BONNEVILLE POWER ADMINISTRATION

**HUMAN RESOURCES**

**Portland, Oregon**

**PERSONNEL LETTER NO. 339-2 (Revised)** **DATE:** March 5, 2004

**SUBJECT:** Medical Evaluation Protocols

**I. [Purpose]{.underline}:** To transmit medical evaluation protocols
for jobs/positions that are covered by BPA's medical surveillance
program.

II. **[Purpose of Revision]{.underline}:** To update the approved
    medical evaluation protocol for Ross Chemistry Laboratory Personnel.
    This Personnel Letter supersedes Personnel Letter 339-2, dated
    August 2, 2002.

III. **[References]{.underline}:**

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A.  Title 5 Code of Federal Regulations, Part 339, "Medical
    Qualification

#  Determinations

B.  Title 5 Code of Federal Regulations, Part 293, Subpart E, Employee
    Medical File

#  System of Records 

###  

# Personnel Letter No. 293-2, Occupational Medical Records

C.  Personnel Letter No. 339-3, Medical Surveillance Program

D.  Personnel Letter No. 339-1, Medical Evaluation of Employees and
    Applicants

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IV. **[Policy]{.underline}:**

The Bonneville Power Administration (BPA) has established medical
evaluation protocols for jobs/positions and individuals that are covered
by BPA's medical evaluation programs. The use of these protocols is
mandatory. The attached medical surveillance protocols describe which
medical procedures BPA has authorized physicians to complete as part of
BPA's medical surveillance program.

**V. [Use of Protocols]{.underline}:**

The appropriate protocol must be sent to the physician performing a
physical assessment of employee (applicant) prior to the examination.
Protocols are developed by the Medical Program Manager and the BPA
Medical Officer and are approved by the Personnel Services Manager. In
some cases, the BPA Safety Office is also involved in the development of
protocols, in conjunction with the Medical Program Manager and the BPA
Medical Officer.

All approved medical surveillance protocols are attached to this
personnel letter.

BPA will not pay for any service that is not authorized by a protocol
unless the Medical Program Manager has authorized the procedure in
question. The Medical Program Manager may authorize deviations from
established protocols on a case-by-case basis. Deviations do not
establish precedent.

In some cases, an employee may undergo a medical surveillance evaluation
and more than one protocol may be appropriate. In such an instance, all
distinct elements of the various protocols should be combined
(redundancy eliminated) to ensure that the employee receives as
comprehensive evaluation as necessary.

**VI. [Modifications of Protocols]{.underline}:**

Any BPA employee who is cognizant of the need to modify an established
protocol should suggest the change through the chain of command and have
the employee's supervisor/manager suggest the modification to the
Medical Program Manager. Suggested changes will contain an explanation
of why the change should occur and include any supporting evidence that
is available to support the request.

Godfrey C. Beckett

Manager, Human Resources, Diversity and EEO

12 Attachments

> [MEDICAL SURVEILLANCE PROTOCOL]{.underline}
>
> (Replaces protocol dated March 22, 2000)

**[Type of Examination]{.underline}**

> Welder Medical Evaluation

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with industrial materials that may emit irritant gases or
> chemical vapors and to identify physical limitations or medical
> problems that can affect the employee\'s ability to safely use
> respiratory equipment in the course of his/her work; and to detect
> early signs or symptoms of illness and to the promote health and
> well-being of the employee.

**[Employees to be Examined]{.underline}**

> Employees who are involved in all types of general welding on steel
> and aluminum structures using heliarc and aircomatic processes. Also
> those who braze, weld, and cut by oxyacetylene process.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> Pre-employment, separation, position change, and annual evaluations
> shall include the following:
>
> General physical examination and medical history, with special
> emphasis on the head, ears, eyes, nose, throat, lungs and skin, as
> well as the nervous system.
>
> These examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck, chest, heart, abdomen, extremities,
> skin, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Lab Work
>
> a\. Blood lab work:
>
> 1.) Complete blood count and chemistry profile.
>
> 2.) Blood lead level and zinc protoporphyrins (FEP).
>
> b\. Routine urinalysis.
>
> 5\. Chest x-ray, 2 views (baseline, and then every five years, unless
> determined by the examining physician to be necessary more often).
>
> 6\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV1/FVC).
>
> 7\. Vision screening.
>
> 8\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> > a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> > initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records."

