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Title: UF employee preplacement health assessments : policies and procedures
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Language: English
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UW |UNIVERSITY of
UFIFLORIDA


Student Health Care Center


1 Fletcher Drive
PO Box 117500
Gainesville, FL 32611-7500
Phone: 352-392-1161


UF Employee Preplacement Health Assessments


Policies and Procedures



University of Florida
Student Health Care Center


Effective June 18, 2004
(Revised 1/31/08)


The Foundation for The Gator Nation
An Equal Opportunity Institution








UF Employee Preplacement Health Assessments


I. Introduction

The University of Florida's Student Health Care Center (SHCC) and Environmental Health and
Safety (EH&S) manage UF's Occupational Medicine Program for the University of Florida. The
SHCC provides the health assessments for new employees and volunteers; conducts regular and
periodic health assessments on select groups of employees; oversees the employee immunization
program; and provides medical assessment and treatment for UF's workers' compensation
program.

Preplacement Health Assessments (PPHA) conducted prior to the individual beginning their
assigned job is a critical component of the Occupational Medicine Program. The goal of the
PPHA is to minimize health risks to the new employee and to minimize liability to the University.
Components of the PPHA are tailored specifically to the employee's job description and position
category. Certain job descriptions/position categories require additional assessments in the form
of laboratory studies, immunizations, or other diagnostic testing.

Two basic types of PPHA will occur. The first is a review of the individual's health history and
immunization records and the second is an actual on-site physical exam and review of
immunization records. For some job descriptions/position categories, the individuals will be
required to complete a comprehensive Health History and Immunization Record that will be
submitted for review by Occupational Health Clinic personnel. If the review deems the employee
has no specific job concerns or limitations and their immunizations are up-to-date as required by
the University, they are cleared to begin their job assignment. If there are concerns or missing
immunizations, the employee will need to be seen by appointment. Some job
descriptions/position categories require an actual on-site health assessment, which will include a
physical exam and may additionally, include laboratory testing and review/update of
immunizations.

II. Confidentiality and Ethical Conduct

All patients, including employees, prospective employees and volunteers, have a right to maintain
the confidentiality of their medical information. Many of the questions that are asked during a
replacement health assessment, while they may have an important impact on the employee's
ability to safely perform the described job duties, cannot and should not be shared with the
employer or prospective employer. Therefore, the SHCC will treat as confidential whatever is
learned about individuals served in a replacement or health assessment situation, releasing
information only when required by law or by over-riding public health considerations, or to other
physicians at the request of the individual employee/candidate according to traditional ethical
medical practice. The SHCC also recognizes that employers (including the University and its
departments) are entitled to counsel about the medical fitness of individuals in relation to work,
but are not entitled to diagnoses or details of a specific nature.

All replacement health assessment and other occupational health medical records at the SHCC
will be handled and stored in a confidential manner according to federal HIPAA laws and Florida
statutes. In addition, all SHCC employees will be held to their signed confidentiality statements
when dealing with occupational health records and information.


Page 2








III. Health Assessment Management System


The Health Assessment Management System, sometimes known as HAMS, is a tracking system
designed to assist departments in matching their position with job duties that require a
replacement health assessment. HAMS was established at the University of Florida in 1994.
Beginning in 2004, HAMS was incorporated in the UF Human Resources position management
section of PeopleSoft as well as on the EH&S Occupational Medicine (OCCMED) web site
www.ehs.ufl.edu/OCCMED/default.asp.

For individuals who will be hired into a specific position, the department must first review the job
duty list in PeopleSoft and indicate whether or not any apply to their position. For individuals
who work with a department but not on a specific position (OPS and volunteers), the department
must review the job duty list outside of PeopleSoft and indicate whether or not any of these
apply. This second list is available at the EH&S OCCMED web site
www.ehs.ufl.edu/OCCMED/INOPON.pdf.

If the job duty indicates a health assessment is required, the SHCC will record the result on the
physical exam page.

