[MCOH-EH] MCOH-EH Digest, Vol 252, Issue 285

Isakari, Marcia misakari at ucsd.edu
Wed Sep 13 13:27:36 PDT 2017
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We do urine instant testing from Quest.

Marcia Isakari, MD, MPH
Medical Director

Center for Occupational and Environmental Medicine
UC San Diego Health
200 W. Arbor Drive #8800
San Diego, CA 92103-8800
T: 858-657-1600 F: 619-543-7065
misakari at ucsd.edu
health.ucsd.edu

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-----Original Message-----
From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of mcoh-eh-request at mylist.net
Sent: Tuesday, September 12, 2017 5:23 PM
To: mcoh-eh at mylist.net
Subject: MCOH-EH Digest, Vol 252, Issue 285

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Today's Topics:

   1. Re:  Drug screening method (Spangler, Mary)
   2. Re:  [EXTERNAL]  hazardous drug administration (Amy Behrman)


----------------------------------------------------------------------

Message: 1
Date: Tue, 12 Sep 2017 23:55:50 +0000
From: "Spangler, Mary" <MSpangler at stanfordhealthcare.org>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Drug screening method
Message-ID:
	<MWHPR01MB270101D4903DC00B4A56D89BCD690 at MWHPR01MB2701.prod.exchangelabs.com>
	
Content-Type: text/plain; charset="us-ascii"

We use saliva.
Mary



Take 3 minutes to watch this doodle on sharps safety.  https://www.youtube.com/watch?v=mpm_7pNn5GM&feature=youtu.be

Mary Spangler, M.S., N.P., COHN-S
Administrative Director, Occupational Health Services Stanford Health Care & Stanford Children's Health Care
300 Pasteur Drive, M/C 5205, Stanford, CA 94305-5513
Office: (650) 725-9583 Fax: (650) 498-7748 (fax) mspangler at stanfordhealthcare.org<mailto:mspangler at stanfordhealthcare.org>
Administrative Assistant Michelle Fitch 650-725-2529   mfitch at stanfordhealthcare.org<mailto:mfitch at stanfordhealthcare.org>
[logo sig.png]                        [Stanford Children Health]
Confidential Information: This communication and any attachments may contain confidential or privileged information for the use by the designated recipient(s) named above. If you are not the intended recipient, you are hereby notified that you have received this communication in error and that any review, disclosure, dissemination, distribution or copying of it or the attachments is strictly prohibited. If you have received this communication in error, please contact me and destroy all copies of the communication and attachments. Thank you.

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Diane Shaw
Sent: Thursday, August 17, 2017 11:34 AM
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] Drug screening method

Urine.

Diane M. Shaw, BSN, RN, COHN-S
Employee Health Nurse/Employee Health Services Tuality Healthcare OHSU Partner
335 S.E. 8th Ave.
Hillsboro, OR 97123
diane.shaw at tuality.org<mailto:diane.shaw at tuality.org>
tel: 503-681-1444 l fax: 503-681-4170

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From: MCOH-EH [mailto:mcoh-eh-bounces+diane.shaw=tuality.org at mylist.net] On Behalf Of Leibu, Rachel
Sent: Monday, August 14, 2017 12:03 PM
To: MCOH/EH
Subject: [MCOH-EH] Drug screening method

Hi List,

I am interested to know which method your institution used to conduct their post offer drug screens:


1.       Urine

2.       Blood

3.       Saliva- is anyone using this method at this point?

Rachel Leibu, MD, MBA, MS
Director Occupational Medicine Service
Atlantic Health System
973-971-5440


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Message: 2
Date: Tue, 12 Sep 2017 20:23:09 -0400
From: Amy Behrman <behrman at mail.med.upenn.edu>
To: MCOH/EH <mcoh-eh at mylist.net>
Subject: Re: [MCOH-EH] [EXTERNAL]  hazardous drug administration
Message-ID: <F802298E-8088-4852-AEA2-459105E30088 at mail.med.upenn.edu>
Content-Type: text/plain; charset="utf-8"