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Welder (01-29-02)

> PHYSICIAN\'S CHECKLIST
>
> BONNEVILLE POWER ADMINISTRATION
>
> **[EMPLOYEE MEDICAL EVALUATION for WELDERS]{.underline}**
>
> (Pre-employment, Separation, and Position Change Evaluations)
>
> EMPLOYEE NAME
>
> **Medical evaluations will consist of a general physical examination
> and medical history with special emphasis on the head, ears, eyes,
> nose, throat, lungs and skin, as well as the nervous system** and will
> also include:
>
> **1. General medical history** with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.
> hobbies.
>
> **2. General physical examination** with vital signs, exam of the
> head, ears, eyes, nose, throat, neck, chest, heart, abdomen,
> extremities, skin and a neurologic examination.
>
> **3. Occupational work history.**
>
> **4. Lab Work**
>
> **a. Blood lab work:**
>
> **1.) CBC and chemistry profile.**
>
> **2.) Blood lead level and zinc protoporphyrins (FEP).**
>
> **b. Routine urinalysis.**
>
> **5. Chest x-ray, 2 views** (baseline, and then every five years,
> unless determined by the examining physician to be necessary more
> often).
>
> **6. Pulmonary function test** (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> **7. Vision screening.**
>
> **8. Respirator Clearance Examination** (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> **a. Health History Questionnaire (BPA Form 5480.16e**) to be
> completed initially and every fourth year (e.g. years 1, 4, 7, 10,
> etc.).
>
> > **b. Annual Health History Questionnaire (BPA Form 5480.19)** to be
> > completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9,
> > etc.).
>
> \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--
>
> I certify that I have performed these services for the Bonneville
> Power Administration employee listed above. Any additional testing or
> evaluations will be the responsibility of the employee unless prior
> authorized. I have counseled the employee as to the results of the
> medical evaluation and have made the following recommendations:
>
> Physician\'s Signature Date
>
> Welder (01-29-02)
>
> PHYSICIAN\'S CHECKLIST
>
> BONNEVILLE POWER ADMINISTRATION
>
> **[EMPLOYEE MEDICAL EVALUATION for WELDERS]{.underline}**
>
> (Annual Evaluation)
>
> EMPLOYEE NAME
>
> **Medical evaluations will consist of a general physical examination
> and medical history with special emphasis on the head, ears, eyes,
> nose, throat, lungs and skin, as well as the nervous system** and will
> also include:
>
> **1. General medical history** with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> **2. General physical examination** with vital signs, exam of the
> head, ears, eyes, nose, throat, neck, chest, heart, abdomen,
> extremities, skin, and a neurologic examination.
>
> **3. Occupational work history.**
>
> **4. Lab Work**
>
> **a. Blood lab work:**
>
> **1.) CBC and chemistry profile with lipid panel.**
>
> **2.) Blood lead level and zinc protoporphyrins (FEP).**
>
> **b. Routine Urinalysis.**
>
> **5. Chest x-ray, 2 views** (baseline, and then every five years,
> unless determined by the examining physician to be necessary more
> often).
>
> **6. Pulmonary function test** (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> **7. Vision screening.**
>
> **8. Respirator Clearance Examination** (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> **a. Health History Questionnaire (BPA Form 5480.16e)** to be
> completed initially and every fourth year (e.g., years 1, 4, 7, 10,
> etc.).
>
> > **b. Annual Health History Questionnaire (BPA Form 5480.19)** to be
> > completed during interim years (e.g., years 2 & 3, 5 & 6, 8 & 9,
> > etc.).
>
> \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\--
>
> I certify that I have performed these services for the Bonneville
> Power Administration employee listed above. Any additional testing or
> evaluations will be the responsibility of the employee unless prior
> authorized. I have counseled the employee as to the results of the
> medical evaluation and have made the following recommendations:
>
> Physician\'s Signature Date
>
> Welder (01-29-02)
>
> [MEDICAL SURVEILLANCE PROTOCOL]{.underline}
>
> (Replaces protocol dated August 7, 1998)

**[Type of Examination]{.underline}**

> Cable Splicers Medical Evaluation

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with industrial materials that may emit irritant gases or fumes
> and to identify physical limitations or medical problems that can
> affect the employee\'s ability to safely use respiratory protection
> equipment in the course of his/her work; and to detect early signs or
> symptoms of illness and to the promote health and well-being of the
> employee.

**[Employees to be Examined]{.underline}**

> Those employees who are involved in splicing lead covered cables and
> copper shielded cables of various types and who are exposed to fumes
> that are emitted from materials that are heated during the process of
> making hot splices.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols. Employees will have a blood lead level
> and blood zinc protoporphyrin level performed twice during the
> calendar year, at the annual exam, and again at a six months interval.

