads of primary organizations, as required.

> \*d. Providing Government employees at KSC with a health services
> program in accordance with NPD 1800.2 (as revised).
>
> e\. Serving as the principal KSC point of contact for coordinating
> medical responsibilities and activities with NASA Headquarters and
> other space flight organizations.
>
> f\. Interfacing with the 45^th^ Space Wing (45SW) concerning medical
> services for KSC workforces and activities at the CCAFS and with the
> 30^th^ Space Wing (30SW) concerning such services for KSC workforces
> at Vandenberg Air Force Base.
>
> g\. Serving as the official custodian of all medical records generated
> by the KSC/CCAFS medical programs.
>
> h\. Serving as Subsystem Manager and implementing PL 93-579, "Privacy
> Act of 1974," for all medical records under 10HIMS KSC-6, including
> CCAFS "Active" medical records generated on or after March 1, 1971,
> and such other medical records subsystems as may be generated for
> KSC/CCAFS programs and functions.
>
> i\. Ensuring that CPR and first-aid training is provided by the Joint
> Base Operations Support Contractor's Occupational Medicine and
> Environmental Health Services (OMEHS) for the following personnel:
>
> 1\. KSC Close Out Crew, Fire Rescue Teams, Ice Team, Red Crew Group
> #1, and KSC Safety representatives assigned to each contingency crew.
>
> 2\. KSC Security.
>
> 3\. KSC/CCAFS personnel required to work in remote areas.

\*Denotes change.

## A-1 of 4 {#a-1-of-4 .unnumbered}

2\. The Occupational Medicine Officer is responsible for:

a.  Administering the KSC Occupational Medicine Program.

b.  Implementing established NASA and KSC policies, programs, and plans
    for medical services at the Kennedy Space Center to ensure maximum
    feasible benefits to the KSC workforce and activities.

c.  Coordinating with 45 SW concerning policies, programs, and plans for
    medical services for KSC/CCAFS workforce and activities at the CCAFS
    and with 30 SW concerning policies, programs, and plans for these
    services for the KSC workforce at Vandenberg Air Force Base.

d.  Providing required Occupational Medicine Program information or
    reports to the Manager, Occupational Health Program, and others.

e.  Assuring the placement of the medical portion of the application for
    physical disability retirement in the medical record for civil
    service employees.

f.  Serving as the responsible individual for advising Center officials
    on significant medical administrative matters which may have an
    impact on missions, operations, community relations, and the overall
    health and morale of employees.

g.  Ensuring that the Occupational Medicine contractor prepares,
    implements, and periodically tests the KSC medical disaster plan.

h.  Arranging with Federal, State, and local agencies and/or community
    hospitals or groups, etc., to obtain supplemental medical/logistical
    support in emergencies.

i.  Reviewing budget requirements for the Medical Program.

j.  Administering the Occupational Medicine responsibilities identified
    in NPG 8715.1 (as revised).

k.  Assuring the aviation medical certification and aerospace medical
    aspects of NASA flightline operations at the KSC Shuttle Landing
    Facility (SLF) and advising other authorities (e.g., Patrick Air
    Force Base (PAFB) and JSC flight surgeons) on same at NASA hangar
    and ramp at PAFB.

3\. The J-BOSC Occupational Medicine and Environmental Health
Contractor, to the extent provided by contract, is responsible for:

a.  Implementing the operational aspects of the comprehensive NASA and
    USAF OMEHS Programs at KSC and CCAFS.

### A-2 of 4 {#a-2-of-4 .unnumbered}

b.  Providing for the maintenance of medical records as the
    administrator for the specified system of records in accordance with
    the Privacy Act.

c.  Acting as the field representative of the KSC Occupational Medicine
    Officer in clinical aspects of the OM program implementation.

d.  Providing for consultative services to KSC/CCAFS personnel in
    matters pertaining to Occupational Medicine.