IV. Health Assessment Procedures

Two basic types of Preplacement Health Assessments for new employees or volunteers exist with
a third option occurring occasionally. Appendix A lists the actual components of these
assessments, broken down by job duty, immunizations needed, laboratory work required, and any
other testing necessary specific to the job duties of the position. Appendix B: The Job Duties
and Health Assessment Components At-A-Glance chart is created to offer specific information
quickly.
A. The first type of Preplacement Health Assessment includes a review of a comprehensive
health history and immunization records to make sure the new employee is adequately
protected from preventable communicable diseases they might be at risk to develop. The
following job duties require a review of these records prior to the new employee
commencing their job:
Animal Contact
Contact with Human Blood or other Potentially Infectious Material
Patient Contact

If the new employee is felt to be "at risk" for health issues related to their position, an on
site physical exam may be warranted. Likewise, if immunizations are missing or
incomplete from the employee's records, these will be administered to the new employee
prior to the new position commencing.

Appropriate health history and immunization forms can be accessed at
www.ehs.ufl.edu/OCCMED/forms.htm.
Completed Animal Contact Forms can be faxed to UF's SHCC Occupational
health department at 392-5078 for official review.
Persons with Patient Contact must make an appointment to be seen and take
completed forms and immunization records with them for review.
Persons with Contact with Human Blood or other Potentially Infectious Material
may need to schedule an appointment if they need Blood Born Pathogen training
or Hepatitis B vaccinations.
Fax completed records to 352-392-5078
Call 352-392-1161 ext 1-4212 to schedule an appointment.


Page 3








The SHCC Occupational Health staff commits to a timely review of the records and will
notify the employee or their hiring authority of any deficits or further requirements within
24 hours or 1 business day.

Any needed immunizations must be administered prior to the employee commencing
their new job duties. These can be obtained from either the UF's SHCC on Fletcher
Drive, main campus, or the SHCC satellite clinic at the Health Science Center in Room
D2-49, second floor Dental Towers. Appointments are required and can be obtained by
calling 352-392-1161 ext 1-4212 (main campus SHCC).

B. The second type of Preplacement Health Assessment is an actual on-site physical exam
and review of immunization records is required for the following types of job duties:
Asbestos Abatement
Climbing
Commercial Driver's License
Frequent Reaching Above Shoulder
Heavy Lifting
Kneeling
Law Enforcement
Operation of Special Purchase Vehicles
Pesticide Use
Repeated Bending
Repetitive Pulling and Pushing
Respirator Use
Scientific Research Diving

C. On occasion there may be a situation when a single specific test is required. For
example, if the only applicable job duty were "works in area of excess noise" a baseline
audiogram would be required before the individual began work.

The SHCC offers PPHAs at its main campus clinic on Fletcher Drive. Appointments are required
and can be obtained by calling 352-392-1161 ext 1-4212 respectively.

Once the health records and/or the physical exam have been completed, reviewed and approved,
the employee is then assigned a work status of either:
No job specific limitations OR
Job specific limitations

If the health assessment identifies limitations to the job, the SHCC will contact Employment and
Classification to initiate review of the job duties. Employment and Classification will work with
the hiring department and EH&S to review possible accommodations and hire eligibility of the
candidate into the position.

Work status is then posted on the PeopleSoft medical exam page. Only after work status has been
assigned is the employee able to assume their new job duties. Should there be missing pieces of
the PPHA, these will also be noted on the medical exam page.

V. How Health Assessments Requests are Initiated

The department will need to initiate the request for a replacement health assessment when they
begin the process to 1) fill a vacant position or 2) change the duties of a filled position. If any of
the new job duties match those listed in HAMS, a health assessment is required.


Page 4








A. Departments must identify applicable job duties on the "Supervisor Checklist for Health
Assessments."
1. For individuals on positions, the department will use the HAMS list within
PeopleSoft.
2. For individuals NOT on positions, the department will use the HAMS list on the
EH&S OCCMED web site.
B. Based on the job duty, the department will determine the type of health assessment
needed.
1. For the review, the Animal Contact individual should send (fax is acceptable) the
appropriate forms to the SHCC at Box 117500 or 352-392-5078.
2. Patient Contact and Blood Contact individuals need to schedule an exam by calling
the SHCC for an appointment at 352-392-1161 ext 1-4212 (Main Campus SHCC).
3. For an audiogram, the department should call the Speech and Hearing Clinic for an
appointment at 352-392-2041.