**[Medical Examination Protocol]{.underline}**

> Pre-employment, separation, position change, and annual evaluations
> shall include the following:
>
> General physical examination and medical history with special emphasis
> on the head, ears, eyes, nose, throat, lungs and skin, as well as the
> nervous system.
>
> These examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. Occupational work history.
>
> 3\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, abdomen, extremities,
> skin, and a neurologic examination.
>
> 4\. Lab Work
>
> a\. Blood lab work:
>
> 1.) Complete blood count (CBC to include RBC indices if history
> indicates lead exposure).

2.  Chemistry profile.

> 3.) Blood lead level and zinc protoporphyrins (to be performed during
> the annual exam and again at a six months interval).
>
> b\. Routine urinalysis.
>
> 5\. Chest x-ray, 2 views (baseline, and then every five years, unless
> determined by the examining physician to be necessary more often).
>
> 6\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV1/FVC).
>
> 7\. Vision screening.
>
> 8\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> > a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> > initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).

# Disposition of Results of the Examination

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records."

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Cable Splicer (03-22-00)

> [MEDICAL SURVEILLANCE PROTOCOL]{.underline}
>
> (Replaces protocol dated August 8, 1999)

**[Type of Examination]{.underline}**

> Carpenter Medical Evaluation

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with industrial materials which may contain potentially hazardous
> particulate or chemical substances and to identify physical
> limitations or medical problems that could affect their ability to
> safely use respiratory protection equipment; and to detect early signs
> or symptoms of illness and to promote the health and well-being of the
> employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in cutting, sanding, or
> drilling industrial materials; the application of various glues,
> lacquers, preservatives to these products; and in some instances may
> use respiratory protection equipment to avoid breathing air
> potentially contaminated by these substances.
>
> Periodically, some of these employees may be involved in asbestos
> removal projects.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> Pre-employment, separation, and position change evaluations shall
> include the following:
>
> General physical examination and medical history with special emphasis
> on the respiratory system, nervous system, skin, and liver.
>
> These examinations will also include:
>
> 1\. Medical history with review of systems, list of medications,
> allergies, and a past medical history noted on their record. Smoking
> history and ethanol intake should be documented, as well as potential
> exposures to chemicals outside the work place, i.e. hobbies. Special
> emphasis should be directed to symptoms of the respiratory system,
> cardiovascular system, and digestive tract. [Obtain the date of
> employee\'s first possible asbestos exposure.]{.underline}
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, abdomen, extremities,
> skin, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Asbestos Initial Medical Questionnaire (attached)
>
> 5\. Informational Attachments (to be furnished to the examining
> physician in accordance with the 29 CFR 1926.58, Appendix 1, D, and
> E).
>
> a\. 29 CFR 1926.58, Appendix 1, D, and E (attached) for review by the
> examining physician.
>
> b\. Description of the employee\'s duties, as they relate to potential
> exposure (to be furnished by the employee\'s supervisor) and
> representative exposure levels or anticipated exposure levels.
>
> c\. Information relative to personal protective and respiratory
> equipment to be used (BPA Form 5480.16, Page 4, Part 1, to be
> completed by the supervisor\--attached).
>
> 6\. Height and weight.
>
> 7\. Blood pressure and pulse.
>
> 8\. Lab Work
>
> a\. Blood lab work: CBC and chemistry profile.
>
> b\. Routine urinalysis.
>
> 9\. Chest x-ray, 2 views (baseline, and then according to schedule
> below). The x-ray may be ordered more often at the discretion of the
> examining physician.
>
> Years since [Age of Employee \_\_\_\_\_\_ ]{.underline}
>
> [first exposure 15 to 35 35+ to 45 45+ \_\_\_\_]{.underline}
>
> 0 to 10 Every 5 years Every 5 years Every 5 years
>
> 10+ Every 5 years Every 2 years Every 1 year
>
> 10\. Pulmonary function test (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> 11\. Vision screening.
>
> 12\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> > a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> > initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> [Annual examinations]{.underline} shall include the following in
> addition to the coverage of the
>
> pre-employment, change of position, and separation evaluations:
>
> 1\. Interval medical history, focusing on changes in the health
> status, illnesses, and work-related symptoms since the pre-employment
> evaluation. (The BPA Safety Office shall furnish Information about the
> employee's interval exposure history, including asbestos exposure
> monitoring of the job site.)
>
> 2\. Asbestos Periodic Medical Questionnaire.
>
> 3\. Additional medical testing may be indicated based on exposure
> information, medical history, and examination. [The BPA Medical
> Officer prior to the testing must approve any additional
> testing]{.underline}.

