Who we are:
- Johns Hopkins Bloomberg School of Public Health (JHBSPH)
- University of New Mexico
What we do:
- We are Occupational and Environmental Health Professionals from Johns Hopkins Bloomberg School of Public Health and the University of New Mexico.
- We provide medical screening exams to all interested former workers from Los Alamos National Laboratory (LANL) and Sandia National Laboratories – New Mexico (SNL-NM).
- The JHBSPH Medical Exam Program is one of several unique programs within the DOE Former Worker Medical Screening Program (FWP). Examinations are performed in Espanola and Albuquerque, NM, by occupational health professionals from JHBSPH and University of New Mexico. We offer initial examinations and re-examinations every three years.
- Physicians, health care providers, and occupational health professionals travel from Baltimore, MD; and Espanola and Albuquerque, NM, to the examination site to conduct physical examinations. Examination sessions are scheduled over a 2-day or 3-day period two to three times per year.
- During examination sessions, former workers have the opportunity to meet with the program occupational medicine physician to discuss their examination results and to ask questions.
- Each participant has a detailed exposure and medical history interview prior to their initial examination and a short medical history interview before each re-examination. These interviews are conducted by a former worker from LANL.
- The NM program staff assists former workers with workers’ compensation claims and, when appropriate, writes letters in support of claims for Federal compensation for former workers from both sites.
- The project has completed 4464 examinations of former workers since the program began in 2000. Of these exams, 3815 were new exams, and 649 were re-examinations of former LANL workers for past exposures to asbestos, beryllium, and radiation, and SNL-NM former workers for past exposure to asbestos, beryllium, radiation, and silica.
- On exit surveys, over 80 percent of program participants stated that they were satisfied with their overall evaluation. Due to an increase in referrals to the program from outside sources we had many program participants who had to wait for a long period of time to receive their examinations and 97 percent who had examinations would recommend the program to other former workers.
- The program works with the Joint Outreach Task Group to develop outreach strategies to recruit former workers who are eligible for the FWP and Energy Employees Occupational Illness Compensation Program Act compensation. The Joint Outreach Task Group has representatives from the National Institute for Occupational Safety and Health, DOE FWP, Department of Labor (DOL) Office of Workers Compensation, DOL Ombudsman’s Office, National Institute for Occupational Safety and Health Ombudsman’s Office, and the DOL Resource Centers.
What we have found:
- Chest X-rays: 15 percent of 2,081 participants demonstrated findings consistent with work-related lung disease.
- Pulmonary function tests: 21 percent of 2,184 participants demonstrated findings consistent with obstructive disease.
- Beryllium Lymphocyte Proliferation Tests (BeLPT): 3 percent of 2,270 participants had at least one abnormal BeLPT.
- Since March 14, 2020, the Johns Hopkins University had been under work-from-home status.
- All educational programs are done via online education.
- All meetings are done via ZOOM.
- Our program employees in New Mexico answer telephone calls materials. and handle questions and issues of the program former workers.
- Since April 2021 we have started examinations and testing with Concentra Health Services, Inc . While Concentra is an occupational health services program that works throughout the country, we are conducting examinations in Albuquerque and Santa Fe, NM.
- Concentra provides examinations and testing as per the JHU FWP medical exam protocol. Program information for each former worker is sent to Concentra and the Concentra Program professionals perform the examinations and testing using JHU FWP materials.
- Once the examinations are completed the program materials are returned to Baltimore, MD. Any abnormal examinations and testing results are forwarded to the participants’ health care provider and the former worker is contacted and asked to communicate with their health care providers.
- Former workers who have questions are asked to contact the NM office. NM program staff answer these questions or refer the former workers to the Baltimore Program Office.
- We send program satisfaction surveys to Concentra with other materials. Participants are asked to complete the survey and it is returned to Baltimore with the other materials. Not every participant has completed the survey but those who have are satisfied with the examination at Concentra but they are not satisfied with the amount of time that has passed since they completed their program interview. We are working to complete all the examinations that we have waiting due to the pandemic and due to program delays over the past two years.
- At the end of the COVID-19 pandemic, we plan to return to New Mexico to resume our program model.
- We have had little contact with former workers at Outreach Meetings due to the pandemic, but we plan to resume attending local outreach meetings once they have resumed.
- Due to the quarantine in New Mexico, the DOL meetings are now presented online, and other meetings are available through ZOOM.
WHAT WE HAVE FOUND:
- Chest x-rays: N= 4341 had at least 1 chest x-ray and 10.0 percent demonstrated findings consistent with work-related lung disease.
