National Supplemental Screening Program Logo

Who We Are:

The National Supplemental Screening Program (NSSP) is managed by Oak Ridge Associated Universities (ORAU). ORAU provides innovative scientific and technical solutions for the Department of Energy (DOE) and other federal agencies to advance national priorities in science, health, education, and national security. ORAU accomplishes the needs of the NSSP by integrating unique, specialized teams of experts and connecting DOE former workers to the right people and resources in their area for medical screening examinations.

The NSSP team of experts includes:

  • National Jewish Health – an academic medical research facility specializing in respiratory, cardiac, immune, and allergic disorders. National Jewish Health provides the NSSP with medical examinations, beryllium lymphocyte proliferation tests, and chest x-ray b-read services.
  • University of Colorado School of Public Health Center for Health, Work & Environment – provides the NSSP with medical examination results letter preparation, operational oversight, and periodic evaluation of the DOE/NSSP medical protocol. The CU team also participates in research activities, sharing responsibility for leading studies with ORAU.
  • Acuity International (formerly Comprehensive Health Services) – a leading provider of medical management solutions, with one of the country’s largest nationwide clinic networks. Acuity provides the NSSP with participant scheduling and medical examination services at more than 2,600 facilities around the country. With staff physician oversight, Acuity medical readiness teams respond to participants’ health care needs. Acuity’s scalable exam and surveillance programs provide dynamic, proven, and robust solutions for national and international workplace health.
  • Axion Health (a Cority Company) – provides the NSSP with ReadySet®, a cloud-based health management system to increase compliance, participant engagement, and organizational efficiency. ReadySet® is currently used by many prestigious U.S. health systems, integrating occupational health and medical surveillance. This system is HIPAA, NIST, and SOC2 compliant; reliable; easy to learn; and quick to implement. ReadySet® is a secure solution covering the health data of over one million individuals.

What we do:

  • The NSSP is the youngest of the DOE Former Worker Programs, beginning operations in 2005. The NSSP provides medical screening examinations to DOE former workers in production, operations, administration, and various other occupation groups from eight primary DOE sites:
    • Argonne National Laboratory
    • Fermi National Accelerator Laboratory
    • Hanford Site
    • Kansas City National Security Campus
    • Princeton Plasma Physics Laboratory
    • Pinellas Plant
    • Rocky Flats Plant
    • Savannah River Site
  • The NSSP also screens former workers from 73 additional DOE sites, including:
    • referrals from site-specific Former Worker Programs (FWPs) in cases where eligible former workers live outside of those programs’ respective medical screening coverage areas and
    • DOE sites for which no other FWP has been established or assigned.
  • The NSSP provides DOE former workers with exposure-based medical screening examinations designed to identify medical conditions of both occupational and non-occupational origin. As a result, former workers have the opportunity to receive wellness information and support for lifestyle changes to improve their health and quality of life.
  • The NSSP provides participants with the opportunity to receive a “rescreening” examination every three years.
  • The NSSP provides DOE former workers with information and assistance in filing Energy Employee Occupational Illness Compensation Program (EEOICP) benefit claims with the Department of Labor (DOL).
  • Over the program’s 15-year existence, more than 99% of responding participants have been satisfied with their experience in the NSSP.
  • The NSSP has developed an active research program involving projects on a range of topics related to former worker health and wellbeing. This recently revitalized research agenda maintains a consistent focus on providing a benefit to former workers and improving the reach, efficiency, and impact of the NSSP. Current projects all involve close collaboration between researchers at ORAU, CU, and NJH.

NSSP COVID-19 Response:

The NSSP, after consultation with the Department of Energy and the other Former Worker Programs, decided to suspend medical screenings and appointment scheduling on March 17, 2020. The program’s official restart of screenings took place on July 23, 2020, with a gradual increase over the following months in both exam volume and geographic distribution of appointments, the latter based on careful evaluation of local pandemic statistics and public health guidelines.

Throughout this “restart” period, which extended into the first half of 2021, the NSSP continued to make use of modified medical screening protocols and multiple materials developed with approval of the Central DOE Institutional Review Board (CDOEIRB). These supplemental materials included readiness assessments for participants and clinics, follow-up calls for recently screened participants, and periodic communications to participants regarding COVID-19 and its impact on the NSSP.

In May 2021, the NSSP expanded screening restart efforts to a few more clinics in the Acuity International network in areas with low prevalence and spread of COVID-19. Soon after, in early June 2021, the NSSP received approval from the CDOEIRB to discontinue the use of several of the supplemental restart materials discussed above while continuing to ensure that screening procedures were in line with then-current guidance from the U.S. Centers for Disease Control and Prevention (CDC) and relevant organizations such as the American College of Occupational and Environmental Medicine (ACOEM).

While the NSSP has not engaged in active outreach activities during the pandemic, we have continued to receive a steady flow of incoming exam requests from DOE former workers. This has led to a backlog of exam requests, which peaked in early April 2021 at 1,069 individuals awaiting scheduling for their NSSP exams. With the expansion of exam volumes and screening locations in May and June 2021, this number gradually began to decrease, as the rate of exam completion finally started to outpace new requests. The highly dynamic backlog is compiled from weekly reports from the NSSP’s provider partners regarding the number of new exams requested, the number of exams scheduled, the current total of participants awaiting scheduling, the number of exams scheduled but not completed, and referrals received from other FWPs.