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records.\"

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Carpenter (03-22-00)

> [MEDICAL SURVEILLANCE PROTOCOL]{.underline}
>
> (Replaces protocol dated August 8, 1999)

**[Type of Examination]{.underline}**

> Personnel Involved in Asbestos Removal Medical Evaluation (other than
> carpenters)

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> are, or have been, involved in the removal of asbestos which contains
> hazardous particulate; to identify physical limitations or medical
> problems that could affect their ability to safely use respiratory
> protection equipment and/or personal protective clothing; to detect
> early signs or symptoms of illness; and to promote the health and
> well-being of the employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in the removal of asbestos
> as part of their job duties and use respiratory equipment and/or
> personal protective clothing to avoid breathing air or having physical
> contact with these substances. This also includes sheet metal
> mechanics who were involved in the removal of asbestos in oven panels
> up through the early 1990's.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> [Pre-employment, separation, and position change medical evaluations
> shall include the following]{.underline}:
>
> General physical examination and medical history with special emphasis
> on the skin, liver, respiratory, gastrointestinal, and nervous
> systems.
>
> These examinations will also include:
>
> 1\. Medical history with review of systems, list of medications,
> allergies, and a past medical history noted on their record. Smoking
> history and ethanol intake should be documented, as well as potential
> exposures to chemicals outside the work place, i.e., hobbies. Special
> emphasis should be directed to symptoms of the respiratory system,
> cardiovascular system, and digestive tract. [Obtain the date of the
> employee\'s first possible asbestos exposure]{.underline}.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, lungs, heart, abdomen,
> extremities, skin, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Asbestos Initial Medical Questionnaire.
>
> 5\. Informational Attachments (to be furnished to the examining
> physician in
>
> accordance with the 29 CFR 1926.58, Appendix 1, D, and E).
>
> a\. 29 CFR 1926.58, Appendix 1, D, and E for review by the examining
> physician.
>
> b\. Description of the employee\'s duties, as they relate to potential
> exposure (to be furnished by the employee\'s supervisor) and
> representative exposure levels or anticipated exposure levels.
>
> c\. Information relative to personal protective and respiratory
> equipment to be used (BPA Form 5480.16e, Respirator Information, be
> completed by the supervisor).
>
> 6\. Height and weight.
>
> 7\. Blood pressure and pulse.
>
> 8\. Lab Work
>
> a\. Blood lab work: CBC and chemistry profile.
>
> b\. Routine urinalysis.
>
> 9\. Chest x-ray, 2 views (baseline, and then according to schedule
> below). The x-ray may be ordered more often at the discretion of the
> examining physician. Every two years, the sheet metal mechanics will
> have B-readings performed on their chest x-rays.
>
> Years since [Age of Employee  ]{.underline}
>
> [first exposure 15 to 35 35+ to 45 45+  ]{.underline}
>
> 0 to 10 Every 5 years Every 5 years Every 5 years
>
> 10+ Every 5 years Every 2 years Every 1 year
>
> 10\. Pulmonary function test (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> 11\. Vision screening.
>
> 12\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> > a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> > initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> [Annual examinations]{.underline} shall include the following in
> addition to the coverage of the
>
> pre-employment, change of position, and separation medical
> evaluations:
>
> 1\. Interval medical history, focusing on changes in the health
> status, illnesses, and work-related symptoms since the pre-employment
> evaluation. (Information about the employee\'s interval
>
> exposure history, including asbestos exposure monitoring of the job
> site shall be furnished by the BPA Safety Office).
>
> 2\. Asbestos Periodic Medical Questionnaire.
>
> 3\. Additional medical testing may be indicated based on exposure
> information, medical history, and examination. [The BPA Medical
> Officer prior to the testing must approve any additional
> testing]{.underline}.

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records.\"

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Asbestos Removal (03-22-00)

[MEDICAL SURVEILLANCE PROTOCOL]{.underline}

> (Replaces protocol dated March 22, 2000)

**[Type of Examination]{.underline}**

> Hazardous Waste Handler Medical Evaluation (non-asbestos)

