For former workers who choose a medical exam, the exam and testing will address the possible health issues identified by Exposure Questionnaire #2 (EQ2). The EQ2 was completed during the confidential interview. Not all participants will receive all of the tests. Former workers are asked to read and sign several consent forms, medical record release forms, and a Health Information Authorization Form. - Medical Screening Consent Form: this consent form gives the program permission to do the examination and testing. There are two of these consent forms. One is kept with the former worker's program records in Baltimore, MD, and the other is given to the former worker for their records.
- Beryllium Lymphocyte Proliferation Test (BeLPT) Consent Form: this consent form is used if a former worker had possible beryllium exposure during their employment at LANL. The consent form gives the program permission to draw the blood needed for the BeLPT. There are two of these consent forms. One is kept with the former worker's records in Baltimore, MD and the other is given to the former worker for their records (see explanation of BeLPT below under Description of Tests).
- Health Information Authorization Form: the purpose of this form is to explain how details about your health that you give us during this program will be used and shared with others. There are two copies of this form. One is kept with the former worker's records in Baltimore, MD and the other is given to the former worker for their records.
Medical Exam The type of exam will vary by the type of exposures that the former worker had at work. Each former worker will also get some medical tests. These tests depend on the exposures the worker had at LANL. Each former worker’s exam will focus on the parts of the body that may have been affected by the types of exposures that were discussed in the exposure and medical history interview (EQ2). All workers will also have their blood pressure checked, and a physician or health care provider will listen to their heart and lungs. The tests that will be done for each exposure are described below. Description of Tests - Chest X-ray: The chest x-ray will include only one view. It is the same as any other medical chest x-ray. There is a small amount of radiation exposure from it. The chest x-ray is done to look for lung changes that may be due to exposure to asbestos, beryllium, or radiation.
- Spirometry (Breathing Test): This is a test to check for effects from exposure to asbestos. The former worker will be asked to breathe out into a small tube while the technician takes measurements. There are no physical risks from this test for a healthy person. Former workers should let the technician know if they have any medical problems, such as, high blood pressure.
- Audiogram (Hearing Test): This is a test to check for effects from exposure to noise. Former workers will sit in a soundproof booth. A technician will ask them to listen to different sounds and say if they hear the sounds.
- Blood Tests: Whether or not a former worker has any of these tests will depend on the work exposures. Not all workers will get all of these tests.
Beryllium Lymphocyte Proliferation Test (BeLPT): This is a blood test to check for sensitization to beryllium. The test will tell the doctors if the workers’ exposure to beryllium caused them to become sensitized to beryllium. At least three or four tablespoons full of blood are drawn for the blood test. The test is done on cells in the blood called lymphocytes. Lymphocytes are one type of white blood cell in the immune system that responds to beryllium. In the laboratory, the BeLPT measures how lymphocytes react to beryllium. If lymphocytes are stimulated, causing them to “grow” when the cells are placed in a solution of beryllium, then this is an abnormal result. This stimulated growth is referred to as “proliferation.” An abnormal blood test is repeated. If the test is abnormal, we will ask the former worker to return for a repeat test. After a second abnormal blood test, an individual is called “sensitized.” Under the Energy Employees Occupational Illness Act of 2000 (EEOICPA) former workers with one abnormal BeLPT may apply for medical benefits and medical evaluations through the Department of Labor (DOL) Program. For more information about EEOICPA and the Department of Labor Program, see the section titled Compensation Programs or click on the website below.
http://www.dol.gov/esa/regs/compliance/owcp/eeoicp/main.htm
Complete Blood Count (CBC): This test counts the number of red cells, white cells, and platelets in the blood. This test will look for possible blood system effects from exposure to radiation. Thyroid-stimulating Hormone (TSH): This test will measure the amount of thyroid hormone in the blood. This test will look for possible effects from radiation to the thyroid. Serum creatinine and blood urea nitrogen (BUN): These tests will look for the possible effects of lead on the kidneys.
Medical Record Review (MRR) (The MRR will not be offered in Phase III of the Program) For those former workers who choose a medical record review, a program doctor reviews selected medical records and sends an opinion about them to the former worker. Opinions can be based on tests, x-rays, and reports that have been done in the past two years. It is possible that either a limited opinion or no opinion can be given about them. If the x-rays and blood tests are more than two years old, it will be necessary for the former worker to come in for an exam. It is an option for former workers to have the selected tests done for the MRR, but this program does not have the funds to pay for these tests or any tests not done at a Former LANL Worker Examination site. In order to do the medical record review, participants are asked to sign several medical release forms, consent forms, and a health information authorization form. There are two different consent forms. The forms are explained below. - Medical Screening Consent Form: this consent form gives the program permission to do the MRR. There are two of these consent forms in the packet. One is returned to the program office in Baltimore and the other is for the former worker's records.
- Beryllium Lymphocyte Proliferation Test (BeLPT) Consent Form: this consent form is used if a former worker had possible beryllium exposure during their employment at LANL. The consent form gives the program permission to perform the BeLPT. There are two of these consent forms in the packet. One is returned to the program office in Baltimore and the other is for the former worker's records (see explanation of BeLPT above under Description of Tests).
- Health Information Authorization Form: the purpose of this form is to explain how details about your health that you give us during this program will be used and shared with others. There are two copies of this form. One is returned to the program office in Baltimore and the other is for the former worker's records.
The former worker takes the following to their primary care provider: - a letter from the program doctors explaining the program and the medical record review;
- a form that indicates which tests, x-rays and records are needed for the review; and
- a medical record release form for the records.
If a beryllium LPT is needed, the program will arrange to have a beryllium LPT done at a laboratory near the former worker's home and sent to one of four DOE-approved BeLPT labs. The program can only pay for the beryllium blood test and the shipping costs for this test to go to the DOE-approved laboratory. The program does not have resources to pay for other tests or the medical records that are requested in the MRR letter. If you have concern about the costs, you should select an examination at one of our clinic sites, where all tests are provided for free. The primary care provider will send the former worker's medical records and chest x-ray to The Johns Hopkins Bloomberg School of Public Health. The chest x-ray is sent for a B-reading. Once all the records and tests are completed the medical record review is done. This should take at least 10 to 12 weeks or longer depending on the time it takes to get the records and tests. | 