At the beginning of July 2021, in response to low nationwide COVID-19 cases and transmission rates and increasing vaccination rates, the NSSP opened scheduling across the country, removing all geographic barriers to screening. Shortly after this, the NSSP devised a plan for managing and ultimately eliminating our backlog of exams created by the screening pause. This plan, shared with DOE Former Worker Program management, outlined a steady monthly increase in scheduling volume through summer and fall 2021, culminating in the elimination of the COVID backlog (i.e., exam requests received prior to the NSSP’s nationwide reopening in July 2021) by the end of Calendar Year 2021.

The NSSP is pleased to report that as of early December 2021, we remain on track to close our COVID backlog by the end of the month and begin working through our post-COVID queue (i.e., exam requests received after July 1st, 2021). Following the week ending on December 3, 2021, only 76 individuals remain on the NSSP’s COVID backlog, with 686 in our post-COVID queue.

Throughout the pandemic, NSSP staff have engaged in numerous activities aimed at process improvement, quality assurance, physical and digital resource organization, research, and more, thereby ensuring that program records and process documentation meet the NSSP’s high quality standards. The primary focus of the NSSP over the five months since reopening screenings nationwide and increasing exam volume to pre-pandemic levels has been to ensure that our quality control procedures are as exacting as ever. We are committed to providing exceptional service to our DOE former worker participants as everyone adjusts to a return to our previous workflow.

What we have found:

The NSSP has conducted initial medical screening examinations for 19,601 former DOE workers from 81 DOE sites and 6,742 rescreening examinations for those workers.

Chest X-Rays (with B-Read interpretation): N = 18,750

5.8%

had findings consistent with asbestosis without pleural disease

1.1%

had findings consistent with asbestosis with pleural disease

4.9%

had findings consistent with asbestos-related pleural disease

0.2%

had findings consistent with silicosis

0.0%

had findings consistent with mixed dust pneumoconiosis

3.4%

had findings consistent with pneumoconiosis, not otherwise specified

   

Pulmonary Function Test: N = 18,594

21.7%

had findings consistent with restrictive lung disease

13.3%

had findings consistent with obstructive lung disease

3.1%

had findings consistent with mixed pattern lung disease

   

Beryllium Lymphocyte Proliferation Test: N = 17,386

2.7%

had at least one abnormal BeLPT

   

Audiometry: N = 16,795

43.1%

demonstrated noise-induced hearing loss for normal speech tones

2.3%

w/ supplemental definition of occupational noise-induced hearing loss

   

Hemoglobin A1c: N = 6,313

55.4%

Normal (A1c value < 5.7)

28.1%

Prediabetes (A1c value 5.7 - 6.4)

16.5%

Diabetes (A1c value 6.5 or greater)

 

Medical Team:

Donna L. Cragle, PhD - NSSP

Donna L. Cragle, PhD

Dr. Cragle stepped down as the Senior Vice President and Director of Health, Energy, and Radiation Management at Oak Ridge Associated Universities (ORAU) in the fall of 2019, but has retained her role as Project Director of the National Supplemental Screening Program (NSSP). She has been involved with research on occupational hazards in Department of Energy (DOE) facilities for more than 35 years. The primary focus of her research has been in the area of occupational epidemiology, with particular interest in radiation and beryllium exposures. She has worked on numerous international projects, including an international committee to assess the body of data related to human health effects related to nickel exposure. She also worked on a data preservation effort for an international radiation epidemiology project involving health effects of radiation exposure. Dr. Cragle has also been involved in decision-making related to maintenance of the large worker databases. She has extensive experience with large-scale studies involving data from multiple worker populations. She has assisted outside researchers in their access to worker data and worked collaboratively with these researchers to facilitate their understanding of the data. Dr. Cragle’s knowledge of occupational epidemiology has resulted in teaching opportunities both nationally and internationally. Her publications have provided significant contributions to the occupational epidemiology literature. Dr. Cragle received her Bachelor of Arts degree in biological sciences from Indiana University, and her Masters of Science in human genetics from Virginia Commonwealth University. Dr. Cragle received her Ph.D. in environmental epidemiology from the University of North Carolina-Chapel Hill.

Jamie Stalker M.D. - NSSP

Jamie L. Stalker, M.D.

