Process and Protocol

B Reading Process and Protocol

 

ABOUT THE NAVY ASBESTOS MEDICAL SURVEILLANCE PROGRAM (AMSP)

 

The AMSP is the medical component of the Navy Asbestos Program, a comprehensive effort to prevent or minimize exposure to and harm from asbestos. All Navy workers, both Active Duty and civilian, are enrolled in the AMSP, making the AMSP the largest program of its kind in the world. The AMSP includes regular medical evaluations of workers (primarily Navy but including Army, Air Force, and Coast Guard) with a history of occupational exposure to asbestos. Enrollment in the AMSP is based upon industrial hygiene risk assessments and interviews by occupational health professionals. The AMSP includes a medical history, physical examination, spirometry, and a chest X-ray. The chest X-ray is evaluated by specially certified physicians in a process called “B reading.” The medical examination and B reading results are maintained in the AMSP database by the Defense Centers for Public Health—Portsmouth (DCPH-P) Occupational and Environmental Medicine Division.

 

PROGRAM CHANGES

 

In February 2017, the multipart (carbon copy) NAVMED 6260/7 (5-90) was replaced by NAVMED 6260/7 (REV SEP 2016). The updated form is available only as a PDF download from the AMSP FORMS AND INSTRUCTIONS page. Starting in 2020, all completed NAVMED 6260/7 forms will be sent back to the originating Clinic via DoD Safe. Oversight of the Navy AMSP has been transferred from Navy and Marine Corps Public Health Center (NMCPHC) to the Defense Centers for Public Health-Portsmouth (DCPH-P). In MAY 2023, the Army and Air Force has switched to a centralized process for requesting B readings. On 1 OCT 2023, the Navy transitioned to the centralized process for B-reads, marking the first DOD-wide B Reading process.

 

ASBESTOS MEDICAL SURVEILLANCE PROGRAM (AMSP) FORMS AND INSTRUCTIONS

 

Asbestos medical surveillance findings are recorded on two forms:

•  Crystalline Silica uses only the B reading form. Crystalline Silica surveillance does not require NAVMED 6260/5.

GUIDELINES FOR COMPLETING NAVMED 6260/7

 

When completing the form electronically, “Invalid” will be displayed in red until all required data in Section 1 has been entered. Invalid forms are not to be submitted. After Section 1 is completed (and the PDF form reads “valid”), the form is to be sent to DCPH-P: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil via DoD Safe.

 

THE AMSP PROCESS AND PROTOCOL

 

Asbestos workers presenting to an Occupational Health (OH) clinic for medical surveillance follow the AMSP process. NAVMED 6260/5 sections 1 and 2, including weight, height, and spirometry results are entered by the staff, and the remaining information is completed by the provider. The form is scanned, the original is placed in the worker’s employee health record, and the electronic (scanned) form is sent via DoD Safe to NMCPHC: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil. Completed forms are not to be saved on the local computer, as the form contains personal health information covered by Health Insurance Portability and Accountability Act of 1996 (HIPAA). A secured Share drive is preferred.

 

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 and saved as a PDF. A single view, posterior-anterior (PA) chest X-ray is obtained and reviewed by the local radiologist. The digital image is pushed to the ECIA (Enterprise Clinical Imaging Archive). The OH clinic sends via DOD Safe to DCPH-P at: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil. NAVMED 6260/7 forms should have section 1 completed (“valid” in green text will appear on the left side of the screen) and be sent using DoD Safe: https://safe.apps.mil. The email should state the number (#) of B readings requested and the DoD SAFE passphrase.

 

Clinics are to ensure that all requested forms have been completed and received. If forms are missing, clinics are to notify DCPH-P. The provider at the OH clinic reviews the B reading and takes any action appropriate, and the NAVMED 6260/7 is placed in the worker’s employee health record. If the completed NAVMED 6260/7 forms are not returned to the clinic within 14 business days from the date the forms were sent via DOD Safe or encrypted email, the OH clinic is to contact DCPH-P: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil.

 

AMSP RECORD REQUESTS

 

Asbestos Medical Surveillance Program (AMSP) records should be in your employee health record (employee medical record). However, if you are unable to locate your employee medical record or it is incomplete, a search can be made of the AMSP database through an AMSP registry privacy act request. For an AMSP registry search, send a request in writing as follows.

1. Write the words “Request for AMSP Registry Search” at the top of your letter.

2. Date your request.

3. Include your daytime telephone number and/or daytime e-mail address so that our staff can get in touch with you during normal business hours if they have questions.

4. Include your complete mailing address.

5. Include your complete Name, Social Security Number (SSN), and Date of Birth.

6. Some information regarding the time frame that you may have been exposed to Asbestos. (For example, “I was in asbestos surveillance in 1992” or “I worked with asbestos some time between 1992 and 1995.”)

7. Send your letter to the following address.

 

ATTN: FOIA Coordinator

Defense Centers Public Health-Portsmouth

620 John Paul Jones Cir, Ste 1100

Portsmouth, VA 23708-2103