Document LpnEDr74wYqKy98ejzqM4N61Q

BEST ,, AVAILABLE COPY O M ED IC AL PROGRAMS P h y s ic a l E x a m in a tio n Program PLAINTIFF'S EXHIBIT ABS-044325 PRIVATE AND CONFIDENTIAL CONSOLIDATION OF PHYSICAL EXAMINATION PROGRAMS IN PERSONNEL DEPARTMENT Duo to the Increasing number of special physical examination programs in effect at the Martinos Refinery, it has boen decided that henceforth all such activ ities bo consolidated for administrative purposes in the Personnel Department. To provide the machinery necessary for maintaining proper records and controls for each of those programs, the. following procedure has boon developed. In conformance with Head Office Personnel's letter dated June 8, 1951, under the subject "Physical Examination Employees Handling CBP-55 and OS-1199" and later supplemented by their letter dated August 29, 1951, "Physical Examination Employees Handling Chemical Products" and upon the recommendation of Dr. Hine from the Emeryville Laboratories, all employees working at the following locations are to receive an initial physical examination, complete blood count and urinalysis. 1. Compounders working on second floor of Insecticide Plant . 2. Fillers at the Insecticide Plant 3. Fillers at the Light Oil Filling House filling insecticide containers Form Exhibit A has been developed to record the incidence of exposure and material to which the employee was exposed. This record is to be submitted to the Personnel Department on a monthly basis. The data contained on this report is posted to the individual employee's record (Exhibit B) and it will be this summary sheet which will indicate whether the employee has received significant contact to warrant a re-examination three months after the initial examination. Subsequent examinations, if warranted, will be made at six month intervals. The following forms have been designed by Dr. Hine for use in this program. Copies are attached. 1. Form I - Occupational History This form is to be completed before the employee is sent to the physician far initial examination. A. copy is given to the examining physician for his information. 2. Form II - Physician's Report of Examination This form is similar to our standard physical examination report but has been expanded to include additional information believed necessary for the purpose of this program. 3. Form in - Special Re-examination This form is to be used to reoortt t>he results of the periodic re-examina tions. It may also be used in the event a sudden acute exposure or suspected chronic exposure necessitatee referral to the physician. 4. Form IV A - Complete Blood Count (a) A complete blood test is required at time of the initial examination, the three month re-examination and the final examination when the employee ceases handling the products. Employees receiving initial physical examinations will undergo a complete blood count which will consist of sedimentation rate, coagulation time, bleeding time and icterus index determination. These would be in addition to what is commonly considered a complete blood count. (b) At the six month interval re-examination, the hemoglobin and white blood count laboratory tests only need be performed. ABS-044326 (c) If the doctor or laboratory making the blood teat does not have the equipment for the "albumin/globin ratio.1*, a "BSP liver function test" will be acceptable. 5. Form IV B - Urinalysis Dr. Hine indicated that the urinalysis need only be performed at time of initial examination, three month re-examination and thereafter to coin cide with the six month check. This test should also be performed in conjunction with the final examination. The above forms should be prepared in triplicate and the original of each form sent to Dr. C.H. Hine, c/o Dr. K.R. Edlund, Shell Development Company, Emeryville, Califcrnia. The duplicate copy is to be retained by Personnel and the triplicate held by the physician for future reference. Dr. Hine stated that wherever practical initial examinations should be given employees prior to their transfer into an assignment requiring them to come in contact with the toxicants. Therefore, to accomplish this objective, it will be the responsibility of the department concerned to give the Personnel Department adequate notice, of any proposed change in personnel working with toxic materials in order that arrangements may be made for scheduling the required physical examina- tion. It will also be the responsibility of departments concerned to advise Personnel of employees no longer exposed to these toxicants in order that final examinations may be scheduled. ; All physical examinations will be performed by Drs. Coatee and Bradshaw and the billing for such services will be directed to the Personnel Department for review before approving for payment. At the suggestion of Dr. Hine, the blood