Introduction to RME

Question 1

State the purpose for the Ionizing Radiation Medical Examination.

Answer 1

Radiation workers receive focused medical examinations to establish whether or not cancer is present which would medically disqualify a person from receiving occupational radiation exposure.

Question 2

b. State the four different types of RMEs.

Answer 2

(1) Preplacement Examination (PE)

(2) Reexamination (RE)

(3) Situational Examination (SE)

(4) Termination Examination (TE)

Question 3

c. Describe who may conduct the RME.

Answer 3

RMEs should be performed by physicians, nurse practitioners or physician assistants who have received BUMED approved radiation health training.

Question 4

Describe who may review the RME.

Answer 4

Requires a credentialed physician’s signature, printed name or stamp, and date of review in the reviewing physician block. All reviewing authority signatures need to identify their qualification with the pertinent designation, “UMO” for Undersea Medical Officers, “RAM” for Aerospace Medicine Specialist, and “RHI” for those trained at the Naval Undersea Medical Institute (NUMI) Radiation Health Indoctrination course.

Question 5

List the components of an RME.

Answer 5

(1) Medical history (blocks 3 – 10)

(2) Special studies (blocks 11 – 13)

(3) Physical examination (blocks 15 – 19)

Question 6

List the standard special studies associated with an RME.

Answer 6

(1) White Blood Count (WBC) and Hematocrit (HCT) within 3 months prior to the conduct of the physical examination.
(2) Urine will be tested for red blood cells using microscopic high-powered field within 3 months prior to conduct of the physical examination.

Question 7

List the components required by the physical examination.

Answer 7

(1) Thyroid
(2) Breast examination (manual and clinical)
(3) Testes
(4) Digital rectal exam (DRE)
(a) The DRE is no longer indicated. Mark Not Examined (NE) in block 18.
(5) Skin

Question 8

State how health record jackets or employee medical files must be marked with respect to the RME.

Answer 8

The requirement for a termination RME will be entered on the front of the individual’s health record jacket or employee medical file as “Termination Radiation Medical Examination Required.”

Question 9

Describe when a (PE) Pre-placement Examination is to be conducted.

Answer 9

(a) Individuals being considered for assignment as radiation workers prior to assignment or transfer to those duties.
(b) Individuals who have been radiation workers at one time or another, received a termination examination, and are now being considered for re-entry into the program.
(c) Individuals who are not required to have a PE but who exceed 500 mrem (5 mSv) exposure in a calendar year, must have a PE within one month of the date they exceed 500 mrem (5 mSv) or as soon thereafter as documented operational requirements permit.

Question 10

Describe when a (PE) Pre-placement Examination is NOT required.

Answer 10

1) Non-radiation workers and members of the general public.
2) Visitors including messengers, service personnel, and delivery personnel.
3) Personnel exposed sporadically such as emergency response personnel; dentists, dental technicians and other dental paraprofessionals; nurses and ward personnel; explosive ordinance disposal (EOD), SEALS, Navy Divers, and Marine Force Recon personnel; and personnel who receive less than 100 millirem of occupational ionizing radiation dose annually unless required by the appropriate radiological controls manuals for specific program requirements.

Question 11

Describe when a (RE) Reexamination is to be conducted.

Answer 11

When personnel who are to continue in routine duties as radiation workers, must have an ionizing RME.

Question 12

Periodicity for (RE) Reexamination.

Answer 12

Every 5 years up to age 50.
After age 50, periodicity will not exceed every 2 years.
Beginning at age 60 the examination is required annually.

Question 13

Reasons to be placed on DINA List.

Answer 13

1. Expired RME.
2. Open wounds or lesions that cannot be protected from contamination.
3. A disqualifying condition is found, but can be resolved in short order, with subsequent REAB submission. Once REAB returns “Physically Qualified”, member can be removed from DINA List.

Question 14

Describe when a (SE) Situational Examination is to be conducted.

Answer 14

1) Any individual who has exceeded the radiation protection standards for radiation workers as stated in Chapter 4 of the NAVMED P-5055.
2) When an individual has ingested or inhaled a quantity of radioactive material exceeding 50 percent of an ALI.
3) When an attending physician deems necessary must be given an ionizing RME.

Question 15

Describe when a (TE) Termination Examination is to be conducted.

Answer 15

Radiation workers will be given a TE as near as practical to, but no earlier than 6 months prior to satisfying one of the following conditions:
1) Upon separation or termination of their active duty or employment if they received a PE, and have documented occupational radiation exposure (including personnel monitored for exposure but who received 00.000 rem).
2) When permanently removed from duties as a radiation worker.

Question 16

What to do if a (TE) Termination Examination is not completed or not performed.

Answer 16

1) A NAVMED 6470/13 will be prepared and completed to the maximum extent practicable.
2) The reasons why the form is incomplete will be recorded in the Summary of Abnormal Findings and Recommendations block [block 14] of the NAVMED 6470/13.

Question 17

What is the Dosimetry Issuance Not Allowed (DINA) List and the reasons to be placed on it?

Answer 17

1) A list for which worker’s dosimetry privileges are removed due to various issues, and dosimetry issue is not permitted until the issue is resolved.
2) Reasons to be placed on DINA List.
* Expired RME.
* Open wounds or lesions that cannot be protected from contamination.
* A disqualifying condition is found, but can be resolved in short order, with subsequent REAB submission. Once REAB returns “Physically Qualified”, member can be removed from DINA List.