The medical science DMZ: a network design pattern for data-intensive medical science (Journal Article) | OSTI.GOV

Technical Report

Quinn, Patricia

administrators, etc.) to reach former workers and “get the word out.” CPWR will establish/maintain an outreach office at each site listed above. This office will serve as the face of the Program to workers and their communities. Communications and intake center: CPWR has two established toll-free phone numbers (1-800-866-9663 and 1-888-464-0009). There is also a dedicated website for the program (btmed.org). Workers can register with the Program by mail, telephone, or on-line. Work history: A standardized, structured work history is administered with modules that accommodate unique exposure scenarios for different occupations and different DOE sites. A work history interview is administered by a trained program interviewer. The work histories are used to determine whether a participant is eligible for the medical examination and to interpret the findings from the medical examination. Medical evaluation: The Program contracts with local medical providers qualified to deliver occupational medical screening services. All providers are credentialed. The Program contracts with a certified national laboratory and with NIOSH certified B-readers to review x-rays. Based on the work history, the participant is referred to a credentialed medical provider who is located close to the participant’s home. If it is not convenient to use a credentialed provider, the Program will make arrangements, if necessary, for the participant to receive a physical exam through the National Supplemental Screening Program. Eligible participants will receive the same core medical exam (including a Beryllium Lymphocyte Proliferation Test, BeLPT), and in addition, based on their work history, they may be assigned to exposure specific modules for asbestos, silica, lead, noise, cadmium, and chromium. Lab work will be sent to a national laboratory for processing, except the blood samples for the BeLPT, which will be sent to a DOE-approved laboratory for evaluation. Determination of work-relatedness and follow-up: A letter of findings will be sent to the participant within 60 days of the exam. The letter is written and/or reviewed by occupational medical health personnel with knowledge of the DOE site(s) where the participant has worked and will include specific follow-up recommendations. Urgent findings are followed up by the provider without delay. Evaluation and quality assurance: All data are entered into the Program Data Management System (DMS). The DMS is web-based and relies on electronic submission of results, whenever possible. A de-identified data set on all participants is provided to Duke University Medical Center for evaluation and analysis. Each participant is asked to complete a satisfaction survey. The DMS will be used for quality assurance purposes and to also report summary data to the DOE. The BTMED.ORG website is encrypted using the industry-standard Secure Sockets Layer (SSL) technology (128-bit encryption keys). Each individual that accesses the website is assigned a unique login ID, password, and token. Passwords are required to meet standards for “strength,” including minimum length, multi-case, and use of numbers. The website is also protected by additional security layers including additional encryption, hardware and software firewalls, Virtual Private Networks (VPNs), and virus protection.

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CPWR is carrying out a screening program for former Hanford construction workers. This program includes continuing screening and re-screening services for the former worker population. The Program contains the following general components: Start-up planning/needs assessment: A modified exposure assessment will be conducted to identify high-risk buildings or areas, primary exposures, and worker populations at risk. Outreach: CPWR, as the research arm of the Building and Construction Trades Department, AFL-CIO, has direct access to workers. CPWR will rely on direct mailings to lists of former workers, and work through and rely on existing organizations (unions, union pension funds, employers, DOE site more »