4\. The managers of program and project offices are responsible for:

a.  Evaluating and specifying medical requirements for their respective
    programs/projects and validating requests for medical certification
    examinations.

> \*b. Coordinating program/project requirements with Spaceport Services
> for feasibility and impact on KSC operations.

5\. Heads of primary organizations are responsible for:

> \*a. Ensuring that requirements for medical support services are
> forwarded, through the appropriate channels, to Spaceport Services in
> sufficient time to permit review and support development.

\*b. Complying with the provisions of NPD 8900.1 (as revised) when
preparing test and checkout procedures.

c\. Ensuring that contracts include provisions requiring compliance with
this Instruction.

6\. KSC civil service employees are responsible for:

a.  Observing all restrictions and procedural requirements to protect
    themselves from health hazards, including the conscientious use of
    personal protective equipment, where specified.

b\. Obtaining medical clearance from one of the KSC Occupational Health
Facilities for return to duty for employees who have been unable to
report to duty for medical reasons for a period of five or more
consecutive workdays. This provision applies to contractor employees as
permitted by terms of their contracts and deemed advantageous to the
Government. The number of days absent may vary for contractor employees.

c\. Notifying their supervisors and seeking first-aid care from the KSC
Occupational Health Facilities for any injury which occurs on the job.

\*Denotes change.

### A-3 of 4 {#a-3-of-4 .unnumbered}

7.  The Personnel Officer is responsible for ensuring that all NASA/KSC
    and

> civil service tenant employees terminating or transferring employment
> have cleared through Spaceport Services/Occupational Medicine and
> Environmental Health Services.

\*8. The Director, Procurement Office, is responsible for including in
all contracts the requirement that all contractor personnel terminating
or transferring employment clear through Spaceport Services/Occupational
Medicine and Environmental Health Services if required by KSC Medical
Standards.

\*Denotes change.

A-4 of 4

GENERAL PROVISIONS

The Occupational Medicine Programs for KSC employees at KSC, Vandenberg
Air Force Base, and CCAFS include, but are not limited to, the
following:

1.  [Program Goals]{.underline}

> General goals are: To minimize sick leave, absenteeism, injury,
> disability, and premature death; to assure optimal working conditions
> with consideration of the total person; and to increase efficiency,
> productivity, and quality assurance as these are affected by the
> health and well-being of the employee.

2.  [Specific Program Elements]{.underline}

> The KSC Occupational Medicine Program shall include, but not be
> limited to, the following:
>
> a\. Providing evaluation, treatment, stabilization, and referral (as
> appropriate) of sick, injured, or troubled employees.
>
> b\. Providing, as required, medical evaluations of employees for
> job-related activities.
>
> c\. Collecting, updating, maintaining, safeguarding, and controlling
> distribution and use of medical and epidemiological information
> related to the health and well-being of the KSC workforce. This also
> encompasses conducting studies directed specifically toward better
> understanding of causes and mechanisms of occupational medicine health
> problems in order to solve, minimize, or eliminate such problems.
>
> d\. Providing medical support to flight missions and mission-related
> research and technology programs required at KSC.

e.  Establishing and operating a voluntary physical exercise program.

