introduction to the RME

Question 1

Purpose of the Ionizing Radiation Medical Examination

Answer 1

Focused medical examination to establish whether or not cancer is present.

All comments written in block 14: Not an indication of cancer or bone marrow suppression

Documented on NAVMED 6470/13, Ionizing Radiation Medical Examination

Question 2

4 different types of RME’s

Answer 2

1. Pre-placement examination (PE)
2. Reexamination (RE)
3. Situational Examination (SE)
4. Termination Examination (TE)

Question 3

Who may conduct the RME

Answer 3

Physicians
Nurse Practitioners
PA’s
Should have attended BUMED approved training RHI

Only physician may sign as reviewer. Must be RHI, RAM, or UMO.

Question 4

Components of an RME

Answer 4

1. Med History
2. Special Studies
3. Physical Examination

Question 5

List Special Studies associated with an RME

Answer 5

1. WBC and hematocrit within 3 months prior to physical
2. UA via dipstick or microscopic within 3 months prior to physical
3. Additional studies may apply as dictated by applicable radiological controls program manual.
   Radiobioassay, internal monitoring, radon health analysis

Question 6

Components required by physical exam

Answer 6

1. Thyroid
2. Manual/clinical breast exam all females over 40
3. Testes
4. DRE all males over 40.
5. Skin

Question 7

Health Record Jacket or employee medical files must be marked with respect to the RME

Answer 7

Termination RME will be entered on front of the individual’s health record jacket or employee medical file as Termination Radiation Examination Required

Question 8

Describe when each type of RME is to be conducted

PE

Answer 8

Individuals being considered for assignment as Radiation Workers prior to assignment

Personnel being reconsidered for re-entry after a TE

Personnel that are not required to have PE as stated above but have exceeded 500mrem in a calendar year

Question 9

Describe when each type of RME is to be conducted

RE

Answer 9

Periodicity for Rad workers:

5 years till age 50

2 years ages 50-60

1 year ages 60+

No later than one month following month and year of previous physical

Question 10

Describe when each type of RME is to be conducted

SE

Answer 10

Any individual has exceeded radiation protection standards per NAVMED P-5055

When an individual has ingested or inhaled radioactive material 50% of an ALI

When deemed necessary by attending physician

(Med history must contain summary for basis of exam)

Question 11

Describe when each type of RME is to be conducted

TE

Answer 11

Upon separation, termination of their active-duty or employment if they have received a PE

When removed as a RAD Worker

No earlier than 6 months prior to separation

If TE not performed:
1. 6470/13 will be prepared and completed to maximum extent
2. Reason why form is incomplete recorded in summary of abnormal findings

Question 12

Considerations of other exam at the same time of the RME.

Answer 12

1. Consultations, reports/findings, exams, that affect continued qualification.
2. May submit medical information from private physicians for consideration. Required information relating to diagnosis, treatment, and continued presence of cancer
3. Outside diagnostic studies that are required to complete the RME must be completed within 45 days

Question 13

Dosimetry Issue not Allowed list

Answer 13

RME expires

changes in clinical scope that is indicative of cancer

open wounds or lesions that cannot be protected from contamination. (Worker actively works with contamination)