VI. Waiver of Preplacement Initial Health Assessment

When filling a vacant position or reclassifying a filled position that requires a health assessment,
on occasion, the selected candidate may meet the criteria for a health assessment waiver as
described below. A promotion or reassignment candidate might be an example. The department
may request a waiver for the required health assessment by submitting the Candidate Waiver
Request Form (www.ehs.ufl.edu/OCCMED/hamswaiv.pdf) to EH&S. (Form may be mailed to
EH&S at Box 112195 or faxed to 352-392-3414.) EH&S will communicate the decision to the
center/department either through PeopleSoft (for complete waivers) or by phone (for partial
waivers).

Health Assessment Waiver Criteria

A. Presence of a previous replacement physical examination of file at the SHCC. If the
individual has left UF employment and then returned, the previous physical exam must
have been completed no more than 12months before. (Conventionally, the exam must
have been performed at the SHCC and not substituted by an outside examiner. In the
case of an off-campus health assessment, if the previous exam, using UF/SHCC forms,
has been completed and approved by the SHCC for substitution of the replacement
examination, the SHCC will allow such an exam to be utilized as the basis for a waiver.)
B. No significant changes will occur in the essential functions of the job.
C. No significant changes should have occurred in the health status or physical capabilities
of the employee in question. Under some circumstances, the employee may be asked to
complete a new health history form for review by SHCC Occupational Medicine staff
D. Preplacement evaluation for the new position may require additional ancillary testing or
immunizations not required for the current position's replacement evaluation. Under
such circumstances, it may be possible to waive part but not all of the replacement
evaluation (e.g. waive the physical exam but require PPD testing or
Measles/Mumps/Rubella [MMR] vaccination).

VII. Substitution of Preplacement Examination

On occasion, the SHCC will be requested by an individual employee/candidate or UF department
to substitute an examination performed by a private physician for the SHCC replacement
examination. Health Assessments done for those who have been offered employment at an IFAS
research center would fall into this process.


Page 5








This request differs from the waiver process, in that the employee/candidate does not have recent
SHCC replacement physical on file and the exam for requested substitution has not been
performed by an SHCC medical provider (physician or physician assistant). It is imperative to
note that the mere provision of a "statement of good health" by private physicians is unacceptable
as a substitution by the SHCC, EH&S and the University.

In order for the SHCC to consider a request for a substitution of a replacement examination,
the following criteria must be met:

A. The physician who performed the examination must be licensed to practice in the State of
Florida. Examinations performed by a physician assistant or nurse practitioner will not
be considered unless co-signed by a physician.
B. The name and state license number of the physician must be printed or typed on the
exam. A signature alone, even when legible, will not be accepted.
C. The components of the examination performed must meet or exceed those of the required
SHCC examination. Whenever possible, the SHCC prefers that the physical examination
be recorded on the SHCC Preplacement Physical Form. The SHCC will provide this
form, at an employee/candidate's request, by mail or fax to the physician in question. It
is also available on the web at www.health.ufl.edu/shcc/OCCMED/pdf/exam.pdf.
D. The examination must have been performed within the previous sixty (60) days.
E. The employee/candidate must have completed the SHCC's Preplacement Medical
History Questionnaire for review by SHCC staff.
F. Any additional ancillary testing or immunizations must also be completed prior to
clearance/recommendation. If performed at an outside health facility, appropriate
documentation is required prior to clearance. Under no circumstances will the statement
"Had measles and rubella as a child" be an acceptable substitution for a UF replacement
MMR vaccination requirement, even when a physician signs such a statement.