3\. [Medical Services]{.underline}

> a\. Providing emergency evaluation and first treatment of injuries or
> illnesses within the competence of the on-duty professional staff and
> the capability of equipment and facilities.
>
> b\. In cases when necessary first treatment is outside the capability
> of available staff and/or facilities, providing ambulance
> transportation for patients, to include emergency transportation, to a
> suitable medical facility.
>
> NOTE: The determination of what constitutes emergency will be made by
> professional medical staff only.
>
> B-1 of 3
>
> c\. Providing health examinations as delineated in KBM-ST-2.1 (as
> revised), "Medical Standards for John F. Kennedy Space Center and Cape
> Canaveral Air Station, FL."
>
> d\. Administering medications and providing medical treatment and
> other therapeutic measures required, at the judgment of the attending
> physician. This service is made available under the conditions and
> within the limitations described below, in accordance with 21 CFR,
> part 1300, Controlled Substances Act of 1970.
>
> \(1\) [Occupational Injuries/Illnesses]{.underline}. Limited only by
> the available facilities and the professional capabilities of the
> medical staff, or by statutory authority.
>
> \(2\) Non-occupational Injuries/Illnesses. Limited to emergency first
> care, or, as needed, to establish the provisional diagnosis to
> determine a need for further evaluation by the employee's personal
> physician. Therapy may be provided to enable an employee to remain at
> work for the remainder of the current work shift; or interim care may
> be provided prior to arrangement for private medical attention.
>
> \*(3) Diagnosis, Treatments, and Medications. Limited to services
> requested in writing by the employee's personal physician, when such a
> procedure is advantageous to the Government (precludes excessive
> work-time loss), when approved by the KSC Chief Medical Officer or the
> J-BOSC Medical Director, when the services are within the capability
> at KSC/CCAFS, and when the necessary directions or medications are
> furnished by the employee.
>
> \(4\) Immunizations. Required by regulations or job assignment; other
> immunizations, on a mass basis, which are approved by the Spaceport
> Services or recommended by the Manager, Occupational Health Program
> (NASA).
>
> e\. Managing and implementing the KSC Employee Assistance Program as
> described in KMI 3792.1 (as revised).

f\. Managing and operating a voluntary physical exercise program
(according to NPD 1800.2, as revised) for all Federal employees and for
contractors, when specifically permitted by terms of their contracts and
deemed advantageous to the Government.

> g\. Implementing and conducting preventive medical programs, within
> constraints of available resources, by standing and applicable
> directives. These programs shall also incorporate training and
> education, as appropriate.

\* Denotes change.

> B-2 of 3

h\. Providing medical services for employees and dependents on NASA
business related international travel or assignment, in accordance with
NASA directives.

\*4. [Tests, Checkouts, and Simulations]{.underline}: The Center's
responsibility with respect to medical and environmental health
activities related to tests, checkouts, and simulations is delineated in
NPD 8900.1 (as revised).

\* Denotes change.

> B-3 of 3

[KSC Civil Service Workers' Compensation Medical Policy]{.underline}

> 1\. All NASA KSC Civil Service employees who become ill due to an
> occupational incident or are injured on the job are to report to one
> of the KSC/CCAFS Occupational Medicine Clinics for evaluation unless
> the illness or injury requires immediate evacuation to a hospital.
>
> 2\. If the individual elects to accept care at KSC, and the KSC/CCAFS
> Medical personnel determine that the individual's illness or injury is
> within the scope of KSC/CCAFS resources, the appropriate diagnostic
> and therapeutic regimes will be instituted.
>
> 3\. If the KSC/CCAFS Medical personnel determine that the individual's
> illness or injury is outside the scope of KSC resources, or the
> individual elects treatment by outside medical sources, then he/she
> will be referred to his/her private physician or other appropriate
> medical personnel. The appropriate forms will be supplied for the
> outside medical personnel to complete. A consent form to release
> Workers' Compensation medical information to KSC Medical personnel
> will be completed. An appropriate line of communication will be
> established between KSC Medical personnel and the ill or injured
> individual's selected medical care provider. On a periodic basis,
> Occupational Medical Services medical personnel will schedule and
> medically evaluate ill or injured personnel for the purpose of
> determining if the individual is able to work in some capacity,
> thereby facilitating return to work.
>
> 4\. If due to special circumstances (e.g., an injury initially thought
> to be minor which worsens after normal work hours or the injury or
> illness occurs during TDY) an individual initially presents to a
> medical facility outside of KSC/CCAFS for treatment, then as soon as
> reasonably possible, the ill or injured individual is to report to a
> medical facility at KSC/CCAFS for evaluation.
>
> 5\. In all cases, the goal will be to minimize morbidity and mortality
> associated with the illness or injury; to optimize the health, safety,
> and well being of the individual; and to return the individual to
> productive work, either in full or limited duty capacity, as soon as
> possible, thereby minimizing the effects of the illness or injury on
> the overall KSC mission. It is the policy of KSC to afford work to
> injured employees consistent with the nature and extent of the injury.
> The supervisor of the injured employee, in consultation with the
> Occupational Medical Services, will provide a reasonable offer of
> suitable light or limited duty, including a description of the duties
> and requirements of the offered position.