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with industrial materials that may contain potentially hazardous
> particulate or chemical substances and to identify physical
> limitations or medical problems that could affect their ability to
> safely use respiratory protection equipment and/or personal protective
> clothing; and to detect early signs or symptoms of illness and to
> promote the health and well-being of the employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in the handling and disposal
> of a variety of potentially hazardous industrial materials and
> chemicals; those who may use respiratory protection equipment and/or
> protective clothing; and those having physical contact with these
> substances.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> [Pre-employment, separation, and position change
> evaluations]{.underline} shall include the following:
>
> General physical examination and medical history with special emphasis
> on the skin, ears, nose and throat and the nervous, respiratory,
> cardiovascular, gastrointestinal, genitourinary, and reproductive
> systems.
>
> These examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, skin, heart, abdomen,
> respiratory, peripheral-vascular, musculoskeletal, genitourinary, and
> reproductive systems, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Height and weight.
>
> 5\. Blood pressure and pulse.
>
> 6\. Lab work
>
> a\. Blood Lab Work:
>
> 1.) CBC and chemistry profile.
>
> 2.) Blood lead level with zinc protoporphyrins (FEP) (if indicated by
> exposure history at the time of the exam).
>
> b\. Routine urinalysis.
>
> 7\. EKG. Baseline and every 5 years unless determined at the annual
> exam to be necessary more often. (Stress EKG [only]{.underline} if
> indicated, based on medical history).
>
> 8\. Stool for occult blood (starting at age 40).
>
> 9\. Chest x-ray, 2 views (baseline, and then every 5 years unless
> determined by the examining physician or based on employee symptoms or
> exposure history to be done more often).
>
> 10\. Vision screening.
>
> 11\. Pulmonary function test (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> 12\. Audiogram (pre-employment, separation, and change of position
> examination only).
>
> 13\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> [Annual examinations]{.underline} shall include the following in
> addition to the coverage of the
>
> pre-employment, change of position, and separation evaluations:
>
> 1\. Interval medical history, focusing on changes in the health
> status, illnesses, and work-related symptoms since the pre-employment
> evaluation. (Information about the employee\'s interval exposure
> history, including exposure monitoring of the job site shall be
> furnished by the BPA Safety Office).
>
> 2\. Additional medical testing may be indicated based on exposure
> information, medical history, and examination. [Any additional testing
> must be approved by the BPA Medical Officer prior to the
> testing]{.underline}.

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records".

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Hazardous Waste (non-asbestos) (01-29-02)

[MEDICAL SURVEILLANCE PROTOCOL]{.underline}

(Replaces protocol dated March 22, 2000)

**[Type of Examination]{.underline}**

> Ross Complex Hazardous Waste Handler Medical Evaluation for Personnel
> at Utilization and Disposal

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with industrial materials that may contain potentially hazardous
> particulate or chemical substances and to identify physical
> limitations or medical problems that could affect their ability to
> safely use respiratory protection equipment and/or personal protective
> clothing; and to detect early signs or symptoms of illness and to
> promote the health and well-being of the employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in the handling and disposal
> of a variety of potentially hazardous industrial materials and
> chemicals; those who may use respiratory protection equipment and/or
> protective clothing; and those having physical contact with these
> substances.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> [Pre-employment, separation, and position change
> evaluations]{.underline} shall include the following:
>
> General physical examination and medical history with special emphasis
> on the nervous, respiratory, cardiovascular, gastrointestinal,
> genitourinary and reproductive systems, skin, ears, nose, and throat.
>
> These examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, lungs, abdomen,
> rectum, skin, peripheral vascular, musculoskeletal and genitourinary
> systems, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Height and weight.
>
> 5\. Blood pressure and pulse.
>
> 6\. Lab Work
>
> a\. Blood lab work:
>
> 1.) CBC and chemistry profile.
>
> 2.) Blood lead level and zinc protoporphyrins (FEP).
>
> b\. Routine urinalysis.
>
> 7\. EKG. Baseline and every 5 years unless determined at the annual
> exam to be necessary more often. (Stress EKG [only]{.underline} if
> indicated, based on medical history).
>
> 8\. Stool for occult blood (starting at age 40).
>
> 9\. Chest x-ray, 2 views (baseline, and then every 5 years unless
> determined by the examining physician or based on employee symptoms or
> exposure history to be done more often).
>
> 10\. Vision screening.
>
> 11\. Audiogram (pre-employment, separation, and change of position
> examination only).
>
> 12\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV/FVC).
>
> Employees who use respiratory protection equipment will need the
> following:
>
> 13\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> [Annual examinations]{.underline} shall include the following in
> addition to the coverage of the
>
> pre-employment, change of position, and separation evaluations:
>
> 1\. Interval medical history, focusing on changes in the health
> status, illnesses, and work-related symptoms since the pre-employment
> evaluation. (Information about the employee\'s interval exposure
> history, including exposure monitoring of the job site shall be
> furnished by the BPA Safety Office.)
>
> 2\. Additional medical testing may be indicated based on exposure
> information, medical history, and examination. [Any additional testing
> must be approved by the BPA Medical Officer prior to the
> testing]{.underline}.

