Medical Screening

Purpose

Emergency response and recovery workers responding to natural disasters, like hurricanes, may work in physically demanding, unclean, or unstable work environments. These areas can expose workers to hazardous conditions that may not be easily predicted or controlled. Because of the possible hazards present, workers should have a medical screening before and after their work.

Medical screening is meant to protect worker health through early identification of work-related conditions, and helps:

• Detect possible adverse mental or physical health effects related to work or exposure
• Identify those who need further medical evaluation and treatment
• Identify potential risks to other workers in the same or similar areas
• Monitor developing trends and patterns of illness, injury, or exposure

Pre-deployment medical screening

All workers who will deploy to the disaster area should be screened immediately before deployment.

The goal for pre-deployment medical screening is to ensure a worker is fit to safely perform potentially hazardous and stressful work. This includes making sure the worker can perform the minimal physical and emotional requirements to work successfully in a disaster area.

Pre-deployment medical screening can:

• Assess ability to use personal protective equipment (PPE) and immunization status
• Document a baseline health status
• Identify risk factors or health concerns
• Identify training needs
• Help detect diseases early on

Possible determinations from the initial basic screening are:

• Cleared for deployment with no restrictions
• Cleared for deployment with specified restrictions on types of activities/exposures
• Recommended for further medical screening
• Recommended for specific training prior to clearance
• Not cleared for deployment

Minimum medical screening information

• Identifying contact information
  • Name, address, telephone, email, age, date of birth, birthplace, sex, social security number
• Contact information for someone who knows where the worker is 6 months after leaving response work
• Response organization
  • Employer or volunteer organization, organization's address, and a contact person's name and telephone
• Usual work
  • Industry, occupation, job tasks, number of years
• Special needs
  • Primary language
• Health status
  • Pre-existing conditions, current symptoms, medications, lifestyle factors, specific risk factors, immunization status, pregnancy status, any other health concerns
• Response-related information
  • Prior training and anticipated deployment location(s), tasks, dates, duration, shift schedules, and PPE

Some workers with significant pre-existing health conditions may need more extensive screening. Additional screening may include a deeper medical history, exams, or testing. Consider more extensive screening if there is concern about:

• Pre-existing condition(s) that may be affected during deployment
• Use of certain PPE, like respirators
• Expected tasks that may require medical monitoring

Post-deployment medical screening

Medical screenings should be done as soon as possible for workers after work is completed or they leave the affected area.

The goal of post-deployment medical screening is to identify workers who need further medical attention. In some cases, post-deployment medical screening may be the only way to find out what hazardous materials are in an environment. This is done by comparing the new screening to the baseline of the pre-deployment screening.

In addition to collecting the minimum medical screening information described above post-deployment, consider the following factors:

• Exposures or risk factors encountered while deployed
• Reports of negative health effects among particular groups of workers with similar jobs, locations, and exposure characteristics

Additional information to collect on response activities may include:

• Type of work performed
• When and where work was performed
• Injuries sustained or symptoms experienced during response work
• For known hazardous exposures or conditions, information on:
  • Type of exposure or conditions
  • Work practices
  • Protective measures