Two years ago, OSHA redid its hazardous drugs webpage about two years ago, as the USP 800 document was in review and release preparation.  

https://www.osha.gov/SLTC/hazardousdrugs/solutions.html

 

We did attach a white paper that went through internal concurrence and so had some changes from the version initially submitted by an outside consultant.  OSHA’s view was that “

https://www.osha.gov/SLTC/hazardousdrugs/controlling_occex_hazardousdrugs.html#pre-placement

That contains the following language: 

1.    The most valuable test in a laboratory assessment is a complete blood count with differential. This allows for a determination of any pre-existing blood condition that may place the worker at increased risk when handling HDs. Other laboratory testing (liver function tests, blood urea nitrogen, creatinine, and a urine dipstick for blood) may sometimes be appropriate (Polovich, 2011). However, these tests should be conducted only at the discretion of the physician, as a function of the medical history obtained, or as part of a formal surveillance program with well-defined goals.

2.    Due to poor reproducibility, inter-individual variability, and difficulty in interpreting individual results, measures of genetic effects (i.e., chromosomal aberrations, micronuclei, or other markers of genotoxic exposure) are not recommended in routine surveillance.

3.    Biological monitoring, i.e., the measure of a specific agent or its metabolite in a body fluid (such as a urine 5-FU level), is also not recommended for a screening protocol on a routine basis due to the large number of agents an employee handles on a given work shift.

There are additional sections on periodic and post-exposure examinations.  This was discussed extensively at one of the MCOH meetings.

 

 

Michael Hodgson, MD, MPH

Chief Medical Officer

Occupational Safety and Health Administration

200 Constitution Ave NW Rm3653

Washington DC 20210

202-693-1768

 

 

 

 

From: MCOH-EH <mcoh-eh-bounces@mylist.net> On Behalf Of Mickelson, John G. via MCOH-EH
Sent: Monday, May 13, 2019 9:44 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Cc: Mickelson, John G. <John.Mickelson2@va.gov>
Subject: Re: [MCOH-EH] [EXTERNAL] ACOEM Medical Center Occupational Health Section

 

Will ACOEM publish USP 800 medical surveillance guidelines?

 

From: MCOH-EH <mcoh-eh-bounces+john.mickelson2=va.gov@mylist.net> On Behalf Of Dr Joe Fanucchi
Sent: Friday, May 10, 2019 1:41 AM
To: MCOH/EH <mcoh-eh@mylist.net>
Subject: [EXTERNAL] [MCOH-EH] ACOEM Medical Center Occupational Health Section

 

Colleagues,

Attendance at the recent American Occupational Health Conference in Anaheim was the highest it's been in more than a decade, and the MCOH Section sponsored eight individual (and very well attended) CME sessions on subjects related to employee health in health care facilities. Additionally, the annual dinner meeting of the Section was very well attended and featured extended discussions on TB screening in health care workers as well as the potential impact of USP800 recommendations.

What does the MCOH Section do?

Not a Section member yet?

Membership in the Section is now over 300, and we'd like to expand that number to take advantage of the wealth of expertise shown by our 1500+ maillist members. If you're already an ACOEM member, you can become a Section member for just $25 per year.

Not an ACOEM member yet?

Non-physicians who have attained the doctorate level degree of PhD, ScD, DrPH, or EdD in an occupational and environmental health discipline, a master's level degree or other advanced training in a related field, or are a certified Physician Assistant, licensed Nurse Practitioner, or a certified Occupational Health Nurse (COHN) may join ACOEM as Associate Members. Annual dues are $225 plus regional component dues.

Full-time residents who have an MD or DO degree and an interest in occupational and environmental medicine may join as Resident Members. Membership includes two free special interest sections of your choice plus the Residents and Recent Graduates Section and complimentary access to the MD Guidelines. Residents must provide documentation of their residency at the time of application. Resident member annual dues are $45.

Full-time medical students earning an MD or DO degree, with an interest in occupational and environmental medicine, are eligible to join ACOEM as Medical Student Members. Membership includes the Residents and Recent Graduates Special Interest Section. Medical students must provide documentation of their full-time enrollment at the time of application. Student membership is complimentary.

Please feel free to contact any of us with any questions.

Regards,

Amy J Behrman MD FACOEM FACP

Chair, Medical Center Occupational Health Section, ACOEM

 

Melanie Swift MD MPH FACOEM

Immediate Past Chair, Medical Center Occupational Health Section, ACOEM

 

Joe Fanucchi MD FACOEM

MCOH-EH Maillist Moderator