Submit the documentation of substitute exam and immunization records via fax to 352-392-5078
with a specific Fax Cover Sheet that can be obtained from:
www.ehs.ufl.edu/OCCMED/faxcover.pdf

VIII. Integration with PeopleSoft

The implementation of the PeopleSoft Human Resources system July 1, 2004 establishes new
business procedures at the University of Florida. July 1, 2004 also dates new procedures for
documenting replacement initial health assessments.
The department identifies job duties that apply to their position through HAMS. For those
individuals who will be on a position, the department will identify the job duties within
PeopleSoft on the UF Position Specific tab/screen. For those individuals who will not be on a
position, the department will identify the job duties outside of PeopleSoft on the form available
from the EH&S OCCMED web site www.ehs.ufl.edu/OCCMED/INOPON.pdf.
When a health assessment is required, the Student Health Care Center will conduct the medical
review. If a physical exam is required, the department schedules it with the SHCC. If a review of
a comprehensive health history and immunization records is required, the individual provides the
SHCC with the appropriate completed forms. The SHCC will post the results on the PeopleSoft
medical exam page.


Page 6








There will be space on the PeopleSoft Medical Exam page to list any missing or incomplete
components of the PPHA. It then becomes the responsibility of the hiring authority to contact the
new employee/volunteer to comply with any additional information requested as part of the
PPHA. The individual who will have the new duties must be cleared for the duties before he or
she begins the work.
For partial submission of requirements, the PeopleSoft results will be entered as "Under Review."
The individual will be cleared in PeopleSoft only after all health requirements are met.


Page 7








Appendix A:


Job Duties that Trigger a Health Assessment
and their Health Assessment Components

Animal Contact

Definition: Individuals who have direct exposure to vertebrate animals and, in some cases, animal
tissues, body fluids or wastes.
Health Assessment: review of health history and immunization records
Forms: Risk Assessment for Animal Contact (http://www.ehs.ufl.edu/Bio/Files/acwaiver.pdf)
Labs:
Serum for Banking All individuals in contact with sheep or goats, non-human primates, alligators
and birds housed outdoors and all females of childbearing age.
TB Screening within 12 months All individuals in contact with non-human primates
Immunizations:
Tetanus Immunization within 10 years All individuals having recurrent animal contact
Rabies Immunization completion of rabies series or positive (+) titer within 2 years All individuals
in contact with unvaccinated carnivores
Other:
Respirator Clearance All individuals in contact with quarantined animals and certain species (Ex.
goats & sheep)
Information: Environmental Health and Safety, 352-392-1591


Asbestos Abatement

Definition: Individuals involved in an abatement effort. Must also participate in the Respiratory
Protection Program (see Respirator Use below).
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Initial Medical Questionnaire for Asbestos Worker Medical Monitoring
(http://www.osha.gov/pls/oshaweb/owadisp.showdocument?p table=STANDARDS&p id=108
66&p text version=FALSE)
Initial Medical Questionnaire for Respirator Use (http://www.ehs.ufl.edu/OCCMED/initial.pdf)
Statement by a Medical Doctor
Immunizations:
Tetanus Immunization within 10 years
Other:
Baseline chest x-ray
Baseline pulmonary function test
Annual medical monitoring
Information: Environmental Health and Safety, 352-392-3393


Climbing

Definition: Focus is on not only leg motion but also hand-over-hand motion such as with climbing
ladders.
Health Assessment: physical exam and review of immunizations
Forms:


Page 8








Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Commercial Driver License

Definition: For those required to have a commercial driver license as part of their UF employment
Health Assessment: Department of Transportation Physical Examination
Forms:
Department of Transportation CDL exam form (Available during Exam)
Medical History (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Labs: Drug testing
Immunizations:
Tetanus Immunization within 10 years
Other: Drug tests and physical examinations on ongoing basis for the duration of time that the employee
is required to operate a commercial motor vehicle
Information: Human Resources, 352-392-4940