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records.\"

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

HazWaste (U&D) (01-29-02)

> [MEDICAL SURVEILLANCE PROTOCOL]{.underline}
>
> (Replaces protocol dated August 8, 1998)

**[Type of Examination]{.underline}**

> Medical Evaluation for Environmental Personnel Involved in Hazardous
> Substance and Waste Sampling

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work in close proximity to environmental substances that are
> potentially contaminated with hazardous or toxic substances or wastes
> and to identify physical limitations or medical problems that could
> affect their ability to safely use respiratory protection equipment
> and/or personal protective clothing; and to detect early signs or
> symptoms of illness and to promote the health and well-being of the
> employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in the handling and disposal
> of a variety of environmental substances that are potentially
> contaminated with hazardous or toxic substances or wastes; those who
> may use respiratory protection equipment and/or protective clothing;
> and those having physical contact with these substances.

**[Frequency of Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols.

**[Medical Examination Protocol]{.underline}**

> [Pre-employment, separation, and position change
> evaluations]{.underline} shall include the following:
>
> General physical examination and medical history with special emphasis
> on the nervous system, respiratory system, cardiovascular system,
> gastrointestinal system, genitourinary and reproductive systems, skin,
> ears, nose, and throat.
>
> These examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, lungs, abdomen,
> rectum, peripheral vascular system, musculoskeletal system,
> genitourinary system, skin and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Height and weight.
>
> 5\. Blood pressure and pulse.
>
> 6\. Lab work
>
> a\. Blood lab work:
>
> 1\. CBC and chemistry profile.
>
> 2\. Blood lead level (**[only]{.underline}** if indicated by exposure
> history at the time of the exam.
>
> b\. Routine urinalysis.
>
> 7\. EKG. Baseline and every 5 years unless determined at the annual
> exam to be necessary more often. (Stress EKG [only]{.underline} if
> indicated, based on medical history).
>
> 8\. Stool for occult blood (starting at age 40).
>
> 9\. Chest x-ray, 2 views (baseline, and then every 5 years unless
> determined by the examining physician or based on employee symptoms or
> exposure history to be done more often).
>
> 10\. Vision screening.
>
> 11\. Pulmonary function test (3 good efforts. FEV1, FVC, and
> FEV1/FVC).
>
> 12\. Audiogram (pre-employment, separation, and change of position
> examination only).
>
> 13\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done
>
> by the Bonneville Power Administration Safety Office).
>
> > a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> > initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> [Annual examinations]{.underline} shall include the following in
> addition to the coverage of the
>
> pre-employment, change of position, and separation evaluations:
>
> 1\. Interval medical history, focusing on changes in the health
> status, illnesses, and work-related symptoms since the pre-employment
> evaluation. (Information about the employee\'s interval exposure
> history, including exposure monitoring of the job site shall be
> furnished by the BPA Safety Office.)
>
> 2\. Additional medical testing may be indicated based on exposure
> information, medical history, and examination. [Any additional testing
> must be approved by the BPA Medical Officer prior to the
> testing]{.underline}.

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the Employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2," Occupational Medical Records.\"

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Environmental (03-22-00)

[MEDICAL SURVEILLANCE PROTOCOL]{.underline}

> (Replaces protocol dated August 7, 1998)

**[Type of Examination]{.underline}**

> Painters Health Evaluation

**[Purpose of Examination]{.underline}**

> To periodically perform medical evaluations on certain employees who
> work with various paints and lacquers that may emit potentially
> dangerous irritant and/or chemical fumes to: detect early signs or
> symptoms of illness; to identify physical limitations or medical
> problems that can affect the employee\'s ability to safely use
> respiratory protective equipment in the course of their work; and to
> promote health and well-being of the employee.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in the spraying of various
> paints, enamels, and lacquers in their work and use respirator
> protection equipment to avoid breathing air potentially contaminated
> by these substances.

**[Frequency of the Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safety protocols. Painters working more than 6 months but
> less than one year will be required to have a pre-employment and
> separation medical evaluation.

**[Medical Examination Protocol]{.underline}**

> Pre-employment, separation, and position change, and annual medical
> evaluations shall include the following:
>
> General physical examination and medical history with special emphasis
> on the nervous system, lungs, skin, and genitourinary system.

1\. General medical history with a review of systems, list of
medications, allergies, and a past medical history noted on their
record. Smoking history and ethanol intake should be documented, as well
as potential exposures to chemicals outside the work place, i.e.,
hobbies.

> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, lungs, abdomen,
> rectum, skin, peripheral-vascular, musculoskeletal, and genitourinary
> systems, and a neurologic examination.
>
> 3\. Occupational work history.
>
> 4\. Height and weight.
>
> 5\. Blood pressure and pulse.
>
> 6\. Lab Work
>
> a\. Blood lab work:
>
> 1.) CBC and chemistry profile.
>
> 2.) Blood lead level and zinc protoporphyrins (to be performed during
> the annual exam and again at a six months interval).
>
> b\. Routine urinalysis.
>
> 7\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV1/FVC).
>
> 8\. Chest x-ray, 2 views, every 2 years (unless determined by the
> examining physician to be necessary more often).
>
> 9\. Vision screening.
>
> 10\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).

**[Disposition of the Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of clinical records will be retained in the Employee Medical
> File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, "Occupational Medical Records."

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Painter (03-22-00)

##### MEDICAL SURVEILLANCE PROTOCOL

(Replaces protocol dated March 22, 2000)

**[Type of Examination]{.underline}**

> Ross Complex Chemistry Laboratory Personnel Health Evaluation

**[Purpose of Examination]{.underline}**

> To periodically examine certain Chemistry Laboratory employees who
> work with industrial materials which may contain potentially hazardous
> chemical substances and to identify physical limitations or medical
> problems that could affect their ability to safely use respiratory
> protection equipment.

**[Employees to be Examined]{.underline}**

> Those employees who are directly involved in performing chemical
> analysis and/or handling samples of potentially hazardous industrial
> materials and who may occasionally use respiratory protection
> equipment to avoid breathing air potentially contaminated by these
> substances.

**[Frequency of the Examination]{.underline}**

> The examination is required annually to verify effectiveness of
> established safeguards.

**[Medical Examination Protocol]{.underline}**

> Medical examinations will consist of a general physical examination
> and medical history with special emphasis placed on the central and
> peripheral nervous system, liver, kidney, heart, skin, and lungs.
>
> These annual examinations will also include:
>
> 1\. General medical history with review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, abdomen, extremities,
> skin, and a neurologic examination.
>
> 3\. Lab Work
>
> a\. Blood lab work:
>
> 1.) CBC and chemistry profile.
>
> 2.) Random urine mercury (if indicated by exposure history at the time
> of the exam).
>
> b\. Routine urinalysis.
>
> 4\. Electrocardiogram (baseline, and then every 5 years unless
> determined at the annual exam to be necessary more often).
>
> 5\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV1/FVC).
>
> 6\. Vision screening.
>
> 7\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).

**[Disposition of Results of the Examination]{.underline}**

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employees
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician, the Safety Office, and the Medical Program Manager in
> Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

**[Retention of Clinical Records]{.underline}**

> Copies of the clinical records will be retained in the Employee
> Medical File System.

**[Retention of Medical Information by BPA]{.underline}**

> Medical records shall be retained in accordance with Personnel Letter
> 293-2, \"Occupational Medical Records.\"

BPA Medical Officer Date

Safety Manager Date

Manager, Personnel Services Date

Medical Program Manager Date

Ross Chem Lab (07-28-03)

[MEDICAL SURVEILLANCE PROTOCOL]{.underline}

> (Replaces protocol dated November 15, 1995)

# **[Type of Examination]{.underline}**

> Mercury Surveillance Medical Evaluation

**[Purpose of Examination]{.underline}**

> To periodically examine certain employees at the Celilo Converter
> Station to screen for evidence of mercury exposure.

**[Employees to be Examined]{.underline}**

> Those employees who are involved in the maintenance of mercury arc
> valves and work in areas of potential mercury exposure. For the
> purposes of this protocol, "areas of potential mercury exposure"
> include the Clean Room, Grid Sandblasting Room, Porcelain Sandblasting
> Room, Grid Welding Room, and Degassing Room.

**[Frequency of Examination]{.underline}**

> An annual examination is required for employees, who have worked in
> areas of potential mercury exposure during the previous calendar year,
> to verify the effectiveness of established safety protocols. The
> Regional Manager responsible for the Celilo Converter Station will
> provide a list of these employees.
>
> New employees, or employees reassigned to the activity, who are
> rotating into work with the mercury arc valves and have not had an
> mercury surveillance exam within the past year, shall be examined
> within four weeks of the effective date of their assignment to the
> facility. This examination shall also be conducted prior to the
> employee's separation or position change.
>
> **Employees who are assigned to work directly on the mercury arc
> valves will have mercury levels performed as follows:**
>
> **1. Twice during the calendar year, the employee is to have a random
> urine mercury sample submitted. The employee should refrain from
> eating fish for 3 days prior to collection of the sample. The urine
> should be collected in the morning, pre-shift.**
>
> **2. When a known exposure incident occurs, the employee must have a
> blood mercury level drawn within 2 or 3 days.**
>
> **3. When mercury air monitoring levels exceed the PEL (permissible
> exposure limits), the employee may choose to have a blood mercury
> level drawn within 2 or 3 days if the employee is concerned that an
> exposure incident may have occurred.**

