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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 asbestos 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. All completed NAVMED 6260/7 forms will be uploaded to MHS Genesis and the originating Clinic will be notified via email. 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 have switched to a centralized process for requesting B readings. On 1 OCT 2023, the Navy transitioned to the centralized process for B readings, 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, “Incomplete” will be displayed in red until all required data in Section 1 has been correctly entered. Incomplete forms are not to be submitted. After Section 1 is completed (and the PDF form reads “valid”), the form is to be saved as a PDF named firstname.lastname and placed in the respective clinic’s shared OneDrive folder. If your clinic does not have a shared one drive folder email DCPH-P: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil .
 
THE AMSP PROCESS AND PROTOCOL
 
Asbestos workers presenting to an Occupational Health (OH) clinic for medical surveillance follow the AMSP process. NAVMED 6260/5 section 1 must be entered electronically. Sections 2 and 3 can be filled out by hand and scanned into the computer to be placed into the shared one drive folder that is named 6260.5 Forms. The original is placed in the worker’s employee health record; if an electronic health record is being used, the form is scanned into the record. 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 drops the form into the clinic’s shared one drive folder. If the clinic doesn’t have a shared one drive folder email: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 section 1).
 
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 an electronic health record is being used, the form is scanned into the record. If the completed NAVMED 6260/7 forms are not returned to the clinic within 14 business days from the date the forms were dropped in the shared one drive folder, the OH clinic is to contact DCPH-P: usn.hampton-roads.navmcpubhlthcenpors.list.nmcphc-amsp@health.mil.
 
AMSP RECORD REQUESTS
 
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. Include 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 sometime 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
 


Web Resources
Clinicians

Clinical guidance, including recognition, management and clinical isolation guidance are generally covered by CDC: CDC Clinical Overview

Clinical management for Fleet medical personnel can be found in the NMCFHPC Fleet Mpox Medical Guidance

Clinical guidance for MTFs can be found in the DHA Mpox Guidance Update_5Sept2024

Currently, neither mpox testing nor treatment are readily available in a forward deployed operational setting. Units should identify suspected cases, isolate them, and move them for care at an MTF when operationally feasible.


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