This Program is funded by the United States Department of Energy (DOE) to examine former workers for health problems that might be due to hazardous exposures they had while they worked at DOE sites. The programs at Los Alamos National Laboratory (LANL) and Sandia National Laboratories (SNL-AL) are two of 35 programs at DOE workplaces. The Johns Hopkins Bloomberg School of Public Health (JHBSPH) conducts the Medical Exam Program for Former LANL and SNL Workers.
This Program will focus on former workers with significant past exposure to one of the following agents or agent categories:
- Silica (SNL-AL only)
These agents and agent categories were chosen based on an extensive evaluation of historical exposures at both sites, the nature and extent of documented and possible health impacts resulting from those exposures, the number of potentially impacted former workers, and worker concerns. The final choice of these five agents was also based on a medical determination of the availability of acceptable screening tests and interventions that will decrease severity, morbidity, and mortality of diseases that may result from exposure.
As new information becomes available this list will be periodically re-evaluated.
General Selection Criteria
At LANL, all eligible workers formerly employed by:
- University of California
- Pan Am World Services
- Johnson Controls International
- Johnson Controls of Northern New Mexico
- other subcontractors
and who worked at LANL anytime since 1943.
At SNL-AL, all eligible workers formerly employed by:
and who worked at SNL-AL anytime since 1949.
Eligibility is determined based on the likelihood that the work you performed resulted in a significant exposure to one or more of the agents listed in the previous question. The determination of a significant exposure will be based on work and exposure history information provided by former workers.
Selection by Job Title
In the first year of the Medical Exam Program for Former LANL Workers, individuals with the following job titles were invited to participate:
- Plumbers or pipe fitters
- Metal workers
- General laborers
Selection by Job Title and Exposure Questionnaire #1
Individuals with the job titles listed below were invited to participate based on the results of a general exposure questionnaire [Exposure Questionnaire #1 (EQ1)] that helped to determine the significance of their exposures. For example, mechanical technicians whose questionnaire responses indicate that they were exposed to asbestos were invited to receive a medical examination for conditions related to asbestos. Another example of former workers who will receive EQ1 are "staff members." These former workers may have had administrative jobs or worked on projects with significant exposures.
- Chemical technicians
- Laboratory technicians
- Mechanical technicians
- General Technicians
At SNL-AL, we did not have rosters or job titles for former workers. Former workers were invited to participate in the program through a mailing that included the general exposure questionnaire, Exposure Questionnaire #1 (EQ1) which helped to determine their exposures at SNL.
To determine if you are eligible for this Program, please contact our New Mexico Program Office via our toll-free telephone number 1-877-500-8615. We will then send you the general exposure questionnaire.
Based on your job title while at LANL or SNL, and your response to this questionnaire, we will decide if you will benefit from participating in this Program. The majority of exams will be offered to former workers who are eligible as determined by the Program. However, a limited number of exams will be provided to former workers who wish to receive an exam regardless of their eligibility status.
You may also choose not to take part in the program.
If you are eligible, you may choose one of the following two options:
- A free medical exam through the Medical Exam Program for Former LANL and SNL Workers or
- A free medical exam through the DOE National Supplemental Screening Program (NSSP)
You may choose one of the following locations for your free medical exam:
- The Johns Hopkins Bloomberg School of Public Health Former Worker Program Office, Española, NM
- Los Alamos National Laboratory Occupational Medicine Clinic, Los Alamos, NM
- The Family Practice Center at the University of New Mexico, Albuquerque, NM
- DOE National Supplemental Screening Program (NSSP)
It is completely your choice as to which location you would like to have the exam. The examination procedures will be identical at all clinics.
Depending on the location you choose, your exam will be performed by:
- Española Office: Physicians from Johns Hopkins and the University of New Mexico
- LANL Occupational optional Medicine Clinic: Physicians and Health Professionals from Los Alamos National Laboratory Occupational Medicine Clinic (HRS-2).
- Family Practice Center at the University of New Mexico: Physicians from Johns Hopkins and the University of New Mexico
- Physicians and Health Professionals from the National Supplemental Screening Program (NSSP).
No. Once you are eligible to receive an examination from the Program, you will complete a detailed exposure and medical history questionnaire, Exposure Questionnaire #2 (EQ2). The results of this questionnaire will be used to determine what type of exam you receive. For example, if your response to EQ2 indicates that you worked regularly around loud noise, your exam will include a hearing test.
The exams will take at least two hours. As mentioned in the previous question, the exams will include tests based on your exposure and medical history. The tests that might be done are:
Spirometry (breathing test): This is a test to check for effects from exposure to asbestos and silica. 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 indicate if they hear the sounds.
- 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, silica, or radiation.
- 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.
- 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.
- For former workers with past exposure to beryllium, they will be tested for sensitization to beryllium and at least three or four tablespoons full of blood are drawn for the:
- 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 website:
After your medical examination, you will receive your results in the mail within 10 to 12 weeks after the exam. The only individuals who will see your examination results are the occupational medicine physician who reviews these results and the program staff who mail the results to you. We will send you copies of your tests that you may share with your primary care provider (PCP). All results are private to the extent allowed by law. Your results will not be shared with anyone without your permission. Your name will never be used in published reports about this study.