Contact with Human Blood or Other Potentially Infectious Material

Definition: Occupational exposure to bloodbome pathogens
Forms: Training and Vaccination Statement (http://www.ehs.ufl.edu/Bio/BBP/tnv.pdf)
Immunizations: Series of three Hepatitis B vaccinations if elected by the candidate
Other: The University of Florida is required to provide site-specific training. In addition, OSHA
regulations and State of Florida statutes require that all employees who could reasonably be
anticipated, as the result of performing their assigned job duties, to face contact with human
blood or other potentially infectious body fluids must be offered Hepatitis B vaccination at no
cost to the employee. Employees/candidates who meet these criteria will be offered Hepatitis B
vaccination and will be strongly counseled to accept. If an employee/candidate declines, they will
be required to sign a declination statement that meets OSHA and CDC requirements. Post
vaccination testing should be done 1-2 months after the last dose of Hepatitis B vaccine.
Information: Environmental Health and Safety, 352-392-1591


Frequent reaching above shoulder

Definition: Includes painting, shelving books, running overhead cable, etc.
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


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Heavy Lifting


Definition: 45 pounds and over
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Kneeling

Definition: More than 2 hours per day
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Law Enforcement

Definition: Law enforcement duties with the University Police Department. Must also participate in the
Bloodbome Pathogen Program (see Contact with Human Blood above) and the Respiratory
Protection Program (see Respirator Use below).
Health Assessment: physical exam and review of immunizations as defined by the State of Florida
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Labs: Drug screen, urinalysis, CBC, PPD, Lipid Panel, Serum Banking
Immunizations:
Tetanus Immunization within 10 years
See Contact with Human Blood
Hepatitis A Series Recommended
Other:
Chest X-ray
Mental health evaluation
Baseline pulmonary function test
EKG
Vision test
Baseline Audiogram
Information: UPD, 352-392-5446


Page 10








Noise, Work in Areas of Excessive


Definition: Noise level defined by OSHA
Health Assessment: Baseline audiogram
Forms:
Hearing Conservation Program: New Hire Questionnaire (Grace to provide)
Other:
Annual audiogram
Information: Environmental Health and Safety, 352-392-1591


Operation of Special Purpose Vehicle

Definition: Includes industrial or farm equipment
Health Assessment: physical exam and review or immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Patient Contact

Definition: Having physical or face-to-face contact with a patient, or having contact with potentially
contaminated items including (but not limited to) blood and/or body fluids
Health Assessment: review of health history and immunization records
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Labs: Titers if indicated
Immunizations:
Two step PPD or evidence of a PPD within the 12 month period prior to commencement of
employment and PPD administered at time of health record review. For prior positive PPDs, a
chest x-ray current within 12 months prior to UF start date is accepted or CXR from SHCC is
required. Persons with a history of BCG vaccination are required to have 2-step PPD. TB
Surveillance of Symptoms required if past positive PPD.
Documented evidence of Measles/Mumps/Rubella (MMR) immunization for all
employees/candidates born after January 1, 1957. If the immunization is medically
contraindicated, Measles Mumps and Rubella titers showing evidence of immunity can be
substituted for this requirement.
Documented evidence of Varicella disease or blood titer confirming disease immunity or proof of two
doses of Varicella Vaccine.
Documented evidence of a series of three (3) Hepatitis B vaccines or blood titer confirming disease
immunity or waiver of vaccines.
One Tetanus, diphtheria and pertussis (Tdap) vaccination required for HCWs with Patient Contact.

If a patient contact employee/candidate does not meet PPD and immunization/titer requirements, that
individual will be listed as "Under Review" until these requirements are met.
Other:
Chest X-ray: All positive PPD
Information: Student Health Care Center, 352-392-1161 ext 1-4212.


