That is great Dr. Rodway. Very much appreciated and that’s totally my thought pattern too. I do occ med and I always caution my patients against imaging and the likes specifically for that. Have a great day.

Curtis

Curtis Chow, FNP, PA, COHN-S, COEE, CEES, CSPHP

Employee Health Coordinator

Dignity Health, Mercy Medical Center, Redding

Employee Health Department

2175 Rosaline Ave.

Redding, CA. 96001

530-225-6194 (O)

530-526-5150 (M)

530-225-7281 (F)

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From: Nancy Rodway [mailto:nrodway@hotmail.com]
Sent: Friday, December 08, 2017 5:27 AM
To: Chow, Curtis - MMCR <Curtis.Chow@DignityHealth.org>; mcoh-eh@mylist.net
Subject: Re: Hazardous Drug Medical Screening Labs

Dignityhealth.org made the following annotations
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As a pathologist and occ doc, I have found that ordering laboratory tests is the easy part. It is the interpretation that can get you in trouble. CMET sounds like one of those tests. What do you do with the result...

My interpretation of the medical surveillance recommendations was that further testing was determined by the specifics of the chemical exposure so a blanket lab panel may not be appropriate, except for a CBC

Just my two cents

Nancy Rodway MD MPH FACOEM FASCP FCAP

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From: MCOH-EH <mcoh-eh-bounces@mylist.net> on behalf of Chow, Curtis - MMCR <Curtis.Chow@DignityHealth.org>
Sent: Thursday, December 7, 2017 12:17 PM
To: mcoh-eh@mylist.net
Subject: [MCOH-EH] Hazardous Drug Medical Screening Labs

We are readying out acute care hospitals for the hazardous drug surveillance per the USP 800 going into effect July 2018. Regarding laboratory testing. The OSHA guidelines state a CBC w Diff is needed but suggest others. One of our facilities is utilizing a urine dip and CMET. Do you feel this is adequate/overkill/inadequate? I realize the urine dip and CMET evaluates the end process of drug breakdown: kidney/liver but am looking for sound medical recommendations. I want to minimize interpretation of labs, costs, etc but want to collect data that will be sufficient to make medical decisions at baseline, periodic and for their exit evaluation. Thank you so much and Happy Holidays to you all.