The AMSP Process and
Asbestos workers presenting to
the MTF for medical surveillance follow MTF Asbestos Surveillance Process.
After registering, NAVMED 6260/5 sections 1 and 2 are completed by the
worker, weight, height, and spirometry data are entered by the staff, and
the remaining information is completed by the provider. The form is copied,
the original is placed in the worker's employee health record, and the copy
is sent to NMCPHC at the follow address.
Navy and Marine Corps Public Health Center
620 John Paul Jones Cir, Ste 1100
Portsmouth, VA 23708-2103
(If the worker is also due for
a B reading chest X-ray, the NAVMED 6260/5 is sent to NMCPHC with the
authorization request, as described below.) If the form is completed
electronically, it is placed in the worker's employee health record and also
attached to an encrypted email and sent to firstname.lastname@example.org. It must not be saved on
the local computer, as it contains personal health information covered by
Health Insurance Portability and Accountability Act of 1996 (HIPAA).
B reading protocol for
workers exposed to ASBESTOS or SILICA
For workers due for a B reading
chest X-ray (see NMCPHC - TM OM 6260 Medical Surveillance
Procedures Manual and Medical Matrix), NAVMED 6260/7 section 1 is
completed (see AMSP Forms and Instructions) by hand or using a computer, and
is reviewed by MTF staff for accuracy and completeness. A single view,
posterior-anterior (PA) chest X-ray is obtained and reviewed by the local
radiologist. The digital image, along with the chest X-ray images of other
asbestos workers at the MTF, is copied to a CD or DVD. (This is generally
done by Radiology but may be done by the Occupational Health clinic,
depending on local policy.) If two exposures were required to obtain the PA
chest image (i.e., the person is so large that two exposures were necessary
to cover the entire chest), count these two images as one chest image, and
prepare one NAVMED 6260/7. As few discs as possible are to be used: There
are to be no fewer than 2 images per disc (unless the MTF has had only a
single X-ray in a month) and no more than 100 images per disc. Once a month
or after the MTF has 100 images (whichever comes first), the MTF contacts
NMCPHC for authorization, which is required to obtain a B reading.
Authorization is obtained as
follows. Using this sample letter, a request is sent to NMCPHC at the
above address. (The UIC in the letter is that of the MTF that is shipping
the chest image CD.) Alternatively, requests for authorization to ship
X-rays for B readings may be sent to NMCPHC by naval message, telefax
(757-953-0670), or encrypted email email@example.com.
For X-rays done as part of
asbestos medical surveillance, a copy (not the original) of the NAVMED
6260/5 (the History and Physical form) must be included with the letter or
fax or attached to the encrypted email. The exact number of radiograph
evaluations requested is to be in the memorandum from NMCPHC. (The number of
B readings is not to be estimated; the request must include the actual
number of B reading X-rays that already have been done.) For silica workers,
NAVMED 6260/5 is not used.
An authorized signature is
required unless the request is by e-mail from a ".mil" address. If the
number of B readings varies from the number on the authorization, NMCPHC is
to be contacted to have the order modified before the CD (containing the
image files) is shipped to the B reader. Failure to comply could result in
an unauthorized procurement with funding charged to the activity.
The B reader will not make
comparisons with old images. Only PA chest X-ray images, NAVMED 6260/7
forms, the authorization memo, and the mailing label are sent to the B
reader. Radiology reports, other X-rays, History and Physical forms, or
related information is not to be sent to the B reader. Chest X-ray images
are not to be sent to NMCPHC.
All the NAVMED 6260/7 forms and
the CD or DVD with their corresponding chest X-ray images are to be sent in
the same package. Forms should be stacked in the order the corresponding
image is listed on the CD or DVD. The NMCPHC Memorandum authorizing the B
readings is to be included. Prepare a mailing label for the CD or DVD mailer
case with the B reader's address. (Only for MTFs still using carbon copy
forms: Prepare a second mailing label with the MTF address to which the B
reader should return the completed NAVMED 6260/7 forms. Place the second
label in the mailing case with the CD, NAVMED 6260/7 forms, and the memo.)
Mark the envelope Confidential.
A certified tracking method
(certified mail by USPS, FEDEX, or UPS) is used, and this information is
mailed to NMCPHC or emailed to firstname.lastname@example.org.
The B reader will return the
completed form along with the CD and invoice for payment to NMCPHC for
processing into the Data Registry. NMCPHC will fax (or encrypted email) the
completed NAVMED 6260/7 back to the ordering MTF. This is incorporated into
the worker's occupational health record. If the NAVMED 6260/7 form is
returned to the MTF by the B reader with the determination that the
radiograph was unreadable, the MTF is responsible for taking appropriate
action to obtain a readable chest radiograph.
When the completed NAVMED
6260/7 is received back from the B reader, the MTF compares the number of
forms received to the number sent. (If forms are missing, a new copy of
NAVMED 6260/7 is generated for each missing form and NMCPHC is contacted.)
The provider at the MTF reviews the B reading and takes any action
appropriate, and the NAVMED 6260/7 is placed in the worker's employee health
If the completed NAVMED 6260/7
forms are not returned to the clinic within two (2) months from the date the
images were mailed, then NMCPHC is to be contacted at 757-953-0779.