Dr. Stalker is a physician with Oak Ridge Associated Universities (ORAU), manager of the ORAU Arvada Office, and Co-Principal Investigator of the National Supplemental Screening Program (NSSP). Dr. Stalker joined the ORAU/NSSP team in 2021, having been a member of the NSSP’s external advisory committee since 2006. She has extensive experience as a medical director in the Department of Energy (DOE) complex and remains dedicated to the health and safety of the DOE workforce. Dr. Stalker has been board certified in internal medicine and spent 20 years practicing occupational medicine, including 10 years managing an onsite occupational health program. Her experience includes integration with human resources, industrial hygiene, radiation safety, legal, finance, business infrastructure, security, quality assurance, external contractors, and DOE-affiliated organizations. She has implemented and managed Accreditation Association for Ambulatory Health Care (AAAHC)-certified clinical and administrative service programs, including occupational medicine, wellness, physical therapy, ergonomics, and disability management (including workers compensation administration) programming. She has extensive familiarity with federal regulations applicable to DOE sites and the creation and implementation of compliant policies and procedures. Dr. Stalker is a frequent presenter at national conferences and meetings, including EFCOG Occupational Medicine Technical Task Group, Integrated Benefits Institute conferences, Virgin Pulse Thrive conferences, American Industrial Hygiene Association (AIHA) meetings, Midwest Business Group on Health conferences, and Conference Board workforce resilience conferences

Lee S. Newman, MD, MA, FCCP, FACOEM, F. Collegium Ramazzini - NSSP

Lee S. Newman, MD, MA, FCCP, FACOEM, F. Collegium Ramazzini

Dr. Newman is Distinguished University Professor at the University of Colorado in the Colorado School of Public Health and School of Medicine. In the Colorado School of Public Health, he has appointments in the Department Environmental and Occupational Health and the Department of Epidemiology. He is Director of the Center for Health, Work and Environment and Director of the National Institute for Occupational Safety and Health-supported Mountain and Plains Education and Research Center. In the School of Medicine, he is in the Division of Pulmonary Sciences and Critical Care Medicine at the University of Colorado Anschutz Medical Campus. Dr. Newman serves as the Co-Principal Investigator of the National Supplemental Screening Program (NSSP). In his past role as founder and CMIO of Axion Health, Dr. Newman led the team in the development of the highly secure software system that has been used by the NSSP since 2005 to efficiently conduct former energy worker exams throughout the country. He has also served as an advisor to many federal agencies, including the DOE, the DOL Energy Employee Occupational Illness Compensation Program (EEOICP), the National Institutes of Health, the Food and Drug Administration, the Environmental Protection Agency, and the Centers for Disease Control and Prevention. Dr. Newman is board certified in internal medicine and pulmonary medicine and is an internationally renowned expert on occupational and environmental lung disorders. Dr. Newman is recognized for his contributions to our understanding of how beryllium affects the immune system. As the former Chief of the Division of Environmental and Occupational Health at National Jewish Health, he pioneered the use of the beryllium lymphocyte proliferation test (BeLPT) and was instrumental in bringing this test into routine use for both clinical diagnosis and screening of beryllium-exposed workers, leading to the current clinical definition of beryllium sensitization and chronic beryllium disease. Dr. Newman received his Bachelor of Arts degree in psychology from Amherst College and his Masters of Arts degree in social psychology from Cornell University Graduate School of Arts and Sciences. He earned his MD from Vanderbilt University School of Medicine, completed internship and residency in Internal Medicine at Emory University School of Medicine, and pulmonary fellowship at the University of Colorado Denver/National Jewish Health.

Jeffrey R. Miller, PhD, CIH, CSP - NSSP

Jeffrey R. Miller, PhD, CIH, CSP

Dr. Miller is Senior Vice President and Director ORAU Government Services and provides executive leadership for the National Supplemental Screening Program. He has more than 30 years of diversified experience in industrial hygiene, occupational safety and health, and environmental protection. He is a subject matter expert in occupational exposure assessment, having designed and conducted large occupational and environmental exposure studies for beryllium, lead (and other heavy metals), carbon monoxide, pesticides, isocyanates, uranium, lithium hydride, asbestos, chlorine, chromium compounds, volatile organic compounds, silica, cutting fluids, nickel compounds, diesel particulate, and welding fumes. He worked for 10 years with state and local public health agencies on occupational disease surveillance programs, 20 years for private sector firms providing environment, safety, and health services to corporations and government agencies, and for the past 9 years conducting occupational exposure and worker health studies with ORAU.

He was a member of the design team for the new Uranium Processing Facility at the Y12 National Security Complex. His doctoral dissertation was on “The Psychosocial Impacts of Beryllium Sensitization and Chronic Beryllium Disease,” a study of DOE current and former workers. He has lead 40+ organizational culture evaluations in the nuclear industry and is past chair of the Energy Facilities Contractor Group (EFCOG) Safety Culture Working Group. He is past Director and Chair of the American Board of Industrial Hygiene, and currently serves on the Ethics Review Committee. He is an active member of the American Industrial Hygiene Association, American Conference of Governmental Industrial Hygienists, American Society of Safety Professionals, American Academy for the Advancement of Science, and the American Geophysical Union. He has a Ph.D. in Public Health from the University of Tennessee, an M.S.P.H. from the University of Colorado, School of Public Health, and a B.S. in Health Sciences from Western Illinois University. He is a Certified Industrial Hygienist ® and a Certified Safety Professional ®.

Contact Information:

Toll-free number:  1-866-812-6703
Web site:  http://www.orau.org/nssp