Thank you Warner; fantastic summary 

Amy Behrman,MD
University of Pennsylvania



> On Sep 1, 2017, at 11:11 AM, Hudson, T. Warner <TWHudson at mednet.ucla.edu> wrote:
> 
> <image001.jpg>
> At AOHC 2017 in Denver there was a long session on this with several 
> excellent speakers. And several of the UC OH Medical directors 
> attended, me among them, and so with 5 of the  UCs having medical 
> centers we too are all interested in doing the right thing.  Mark 
> Russi, MD Medical Director of Occupational Health at Yale Hospitals 
> presented a fantastic segment of the Denver sessions on this and among 
> other things reviewed the published data on what you find if you do 
> lab tests (CBC, U/A, BUN/creat, AST/ALT) on 1000 healthy non exposed 
> individuals, and you will have over 900 abnormal results to chase 
> down.  So consensus among the medical directors all trained in USPSTF 
> and first do not harm is that doing physicals and labs as part of this 
> surveillance will generate so much chasing of incidental personal 
> health findings like the lab tests just noted at significant time, 
> expense and hazard to these individual with no evidence based medicine 
> evidence of benefit, that we at UC are going on the minimalist end of 
> this ?surveillance? spectrum; education, review of use of PPE and 
> exposure history and potentially more if exposure occurs depending on 
> the exposure.  Warner
>  
> T. Warner Hudson, MD FACOEM, FAAFP
> Medical Director, Occupational and Employee Health UCLA Health System 
> and Campus Office 310.825.9146 Fax 310.206.4585 Pager 800.233.7231  ID 
> 27132 E-mail twhudson at mednet.ucla.edu Website www.ohs.uclahealth.org
>  
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of 
> Morelli, Karen J
> Sent: Friday, September 01, 2017 5:39 AM
> To: MCOH/EH <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration
>  
> I, too, would love to see if anyone has a hazardous drug surveillance program in place as our system is looking at this as well.
>  
> Karen Morelli RN, BSN
> Clinical Manager
> WorkHealth LLC
> Eastern Maine Healthcare Systems
>  
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Angeli 
> Mancuso
> Sent: Thursday, August 31, 2017 4:59 PM
> To: MCOH/EH
> Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration
>  
>  
>  
> **********************************************************************
> **********************************************************************
> * The e-mail below is from an external source. Please do not open 
> attachments or click links from an unknown or suspicious source.
> **********************************************************************
> **********************************************************************
> *
>  
>  
> Hi all,
>  
> I sincerely appreciate the input and perspectives from this group. I have some follow up questions that I?m curious how others are handling:
> 1)     For current employees, how are you getting folks into compliance with this regulation? Are you asking them to complete the questionnaire and lab work (CBC, metabolic panel, UA) now and considering this a baseline?
> 
> 2)     What are you doing with abnormal lab results for these current employees? Referring to their own physician? Doing follow up and more extensive testing through Occupational Medicine to determine other underlying health conditions and then referring to PCPs?
> 
> I?ve really appreciated the shared policies and forms from everyone! Thanks for being such a great community!
>  
>  
> Angeli Mancuso, RN, COHN-S/CM
> Manager, Employee Health & Safety | Cottage Health P.O Box 689 | 400 
> W. Pueblo St | Santa Barbara, CA 93102-0689
> Office: (805) 569-7866 |  Fax: (805) 569-8271 a1mancus at sbch.org | 
> cottagehealth.org www.lifewhereyouloveit.org
>  
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of 
> Allen-Hardy, Blythe
> Sent: Tuesday, August 01, 2017 3:39 PM
> To: MCOH/EH
> Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration
>  
> I?m fairly new to the organization so still learning how it is determined who?s in the program. I?m assuming that a list is giving to occur health by the director of oncology nursing. I can respond back once I get further clarification.
>  
> <image002.jpg>
>  
> Blythe Allen-Hardy, MD, FACOEM
> Medical Director, Employee Health
> Texas Medical Center
> 6411 Fannin, JB500
> Houston, Texas, 77030
> W: 713-704-2792
> C: 720-840-9593
> F: 713-704-6350
> Blythe.allen-hardy at memorialhermann.org
>  
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of 
> Thrasher, Terri
> Sent: Tuesday, August 01, 2017 1:34 PM
> To: MCOH/EH
> Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration
>  
> How do you determine who to place in surveillance and how many employees are you running through the surveillance labs?
> Terri
>  
> Kindest regards,
>  
> Terri
>  
> Terri L. Thrasher RN MSN
> Sr. Director HR
