Document R2YZ7rOENra53k05xz23gjk7z

INTERNAL CORRESPOND5NCE CefiOQ t /jr. CAlS mbpcpat;::, kinu orr, ca UNION CARBIDE CORPORATION ^ssstar* Crr^srsts Mec:C3 D.rci:c' vVes'e"'** ^Recor, 2 j -- J. L. Myers Metals King City, California ----- May 2, 1984 ----3--: ^ Western Medical Region H. B. Rhodes R. K. Smith R. F. Wolff T. A. Lincoln, M.D. Site Visit My visit to King City was very short but very nice. I appreciated the inclusion of my wife in our visit to the Rotary Club. She enjoyed the program. I am sorry our time seemed to be so compressed and during my next visit I will allocate more time for you and Dr. Hyde. It would be a good idea to talk to all of the physicians at the Clinic about Union Carbide's policy and our expectations of contract physicians. If the economy improves we will resume some regional meetings for contract physicians. Dr. Hyde stated he attended one several years ago in Los Angeles and it was excellent. I consider your medical program to be excellent and am quite pleased that the recommendations from my 1982 visit have been implemented so completely. This shows you and your staff are truly concerned about the health and well-being of your employees and have their best interest in mind. I have two (2) recommendations as a result of this visit and enclose them for your review and consideration. Tell Bob Kronkhyte that I wish him well in his new endeavors. Sincerely, T. Guy Fortney M.D. f-/4 IGF:mlm Enclosure UCC 025120 RESULTS QKjB/3Q/8)RECOMMENDATIONS METALS DIVISION KING CITY, CALIFORNIA Recommendation No. 1 It is recommended that all medical records be transferred from their present site in the Plant Manager's office to the Medical Clinic in King City. Dr. Hyde is in complete agreement that the best method of protecting confidentiality of medical records is if they are under the custody of a medical professional. Dr. Hyde is agreeable to storing these records in his facility. Comment All medical records of active employees have been transferred to the contract physician's office and maintained in a separate fireproof file. This has not presented any hardship to the Plant Manager. The contract physician feels more comfortable with the medical records maintained this way, knowing that the confidentiality is protected. Recommendation No. 2 Initiate use of medical examination form UC 186-90, revised 2/80. After all employees have one of the above forms in their medical record, it is recommended that medical re-examination record form UC 275-26, revised 5/82 be used for subsequent examinations. Conment Each employee has form UC 186-90 as a part of his/her medical record, henceforth, they will be using the medical re-examination record form. Recommendation No. 3 I recommend that arrangements be made with the Medical Clinic to offer employees tetanus toxoid inmunizations. Comment The Medical Clinic is offering tetanus toxoid to employees at the time of their periodic examination when appropriate. Recommendation No. 4 Adopt a method so that the examining physician can report findings of the pre-employment or periodic examination to management without giving the full results of the examination. Example: 1) Employee able to do full duty. 2) Employee able to work with restrictions. 3) Em ployee able to wear a respirator, etc. Comment The contract physician is now reporting to the Plant Manager using a form which states when the employee had the examination and whether the employee is/is not medically qualified and if a restriction is necessary. Recommendation No. 5 Devise a method of assuring that employees are notified of changes and abnormalities on their physical examinations. Some written record should be made that this notification has been accomplished. UCC 025121 Results of 8/30/82 Recommendations King City, California Page 2 Comment The contract physician has devised a form to notify the employees of the results of their physical examinations. After all of the test re sults have been returned the physician writes whether everything is nor mal or list abnormalities with instructions for the employee. A copy of this is maintained in the medical record. Recommendation No. 6 Adopt a method of informing employees the results of their audiogram when there is a significant shift. Cal-OSHA requires that employees with a significant shift be notified in writing within 21 days from the time the plant is notified that a shift has occurred. This means that when the report from HCNC is received stating that an employee has a signifi cant shift, that there are 21 days to notify this employee. The notifica tion is required to be in writing. Comment The physician is now waiting until notification is reviewed from HCNC that the employee has a permanent significant shift and then the employee is informed in writing. Suggestion No. 1 I suggest that consideration be given to adopting the new Cal-OSHA frequency schedule for medical surveillance of asbestos workers. This schedule is different from the federal asbestos requirement and is more realistic and more lenient. I feel that in adopting this scheduling method employees will have less exposure to x-ray. There should also be some cost savings in such a scheduling. Consent The plant has adopted Cal-OSHA's scheduling of asbestos examinations as suggested. Suggestion No. 2 As there is no federal or Cal-OSHA requirement for sputum cytology, consideration might be given to discontinuing this procedure. Collection method is time consuming and one that most employees do not enjoy. There ^ are some experts in the field that do not feel this method of screening is cost effective. Comment The plant is still performing sputum cytology on an annual basis of ^ all employees. H 1W ( S ,, UCC 025122 RECOMMENDATIONS METALS DIVISION ^^JOHS-UIX^CALIFQRNIA ^AprTl 25, 1984 , Consent A review of the medical, records at the Medical Clinic reveal that the records of occupational injuries and return to work evaluations are maintained in the employee's private medical file and not in the occupa tional medical file along with the medical surveillance examinations. Recommendation It is recommended that the record of occupational injuries and return to work evaluations be placed in the employee's occupational medical file. One file would then provide the entire Union Carbide health history of each employee. Comment I was informed that some employees insist on exercising their California right to have their physician treat all occupational in juries and/or illnesses. It was mentioned that our contract physician was not examining employees upon returning to the work place. Corporate and Medical Division Policy states that all occupational injuries or illnesses irregardless of the length of absence are to be evaluated by the company physician to determine the employee's ability to return to the work place and safely perform the required work. Recommendation I recommend that all of these individuals should be seen by the contract physician who is more familiar with the work place and re quirements than other physicians in the area. Comment The facility is still performing annual sputum cytology examina tions on all employees. Recommendation It is recommended that sputum cytology be performed only on employees at the time of their asbestos evaluation examination. This would be on the scheduling frequency prescribed by Cal-OSHA or according to high risk categories. These would include smokers, ten-year exposure record, or over 50 years of age. UCC 025123