6.  The mechanism to implement this policy is described in KDP
    KDP-P-2555, "KSC Civil Service Workers' Compensation Medical
    Process".

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# [**\***KSC SKIN CANCER PREVENTION PROGRAM]{.underline} {#ksc-skin-cancer-prevention-program .unnumbered}

1\. [INTRODUCTION]{.underline}

The KSC Skin Cancer Prevention Program is designed to identify employees
at high risk for intense sun and ultraviolet (UV) exposure and reduce
their risk for skin cancer via administrative measures, personal
protective equipment, education, and skin cancer screening and
detection. The program's goals are to minimize the incidence of skin
cancer and to provide early detection and intervention for those who do
develop this disease.

2\. [OBJECTIVES]{.underline}

To prevent suffering and death associated with skin cancer among NASA's
workforce, contractors, and clients, and for the Agency to serve as a
model for other Federal Agencies.

It is the Agency's goal that the number of new skin cancers detected
during the fifth year of the program will be only 75% of the new skin
cancers detected during the first year of the program.

3\. [BACKGROUND]{.underline}

There are three basic types of skin cancers: basal cell carcinomas (\~
75% of total skin cancers), squamous cell carcinomas (\<25%), and
malignant melanomas (\< 5%). Basal cell carcinoma and squamous cell
carcinoma are associated with sun exposure, specifically ultraviolet
radiation (85 -- 90% of these cancers occur in sun exposed areas). The
association between sun exposure and malignant melanoma is more tenuous
(\~ 20% occur in sun exposed areas). Decreasing sun and UV exposure,
increasing education about skin cancers, performing detailed skin
evaluations and providing targeted dermatological medical care for
suspicious skin lesions should reduce the incidence of skin cancers.

4\. [IMPLEMENTATION]{.underline}

4.1 [Administrative Measures]{.underline}

Administrative measures to potentially reduce intense sun or UV exposure
include identification of those individuals in high-risk exposure
occupations and development of a mechanism to minimize their exposure.

A. Examples of high sun and/or UV exposure occupations include but are
not limited to:

> 1\. Roofing Crew
>
> 2\. Road Crew (painters and those who do maintenance on the roadways)
>
> 3\. Roads and Grounds personnel

\* Denotes change.

D -1 of 4

> 4\. Security Guards
>
> 5\. Welders (additional non-solar UV exposure)
>
> 6\. Construction personnel, including those that perform
> surveillance/monitoring of construction jobs
>
> 7\. Personnel that work on the Shuttle Recovery Ships
>
> 8\. Personnel that work at the Hangar AF Wharf
>
> 9\. General Maintenance Workers
>
> 10\. Painters
>
> 11\. Shuttle pad mechanics
>
> 12\. High Voltage crews
>
> 13\. Water and Waste personnel
>
> 14\. Environmental Health Specialists
>
> 15\. Propellant Mechanics
>
> 16\. Contamination Control UV Light users
>
> 17\. Other workers with significant sun or artificially produced UV
> exposure as a part of their official duties

B. Examples of mechanisms to reduce UV exposure include:

> 1\. Limit outside work activities during peak midday solar exposure
> (10:00 a.m. to 2:00 p.m. standard time, 11:00 a.m. to 3:00 p.m.
> daylight savings time).
>
> 2\. Educate supervisors and employees in the use of appropriate
> personal protective equipment (e.g., brimmed hats, long sleeved
> shirts, long trousers, sunscreen, and sunglasses), and add these
> requirements to job procedures.
>
> 3\. Encourage voluntary outdoor activities (e.g., running) during
> non-peak sun exposure hours.