Page 11









Pesticide Use

Definition: Individuals who use pesticides as defined in the Medical Monitoring Program for Pesticide
Users
Health Assessment: physical exam
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam .pdf)
Medical History (Same as Above)
Labs:
Liver function test
Kidney function test
Baseline cholinesterase test (two blood samples within two weeks)
Immunizations:
Tetanus Immunization within 10 years
Other: Annual medical monitoring
Information: Environmental Health and Safety, 352-392-1591


Repeated Bending

Definition: More than 2 hours per day
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Repetitive Pulling and Pushing

Definition: Repetitive pushing and pulling of loads, materials or objects for any length of time
Health Assessment: physical exam and review of immunizations
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Immunizations:
Tetanus Immunization within 10 years
Information: Environmental Health and Safety, 352-392-1591


Respirator Use

Definition: For individuals required to wear a respirator on a routine or emergency basis
Health Assessment: physical exam
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
Initial Medical Questionnaire for Respirator Use (http://www.ehs.ufl.edu/OCCMED/initial.pdf


Page 12








Labs:
Immunizations:
Tetanus Immunization within 10 years
Other:
Baseline pulmonary function test
Annual medical monitoring
Information: Environmental Health and Safety, 352-392-1591



Scientific Research Diving

Definition: For individuals who participate in UF affiliated research diving
Health Assessment: physical exam
Forms:
Preplacement Physical Exam (http://www.health.ufl.edu/shcc/occmed/pdf/exam.pdf)
Medical History (Same as Above)
SCUBA Diving Medical History Form (http://www.ehs.ufl.edu/Dive/forms/historv5.pdf)
Medical Evaluation of Fitness for SCUBA Diving Report
(http://www.ehs.ufl.edu/Dive/forms/medic6.pdf)
Labs:
Urinalysis
CBC
Blood Typing
Immunizations:
Tetanus Immunization within 10 years
Other:
Baseline chest x-ray
12 lead EKG
Baseline pulmonary function test
Audiogram
Visual acuity
Periodic medical monitoring
Information: Environmental Health and Safety, 352-392-1661


Page 13












Appendix B


Job Duties and Health Assessment Components at a Glance


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Animal Contact / / /* "* *
Asbestos Abatement*** V V
Climbing / /
Commercial Driver's License / V/ -/ /
Contact w/Human Blood 1* *
Frequent Reaching Above Shoulders / /
Heavy Lifting /
Kneeling / /
Law Enforcement / -/ / / V/ V/ V/ V/ v/ /
Noise V
Operation of Special Purpose Vehicle / V
Patient Contact / V / / V/ V V/ /*
Pesticide Use / V -/ V V
Repeated Bending__ /
Repetitive Pulling & Pushing /
Respirator Use a) N-95; b) Tight fitting / / / /*
Scientific Research Diving/ -/ / /


V = Item required
* = Item specific to a situation


** = Requirement waived if born < 1957
*** = Medical Monitoring has age specific requirements


Page 14










Appendix C: Forms


Go to the EH&S or SHCC OCCMED web page for most current forms.

EH&S Home Page: http://www.ehs.ufl.edu
EH&S Occupational Medicine Home Page: http://www.ehs.ufl.edu/OCCMED/default.asp
EH&S OCCMED Forms Page: http://www.ehs.ufl.edu/OCCMED/forms.htm
SHCC website: http://shcc.ufl.edu/occmed/


Page 15










Appendix D:


OCCUPATIONAL MEDICINE ETHICS STATEMENT

Physicians and other health care providers at the University of Florida Student Health Care Center
providing occupational medical services will always strive to abide by the Code of Ethical Conduct of the
American College of Occupational Medicine.







Code of Ethical Conduct for Physicians
Providing Occupational Medical Services

These principles are intended to aid physicians in maintaining ethical conduct in providing occupational
medical service. They are standards to guide physicians in their relationship with the individuals they
serve, with employers and workers' representatives, with colleagues in the health professions, and with
the public.

