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41:4701 LABORATORY EXAMINATIONS Various laboratory examinations are performed as part of many clincial examinations. These may be specific blood tests for biologic monitoring for certain exposures (e.g., lead, cadmium, mercury, cholinesterase, etc.) or other medical surveillance required by a health standard or performed for any other purpose. At times, laboratory tests will be requested, as indicated, upon an examination by a physician. Routinely, as part of the Comprehensive "Core" Medical Examinations there are a number of blood and urine tests required. These are performed as part of Preplacement, Ter mination and Periodic Medical Examinations. The tests that are required are outlined on the protocols for these examinations as included in the Protocol Section of this Manual. The laboratory tests that are routinely done for these latter examinations for the TCI Medical Department are designated as a "customized" Profile 161, These consist of Metpath Profile 160 which is a Chem-Screen of 25 blood chemistries, a CBC with differential and indices, and a urinalysis including microscopic examination. At the time of an examination, appropriate blood and urine specimens are collected. These are sent to the laboratory for analysis and reporting. The report from the laboratory is incorporated in the medical record of the employee. All laboratory tests are performed by Metpath Laboratories, 1 Malcolm Avenue, Teterboro, New Jersey 07608, telephone (201) 288-3600. This applies to all TCI in-house medical facilities and outside contract clinics or physicians. An attempt is also made to have the same labora tory profile performed by Metpath in the few occasions requiring a one-time service by a fee-for-service physician with whom we have no working agreement even at a remote location. The primary reason for maintaining only one laboratory, to the degree possible, for all laboratory studies is to assure better quality control and standardization of results, reports, etc. This greatly facilitates recordkeeping, interpretation and affords much better liaison, monitoring, and resolution of problems by the TCI Medical Department. It also enhances the development of a data-base and incorporation with any record system developed by TCI and analyses of the data. Additionally, the laboratory can provide us directly with certain computerized reports and analyses of the data in relation to selected cohorts, plants, and/or the total work force of TCI. To these ends, we have a national contract with Metpath with direct billing to us in all cases, affording cost effectiveness and control. All biologic specimens collected are either picked up directly by Metpath or other definitive arrangements for sending to the laboratory are in effect or should be made by any given location. Here the goal is to expedite arrival of the sample at the laboratory to prevent deterioration and to ensure receipt of timely reports (usually withn 48 hours). The Corporate Medical Department should be made aware of any problems or deficiencies in these services that the site personnel or contractors cannot satisfactorily resolve. (24R)B22-23 10/23/79 rEN 7804