- Pulmonary function tests: N = 3334 had at least 1 test and 2.1 percent demonstrated findings consistent with obstructive disease, and 2.4 percent had mixed pattern of disease.
- Beryllium Lymphocyte Proliferation Tests: N = 4242 had at least 1 test and 1.5% had at least one positive BeLPT.
- Audiograms: N = 3281 and 54 per cent demonstrated hearing loss for normal speech tones and 4 percent had the supplemental definition of hearing loss.
Maureen Cadorette, PhD, COHN-S
Dr. Cadorette has been a nurse for over 40 years. She graduated from Nursing School in 1972 and completed a Bachelor’s degree in nursing in 1992. She has a Master’s in Public Health (1994) and a PhD in Occupational and Environmental Health (2005) from John Hopkins University. She has worked in many areas of nursing, but Orthopedics was her longest stint, and she was at one time certified in Orthopedic Health Nursing. Today, she is a Certified Occupational Health Nurse. She has worked at John Hopkins University as a staff member and an Assistant Scientist since 1997, and she has worked in Occupational Health for 20 years. She is on the faculty of the Education and Research Center for Occupational Safety and Health at JHBSPH. They are funded by the National Institute for Occupational Safety and Health, and they educate occupational health professionals. She has been with the FWP since 1997 as a project coordinator and now as a Co-PI. She manages the day-to-day activities of the program and works with their staff in New Mexico to keep the program working smoothly. Dr. Cadorette has worked to complete the contract with Concentra and oversees the examinations and testing of former workers who have had examinations through Concentra.
Brian S. Schwartz, MD, MS
Dr. Schwartz is a Professor in the Department of Environmental Health Sciences in the JHBSPH. He is jointly appointed in the Department of Epidemiology in the School of Public Health and in the Department of Medicine in the School of Medicine. He joined the faculty at Johns Hopkins University as an Assistant Professor in 1990 and was promoted to Professor in 2001. He served as Director of the Division of Occupational and Environmental Health from 1996 to 2006 and as Director of the Occupational and Environmental Medicine Residency from 1993 to 1998, for which he is currently Deputy Program Director. He is a board-certified specialist in internal medicine and occupational and environmental medicine. Dr. Schwartz has been evaluating patients concerned about occupational and environmental diseases since 1990 in the Johns Hopkins Center for Occupational and Environmental Health. He also has an active research program on how metals, solvents, other chemicals, industrial processes, and environmental and community conditions can affect health. Dr. Schwartz has been the leader or co-leader of the FWP at LANL and SNL-NM since 2000. The two programs take a unique approach in that program health care providers perform all the examinations themselves. The two programs have completed over 4,000 examinations of former workers.
Aisha Rivera Margarin, MD, MS
Aisha Rivera is board certified in Occupational and General Preventive Medicine and serves as the Program Director for the Johns Hopkins Occupational and Environmental Medicine Residency. In that role, she is responsible for organizing training and educational experiences, evaluating and mentoring residents and maintaining the residency's Accreditation Council for Graduate Medical Education accreditation through a number of reporting and administrative tasks. She also serves as a Medical Advisor to the International Association of Fire Fighters through a longstanding relationship between the union and the residency program and is the course director for the Department of Environmental Health and Engineering's Clinical Occupational and Environmental Toxicology Course. She enjoys overseeing the growing premed focus area for the Master of Health Sciences offered by the Department of Environmental Health and Engineering where she gets to connect with students aspiring to pursue careers in medicine. She joined the FWP team as co-investigator in June 2020.
Outside of JHBSPH, she maintains various professional relationships, including working as a per diem physician with Concentra where she was most recently medical director and providing oversight for an onsite clinic, is a credentialed Clinical Peer Reviewer for several private companies, and has been assisting the New York City Metropolitan Transit Authority with reviewing their practices in response to COVID-19 pandemic.
Her professional interests include: mentoring students and residents, medical education, firefighter health and safety, medical surveillance, healthcare worker health, exploring the link between workplace culture and worker well-being, systems thinking, women in the workplace, vulnerable populations, work as a social vulnerable populations, workplace policies that promote healthy families, and international occupational health. She is a member of the American College of Occupational and Environmental Medicine and is currently on the Presidential Taskforce to Increase Occupational and Environmental Medicine visibility and a separate committee on fundraising for education.
Toll-free number: 1-877-500-8615
Web site: http://www.jhsph.edu/lanlfw/