C. Responsibilities:

1\. Each NASA and on-site contractor organization is responsible for the
development of administrative measures and the subsequent promotion of
healthful UV exposure practices for individuals within their
organization.

> 2\. Each NASA and on-site contractor organization is responsible for
> identifying the individuals within their organization that are at risk
> for high sun or high UV exposure in performance of their duties.

3\. Each NASA and on-site contractor organization is responsible for
identifying those activities that can be limited during peak midday
solar exposure (10:00 a.m. to 2:00 p.m. standard time, 11:00 a.m. to
3:00 p.m. daylight savings time).

D-2 of 4

4.2 [Personal Protective Equipment]{.underline}

A. Appropriate personal protective equipment includes:

> 1\. UV cards to quantify exposure
>
> 2\. Wide brimmed hats

# 3. Sunscreen {#sunscreen .unnumbered}

4\. Tarps, umbrellas, and other sun shields as appropriate

> 5\. Clothing such as long-sleeve coveralls

6\. Economical limited life sunglasses for outside workers (cataract
prevention)

B. Responsibilities:

> 1\. Each NASA and on-site contractor organization is responsible for
> procuring appropriate personal protective equipment for their
> employees identified as at risk for high sun or high UV exposure in
> performance of their duties.

2.  The KSC Exchange and the KSC Visitor Complex is responsible for
    assuring hats and sunscreen are available for sale to employees,
    visitors and guests during daytime Shuttle launches and landings.

4.3 [Educational Measures]{.underline}

A. Educational measures and materials will include:

1\. Health education and wellness program instructional pamphlets,
posters and signs about skin cancer, skin cancer recognition, skin
cancer prevention, and skin cancer protection

2\. Emphasis on continuing medical education for physicians in skin
cancer surveillance

3\. Physician-to-patient education during Occupational Health physical
examination visits

4\. Instruction of workforce in total body skin self-examination through
educational materials

B. Responsibilities:

1\. The J-BOSC Occupational Health Contractor (SGS/CHS) Health Education
and Wellness Program is responsible for procuring and distributing
educational materials.

2\. The J-BOSC Occupational Health Contractor (SGS/CHS) is responsible
for providing in-service training for the physicians on skin cancer
surveillance and skin examination.

D-3 of 4

3\. The J-BOSC Occupational Health Contractor (SGS/CHS) physicians are
responsible for educating their patients who receive occupational
physicals on the importance of sun and UV protection and skin cancer
surveillance and self-examination.

4.4 [Skin Cancer Surveillance]{.underline}

A. Skin cancer surveillance will include:

1\. Encouragement of workforce to perform monthly total body skin
self-examination

2\. Total body skin examination by physician offered to those who
receive occupational physicals

> 3\. Referral to dermatologist or skin cancer specialist of those with
> suspicious lesions or those at high risk for skin cancer development
>
> High risk individuals include:

1.  Family history of skin cancer

2.  Personal history of skin cancer

3.  Persons with atypical moles

4.  Persons with numerous moles (greater than fifty)

5.  Fair/light skinned individuals

6.  Personal history of intense sun exposure

B. Responsibilities:

1\. The J-BOSC Occupational Health Contractor (SGS/CHS) Health Education
and Wellness Program is responsible for procuring and distributing
educational materials concerning total body skin self-examination.

> 2\. The J-BOSC Occupational Health Contractor (SGS/CHS) physicians are
> responsible for performing total body skin examinations on their
> patients who receive occupational physicals, and for referring
> individuals with suspicious lesions or who are at high risk to a
> dermatologist or skin cancer specialist.

D-4 of 4