**[Medical Examination Protocol]{.underline}**

> [**Pre-employment, separation, position change evaluations** shall
> include the following]{.underline}:
>
> General physical examination and medical history with special emphasis
> on the oral cavity, neurologic system, and mental status evaluation.
>
> These examinations will also include:
>
> 1\. General medical history with a review of systems, list of
> medications, allergies, and a past medical history noted on their
> record. Smoking history and ethanol intake should be documented, as
> well as potential exposures to chemicals outside the work place, i.e.,
> hobbies.
>
> 2\. General physical examination with vital signs, exam of the head,
> ears, eyes, nose, throat, neck and chest, heart, lungs, abdomen, skin,
> and neurological examination.
>
> 3\. Neurological examination shall include:
>
> a\. Cranial nerve, sensory, motor, and reflex evaluation.
>
> b\. Brief mental status evaluation.
>
> c\. A sample of handwriting to evaluate for the presence of tremor.
>
> 4\. Examination of the oral cavity to determine the presence of
> lesions and/or signs of inflammation.
>
> 5\. Lab Work
>
> a\. Blood lab work:
>
> 1.) CBC and differential.
>
> 2.) Chemistry profile with lipid panel.
>
> 3.) Random urine mercury level.
>
> b\. Routine urinalysis.
>
> 6\. Chest x-ray, 2 views (baseline, and then every five years, unless
> determined by the examining physician to be necessary more often).
>
> 7\. Pulmonary function test (3 good efforts. FEV1, FVC, and FEV1/FVC).
>
> 8\. Vision screening.
>
> 9\. Respirator Clearance Examination (to include respirator fit
> testing and training to be done by the Bonneville Power Administration
> Safety Office).
>
> a\. Health History Questionnaire (BPA Form 5480.16e) to be completed
> initially and every fourth year (e.g. years 1, 4, 7, 10, etc.).
>
> b\. Annual Health History Questionnaire (BPA Form 5480.19) to be
> completed during interim years (e.g. years 2 & 3, 5 & 6, 8 & 9, etc.).
>
> **[Annual examinations]{.underline}** shall cover the same as the
> pre-employment, change of position, and separation evaluations with
> the following changes:
>
> Twice during the calendar year, the employee is to have a random urine
> mercury sample submitted. The employee should refrain from eating fish
> for 3 days prior to collection of the sample. The urine should be
> collected in the morning, pre-shift.
>
> **[Optional examinations]{.underline}** shall be made available to
> employees who work in the Mercury Arc Valve Program but who have not
> worked in areas of potential mercury exposure during the previous
> calendar year. The exam will be the same as the annual examination.

## Elevated Random Urine Levels

### If random levels exceed the BEI (Biological Exposure Index), a second random urine mercury level is to be repeated as [soon as possible]{.underline} and a blood mercury should be obtained.

If the second random urine sample is elevated, the employee should be
removed from areas of possible exposure and have a medical surveillance
examination.

> If the blood mercury is above the reference range, a second sample
> should be obtained. If the second level is elevated, the employee
> should be removed from areas of possible exposure and have a medical
> surveillance examination.

[Disposition of Results of the Examination]{.underline}

> The BPA Medical Officer shall review copies of the examination and
> test results. If it is necessary to restrict any of the employee\'s
> official duties because of a medical condition discovered during the
> examination, the BPA Medical Officer shall consult with the Examining
> Physician. If the circumstances warrant, information relative to the
> job restriction may be shared with the Safety Office and the Medical
> Program Manager in Personnel Services.
>
> The BPA Medical Officer will be responsible for making a medical
> decision regarding the advisability of a more extensive evaluation.

[Retention of Clinical Records]{.underline}

> Copies of the clinical records will be retained in the Employee
> Medical File System.

[Retention of Medical Information by BPA]{.underline}

> All medical records, maintained confidentially and in compliance with
> federal regulations, are kept in locked files. The confidentiality of
> all employee medical records shall be protected as required by the
> Privacy Act of 1974. Medical records shall be retained in accordance
> Personnel Letter 293-2, \"Occupational Medical Records.\"
>
> BPA Medical Officer Date
>
> Safety Manager Date
>
> Manager, Personnel Services Date
>
> Medical Program Manager Date

Mercury (12-10-01)