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THE CORPORATE WELLNESS BLOG

Posts Tagged ‘Medical Surveillance’

Women and Medical Surveillance Programs: New challenges as the female workforce grows

Sunday, October 25th, 2009

Employees who participated in medical surveillance programs up until recently were overwhelmingly male.  That has changed in recent years and nearly every employer now has both male and female employees who are required to participate in annual medical surveillance requirements.  Yet, here has been no  medical surveillance program design, testing requirements or interpretation of findings based on gender.  Well, that may be changing very soon…

Recently, Corporate Wellness identified a pattern of abnormal laboratory findings in female employees who completed serum cholinesterase screens as baseline tests for a new environmental consulting client. They have more female employees than many others in the industry.  While the laboratory normal range for this test is 1900 to 3800 units per milliliter (U/mL), more than half of the female employees we tested this year had significantly lower results – some hovering around the 1000 U/mL mark even after retesting.  Normally,  we’d recommend limited potential for exposure and retest for 75% of normal and removal from all assignments that might include exposures for findings that are 60% of normal or below.

Together with Dr. Randy Young who heads clinical operations for LabCorp, we took a closer look.  We found that although there is currently only a single normal range for both males and females, normal findings for females, and especially females using estrogen based birth control, are more likely to be in the 1000 to 1800 units range – well below the published “normals” of 1800- to 3800 units.

LabCorp examined its own results, for our clients’ employees and their entire patient population and found that our observations appear to be correct.  And they will be publishing a new set of “normals” for both serum and rbc cholinesterase that are gender based.

For the moment, we are sending letters to all female employees whose laboratory results are below 1800 units, explaining where we are in the process of helping set new gender based normals but also offering retest if they’d like it.

We suspect that this may be the first of many things we learn as a result of the changing workforce.

Finally – US DOL Issues Revised FMLA Regulations

Tuesday, November 18th, 2008

It’s here and it’s 750 pages long.  It was originally published in February, 2008.  And on November 17th, the Department DOL Logoof Labor finally published its revised regulations to guide employers as we navigate FMLA.

Employers had identified many areas that required clarification  since the FMLA was enacted. And the new regulations do address many of them.  For instance, most of us see a potential of abuse of intermittent leave and  we also find gray areas that prevent asking medical questions regarding FMLA that are allowed under the ADA.

But, and it’s a big but, according to Frank Alvarez of Jackson Lewis, ” Many employers do not have the resources to master complex FMLA rules.  Most are cutting staff and slashing training budgets.  At the same time, they can’t afford to ignore this issue.  FMLA is a major compliance obligation, and in the midst of today’s economic uncertainty, attendance and productivity can be keys to a company’s survival.”

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Hidden Costs of Medical Surveillance

Wednesday, October 29th, 2008

Recently, we were asked ” Just what are the hidden costs of managing medical surveillance programs that you sometimes talk about?”  That may sound like a simple question but it really leads to a series of much more difficult questions.

 When was the last time that one of your new hires had his start date delayed because his medical clearance had not been received?

Did the delayed start cost you billable hours?

Did the delayed start cost you additional overtime or additional payments for contract personnel?

When was the last time one of your field personnel had to return to a clinic a second time or even a third time because some portion of the annual medical requirement had been omitted?

How many errors are there on the bills you review?

The cost of an asbestos exam isn’t simply what the clinic charges you for that exam.  Did they do the correct exam, with only the necessary components, in a single visit with minimal waiting time and report it  and bill it accurately in a timely fashion?