No study participant will be asked to provide us with classified information. You should not answer any questions that you feel uncomfortable with or have concerns about. If you think you may have classified information and you need to clarify this, please feel free to contact Classifications Office at LANL or SNL (505) 667-5011.
You will receive a copy of your results with a letter telling you that all of your examination and test results are normal. You may take these results to your primary care provider. If you have any further questions or comments about the Program, we encourage you to contact us either by toll-free telephone at (877)-500-8615 or by email at firstname.lastname@example.org. You can also continue to access information about the Program through this website.
Due to the current limits of our budget, we will not be able to provide you with follow-up examinations and tests. We do hope that as a part of our program, you will become more aware of the signs and symptoms of conditions that may result from your exposures, so that you may bring these symptoms to your healthcare provider’s attention if you experience them (SEE BELOW).
Although the Program will not be able to provide follow-up examinations, we will retain a copy of your records (in addition to the copy mailed to you), which include all test and examination results. These records can be made available to your healthcare provider at any time if they are needed (SEE BELOW).
You will receive a copy of all your test and examination results, and a letter explaining that these results were not all normal. The letter to your primary care provider (PCP) will include recommendations for additional testing if the abnormal results indicate that you may have a work-related disease.
For any of your test results not within normal limits, you will need to follow up with a physician to receive additional testing. We recommend that you follow up on these results as soon as you receive them in the mail. If you do not have a PCP, the Former Worker Program can help refer you to one. In either case, the program will provide any necessary information and assistance. You may also be eligible for worker’s compensation.
For help locating a Primary Care Provider, call the Española Program Office toll-free at (877) 500-8615.
The DOE has funded the Johns Hopkins Bloomberg School of Public Health and the LANL Former Workers Program to offer participants in the original program a repeat asbestos and/or beryllium examination and testing.
Beginning in March of 2006, re-examinations are available for those former workers who previously reported exposure to asbestos or beryllium. If you were exposed to asbestos, you will receive an exam and testing for asbestos. If you were exposed to beryllium, you will receive an exam and testing for beryllium. If you are a former worker who was exposed to asbestos and beryllium, you will receive an exam and testing for both agents.
Any former worker who is interested in a re-examination for past asbestos or beryllium exposure should contact the New Mexico Program Office in Española, NM. Former workers are asked to complete a short Exposure and Medical History Questionnaire #3 (EQ3) and to schedule an appointment for the re-examination at our next examination session in Española, NM. The contact numbers are: 1-877-500-8615 (toll-free) and 1-505-753-0193 (local).
The re-examination will include the same components as the original examination. Former workers with past asbestos exposure will receive an examination, a breathing test, and a chest x-ray (one view). Former workers with past beryllium exposure will receive an examination, a beryllium lymphocyte proliferation test (BeLPT), and a chest x-ray (one view) if the physician determines that the chest x-ray is needed. If a former worker had exposure to both agents, all the components described above will be done but only one chest x-ray will be done. The chest x-ray will be sent for a B-reading. A B-reading is done by a certified physician who is looking for occupationally related lung disease.
Former workers will receive results letters 10 to 12 weeks after their examination. A letter is included for the former worker’s Primary Care Provider that will include recommendations for further testing if needed. The Medical Exam Program for Former LANL and SNL Workers will assist you in obtaining treatment and benefits by offering recommendations to you and to your health care provider. We will not provide that treatment or those benefits ourselves.
In the fall of 2005, a new DOE medical screening program called the National Supplemental Screening Program (NSSP) was established to provide services to those former workers who do not live near a medical screening site. This includes workers from a facility that does not have an established Former Worker Program, as well as those former workers from a facility that does have a Former Worker Program but who no longer live near that facility. The NSSP also provides the option of receiving a medical screening from your own private physician. The options offered through the NSSP include the following:
Medical Examinations Provided to Former Workers Who Do Not Live near the Testing Sites. Participants will complete an exposure and medical history questionnaire from the Former LANL Workers Medical Exam Program. We will advise the NSSP of the recommended testing that should be conducted. The former worker will then be contacted by the NSSP, and a medical screening will be scheduled at a participating clinic closest to the worker’s current address. The NSSP will review test results, and the test results will be sent to the former worker as well as to the Former LANL Workers Medical Exam Program (if the former worker has signed a medical release form to allow this). The test results will then be included in the medical results database.
- Medical Examinations Provided to Former Workers Using Their Own Physicians. Former workers who would prefer to be screened through their personal physician may have a medical screening arranged by the NSSP. The Former LANL Workers Medical Exam Program will advise the NSSP of the recommended testing that should be conducted. The NSSP will review test results, and the test results will be sent to the former worker as well as to the Former LANL Workers Medical Exam Program (if the former worker has signed a medical release form to allow this). The test results will then be included in the medical results database.
Participating in our medical screening program will give you a chance to:
Johns Hopkins Bloomberg School of Public Health
Former Worker Exam Program
New Mexico Program Office
Española, NM, 87532
Toll-free telephone (877) 500-8615