count and urinalysis examinations will be made initially by the Shell Development nurse at the refinery First Aid dispensary. Subsequent laboratory work will bis performed by the refinery First Aid Attendant who is a registered nurse. He will forward such samples to Emeryville, c/o Dr. Hine, for analysis until such time as he is able to perform the analytical work locally. Details of arranging for physi cal examinations and related work will be worked out between Personnel and the department concerned. In the staffing of jobs requiring employees to come in contact with these toxic materials, pjo person should be selected who has a history of tuberculosis, chronic respiratory disease, liver disease, kidney disease or chronic skin condi tions, nor- should persons who are alcoholics be permitted to work with these toxic substances. Any questionable case should be referred to the Personnel Department. With reference to the special physical examination required of employees in the Diapatching Department associated with the blending of tetraethyl lead com pounds with gasoline, the present program is as follows! 1. All operators working in the ethyl blending operation, specifically the Pumper/Gauger Specials and the Zone U Gaugers, undergo an annual exami nation by a duPont doctor. These examinations are usually performed in August cr September and arrangements are made by the.Dispatching Depart ment to have the men available. A report from the examining physician is received by the Dispatching Department Manager shortly after the examinations and indicates thereon the employees approved for continued work in this activity. ABS-044327 i -3- 2. Employees transferred to either a Pumper/Gauger Special or Zone 4 Gauger position should receive an examination either before reporting for duty or immediately thereafter. This examination should be made by either. Dr. Coates or Dr. Bradshaw as they are familiar with the requirements. In consolidating this program with the other medical plans in the Personnel Department, it will henceforth be the responsibility of the Dispatching group to advise the former department of employees requiring interim examinations and also those employees who should receive examinations at the annual affair. All correspondence and record keeping will be handled by Personnel. In connection with the special physical examinations required of employees working with radioactive isotopes. Dr. Hine has suggested the following program: 1. An initial physical examination including a chest x-ray. The physical examination could be carried out at Emeryville according to Dr. Hine while the x-ray could be taken locally (Drs. Coates and Bradshaw.) 2. Physical examinations to be repeated at six month intervals. Examina tions to be carried out at Emeryville* 3. Complete blood examinations and urinalysis, (Forms IV A and IV B respec* tively) are to be carried out at three month intervals. The initial.and subsequent six month examinations can be performed at Emeryville at the time the employee undergoes a physical examination. The blood examina tions and urinalysis at the three month interval mid-way between the Emeryville visits are to be performed locally by Drs. Coates and Bradshaw. A copy of the results in the latter instance should be for warded to Dr. Hine. 4. Dr. Hine strongly advised the establishment of a film badge service as protection to employees and also to comply with legislation; Arrangements were made with the Industrial Health and Hygiene Associates, 2380 Ellsworth Street, Berkeley, to provide the service. Badge films are to be forwarded at weekly intervals to the service which will make a monthly report as to the amount of exposure the individual was subjected to as well as other pertinent information. The program suggested by Dr. Hine was adopted and has been in operation since February, 1951. Under the proposed arrangement where all medical programs would be cen tralized in the Personnel Department, it will be the responsibility of the Research Department to submit oh a monthly basis certain data as to incidence of exposure of those employees working with radioactive isotopes. This information can be reported on a form developed for this purpose (Exhibit A). The Research group will continue as in the past to send the exposed badge films to the badge service company at weekly intervals. Their report should be directed to the refinery Personnel Depart ment for review and discussion with the interested parties in the Research group. December 19, 1951 ABS-044328 o sTf roaDs>aa ^a 4 1 s n*>) mi i i i i< S' o sM S' 3 lw K*> teKn lo M lo KO IS p IK a aIS IS p* IK IS so G scP* IS .4 IS fACr+ j--s IfOM <O* IP | ~a 3 IK I'** IK IS IK IK 18 leNa) 18 ABS-044329 IS 'HC* ?c*- 9n S' Wc* .< 1 <& . ft ft R'1 & M co 4 '1 & aa T3 It<J O<>Q o *s! s1? *r> > CCoAJ0CoIfOAcO)