Document 0q9QRBZabx0w9dy2MG88DoDKV

i Uniroyal Chemical Company, Inc. 720 Fairport Nursery Road Paineaville, Ohio 44077 May 3, 1991 L. Mark Wine, P.C. Kirkland & Ellis 655 Fifteenth Street, N.W. Washington, D.C. 20005 He: Medical Surveillance Study for OSHA Butadiene Rulemaking Enclosed please find completed survey re the captioned per your request of April 23, 1991. MAW:mhh enc cc: RWK Industrial Relations Manager URL 20618 ' ** SURVEY OF CMA BUTADIENE PROOUCERS/USERS 1. Dots your company have i program pf periodic medical examination* For employees qai already covared by OSHA regulations? ____ Yt* JL No If your eoaoeny does not have such an Internally-driven program, please STOP HERE and return the questionnaire. Thank You. 2. What is the frequency of your company's health surveillance program? N/A _2L Annual ____ Every 2 yri. __ Every 3 yrs, ____ Every 4 yrs, 3. Is a standard history taken from the employee? jL Yes ____ ' No If No, skip to question 5. 4. Which of the following elements Is routinely Included in ths history? Fast Medical History Family History X Occupational History * Occupational Exposure Social History to Chemicals Reproductive History Chamlcil Exposure In 61 History Hobbles/At Home Allergic History Occupational Radiation Cardiovascular History Exposure Pulmonary History Occupational Noise Exposure Recreational Noise Exposure 5. Ooes your program Include a physical examination of the employee? _X. Vs ____ Ho 6. If the employee is examined, who is the examiner? y Physician __ PA ____ Nurse ____ Other Practitioner 7. Is this service provided On-site 2L By company*emp1oyeed personnel ^_ By contract personnel URL 20619 APR 30 '91 t*:0l KIPKLAND*ELLIS UASDC PAGE.002 A i * i I *'U -- a bjo f\a,4 7. which of th following examinations are performed? Chest X-ray eco Spirometry Vision Test Audiometry Height Weight Vital Signs _2L x x,, Respirator Fit Testing C6C, HG8 m Indices HCT Urinalysis SMA-12, 18 or other panel liver Pinal Kidney Panel FIS Coronary Risk Panel 8. Are physical and laboratory txaalnations and findings Interpreted in lignt or the employee's workplace exposure to chemical and physical agents? - X Ves _ No 9. Are employees consistently notified of positive findings? _X. Ys __ Ne IS. Art tnpioytti eontlsttntly notlfltd of ntgitlvt finding*? _2L Yts __ No 11. Are healtb/medlesl data for gcgUfiA of amployeas with comon chemlcal/physteal agent txposura routinely evaluated to screen for occupational health effects in the cohort? JL Tea ____ No URL 2 0 6 2 0 12. What Is the nature of this evaluation of group data? Clinical Evaluation Formal Epidemiology __ Other _ ____ Again. CMA will be using this information to help design and propose an alternative medical surveillance program for the 05HA butadiene standard. This Should result in a program whleh Is optimally satisfactory to both OSHA and butadiene producers and users. APR 30 * 91 1^:02 V IPKLhND*ELLIS UASDC PAGE003 \.s