> Employee Health, Occupational Safety, Environmental Health, Employee 
> Relations, Leave Management  HR Compliance/Policy, Workers 
> Compensation, 803-SAFE, Injury Management, Non CCHMC Badging, Early 
> Education and Childcare Center
> 3333 Burnet Ave
> Cincinnati Ohio 45229  MLC 9006
> 513-636-6240
>  
>  
>  
> From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of 
> Allen-Hardy, Blythe
> Sent: Tuesday, August 01, 2017 2:22 PM
> To: 'MCOH/EH' <mcoh-eh at mylist.net>
> Subject: Re: [MCOH-EH] [EXTERNAL] hazardous drug administration
>  
> Cathy,
>  
> At Memorial Hermann we have a surveillance program that I am in the process of updating due to the USP 800 requirements. We have a policy in place in our hospitals on how the drugs are handled etc and it is fairly comprehensive. The medical surveillance I believe as involved checking a CBC, UA and completing an annual questionnaire. I am developing a medical surveillance guideline that will addl laboratory tests such as LFT?s, BUN/Cr to the CBC w/diff and UA. Will also add a focused exam component for post exposures.
>  
> That may be overkill but I want to make sure we have a comprehensive program. Feel free to contact me for further questions.
>  
> <image002.jpg>
>  
> Blythe Allen-Hardy, MD, FACOEM
> Medical Director, Employee Health
> Texas Medical Center
> 6411 Fannin, JB500
> Houston, Texas, 77030
> W: 713-704-2792
> C: 720-840-9593
> F: 713-704-6350
> Blythe.allen-hardy at memorialhermann.org
>  
> From: MCOH-EH 
> [mailto:mcoh-eh-bounces+blythe.allen-hardy=memorialhermann.org at mylist.
> net] On Behalf Of Senior, Cathy (Employee Health)
> Sent: Tuesday, August 01, 2017 11:42 AM
> To: 'MCOH/EH'
> Subject: [EXTERNAL] [MCOH-EH] hazardous drug administration
>  
>  
>  
> Does anyone have a medical surveillance plan for employees who handle 
> hazardous drugs. We are seeing more administration of these hazardous 
> drugs between starting the intravesical therapy and the biologics that 
> are administered. We follow the ONS guidelines for safe handling of 
> hazardous drugs as outlined in our policy. We already have the 
> appropriate work practice in place including proper use of PPE and 
> education for the staff that handle these drugs. There has been a 
> concern voiced by one of our educators that institutions such as NIOSH 
> have recommendations for medical surveillance to make it a 
> comprehensive prevention program that we do not have in place.  Some 
> of the drugs we administer is  Carboplatin, VP-16, Taxol, Cisplatin, 
> Cytoxan, Erbitux, 5-FU, Abraxane, Gemzar, Herceptin, Parieto and 
> Rituxan to name a few. We also give biologics to out-patients in our 
> short stay unit. Any help would be much appreciated.  Thanks
>  
>  
> Cathy Senior RN BSN CDE
> Employee Health Director
> Penn Highlands DuBois
> 100 Hospital Avenue
> P.O. Box 447
> DuBois Pa 15801
> Phone 814-375-3392
> Fax 814-372-2610
> cesenior at phhealthcare.org
> www.phhealthcare.org
> <image004.png>
>  
> This email and any attached files are sensitive in nature and intended solely for the intended recipient(s). If you are not the named recipient you should not read, distribute, copy or alter this email. Any views or opinions expressed in this email are those of the author and do not represent those of Penn Highlands Healthcare or its affiliates.. Warning: Although precautions have been taken to make sure no viruses are present in this email, the company cannot accept responsibility for any loss or damage that arise from the use of this email or attachments.
>  
> 
> CH Disclaimer: This electronic mail message is intended exclusively for the individual or entity to which it is addressed. This message, together with any attachment, may contain confidential and privileged information. Any views, opinions or conclusions expressed in this message are those of the individual sender and do not necessarily reflect the views of Cottage Health, its subsidiaries or affiliates. This document may also contain information covered under the Health Insurance Portability and Accountability Act (HIPAA, PL 104-191) and implementing regulations and must be protected in accordance with those provisions. Re-disclosure without patient consent or as otherwise permitted by law is prohibited. Any unauthorized review, retransmission, use, printing, copying, retention, disclosure, distribution or the taking of any action in reliance upon this information by persons or entities other than the intended recipient is strictly prohibited and may be unlawful. If you have received this message in error, please immediately advise the sender by reply email message to the sender and delete all copies of this message from your system without copying.
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> 
> 
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End of MCOH-EH Digest, Vol 252, Issue 285
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