Physicians should:
1. accord highest priority to the health and safety of the individual in the workplace;
2. practice on a scientific basis with objectivity and integrity;
3. make or endorse only statements which reflect their observations or honest opinion;
4. actively oppose and strive to correct unethical conduct in relation to occupational health service;
5. avoid allowing their medical judgment to be influenced by any conflict of interest;
6. strive conscientiously to become familiar with the medical fitness requirements, the environment
and the hazards of the work done by those they serve, and with the health and safety aspects of
the products and operations involved;
7. treat as confidential whatever is learned about individuals served, releasing information only
when required by law or by over-riding public health considerations, or to other physicians at the
request of the individual according to traditional medical ethical practice; and should recognize
that employers are entitled to counsel about the medical fitness of individuals in relation to work,
but are not entitled to diagnoses or details of a specific nature;
8. strive continually to improve medical knowledge, and should communicate information about
health hazards in timely and effective fashion to individuals or groups potentially affected, and
make appropriate reports to the scientific community;
9. communicate understandably to those they serve any significant observations about their health,
recommending further study, counsel or treatment when indicated;
10. seek consultation concerning the individual or the workplace whenever indicated;
11. cooperate with governmental health personnel and agencies, and foster and maintain sound
ethical relationships with other members of the health professions; and
12. avoid solicitation of the use of their services by making claims, offering testimonials, or implying
results, which may not be achieved, but they may appropriately advise colleagues and others of
services available.


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Appendix E:


Immunizations and Tuberculosis Screening Requirements for
Employees with Patient Contact

Influenza: All Health Care Workers (HCW) who breathe the same air, as patients should be vaccinated
annually in early fall.

Hepatitis A: HCWs are not at increased risk for Hepatitis A Disease and therefore do not need receive
this vaccination routinely.

Hepatitis B: All HCWs with direct patient contact and any workers who deal with blood and body fluids
are strongly encouraged to receive a series of three (3) sequential doses of Hepatitis B vaccine prior to
direct work with patients. For HCW who received this series in the past, no further boosters or
serological test for immunity is recommended. However, for those HCWs just completing their series, a
post vaccination serologic test for immunity is required 1-2months after the third (3rd) dose is received.

MMR: HCWs born in or after 1957 who cannot document prior vaccination should receive two (2) doses
of MMR separated by at least four (4) weeks. Alternatively, serological testing can be done to determine
if the HCW is immune to measles, mumps and rubella. HCWs born before 1957 have this requirement
waived.

Tdap or Td: All HCWs with patient contact need to be vaccinated for Pertussis with Tdap after
completing the primary 3 dose regime for Diphtheria, Pertussis and Tetanus.

Varicella: Health Care Workers (HCW) born in or after 1957, who cannot document prior vaccinations
should receive two (2) doses of varicella vaccine or demonstrate serologic immunity. HCW born before
1957 have this requirement waived.

PPD: HCW new to UF, designated as Patient Contact, including those with a history of Bacille Calmette-
Guerin (BCG) vaccination, will receive the two-step PPD screening for Tuberculosis. This two-step
method is used to reduce the likelihood that an older TB infection is not misinterpreted as a recent
infection. The two-step PPD procedure is as follows:
1. New employee receives PPD test (Mantoux method) at time of Preplacement Health Record
Review and returns to have the test read in 48-72 hours.
2. Employee is instructed to return to Occupational Health in 7 days to have second PPD placed.
Employee returns to have 2nd PPD read in 48-72 hours.

A single-step PPD may be administered if the employee has had a documented PPD placed and read
within the previous 12 months of the UF hire date.

Those with documented known positive skin test in the past must show proof of a negative chest x-ray
that is current within 12 months of UF hire date or receive a chest x-ray at Student Health Care Center
(SHCC) prior to the employment start date. Those with prior positive skin tests must also complete a
Screening for Tuberculosis symptoms form and submit this to the Occupational Health Program for
review.

New employees will not be cleared for Patient Contact until after the first PPD is read. It is possible that
the date of the second PPD may fall after the employee begins work.


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References:
CDC Immunization website, www.cdc.immunize, for Health Care Workers, January 2008
Core Curriculum on Tuberculosis: What Every Clinician Should Know. Fourth Edition. US Department
of Health and Human Services, 2000
Epidemiology and Prevention of Vaccine Preventable Diseases. Ninth Edition. Centers for Disease
Control and Prevention, January 2006
Varicella in Health Care Settings, MMRW, April 5, 2005
Tuberculosis Infection Control in Health Care Personnel, Center for Disease Control and Prevention,
2007
Immunization Action Coalition/Vaccination Information for Healthcare Professionals, www.immunize.org


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