B.1 Summary

LLNL recognizes the need for medical safeguards for beryllium workers at its facilities. LLNL offers medical examination and evaluation for LLNL employees and undertakes notification procedures in beryllium work areas and regulated beryllium work areas in support of workplace safety and health. LLNL strives to inform all employees in beryllium work areas and regulated beryllium work areas that exposures to airborne levels of beryllium, including those less than regulatory limits, may trigger sensitization among some individuals and that such sensitization has, in some cases, led to CBD. Programs and services offered to LLNL employees include tests for beryllium sensitivity and CBD, a medical examination program, and management assistance in seeking alternative assignments, when appropriate. The medical surveillance and notification requirement applies to current and prospective LLNL employees. Testing for beryllium sensitivity is recommended for employees assigned to beryllium work areas or regulated beryllium work areas.

B.2 Beryllium Sensitivity Tests

LLNL offers all LLNL workers who are beryllium-associated workers periodic tests for beryllium sensitivity. The tests are offered as a medical examination (either initial or periodic) that includes the Be-LPT or other blood tests for beryllium sensitivity as designated by the LLNL Medical Director. Workers who are, or may become, beryllium-associated workers are encouraged to accept either the Be-LPT or an equivalent designated test. Such workers shall be asked to acknowledge receiving information concerning beryllium sensitization and disease and being offered the beryllium sensitization test. The Health Services Department informs each individual of the test results, including the risks associated with developing CBD, if sensitivity to beryllium is shown. Test results are treated as confidential medical information and are released only with the individual's consent (consistent with current LLNL requirements) or as required by law, including 10 CFR 850 (Chronic Beryllium Prevention Program). Testing for beryllium sensitivity is recommended for all LLNL employees who are beryllium-associated workers and for any LLNL and UC employees transferring to an assignment in a beryllium work area or regulated beryllium work area.

The Be-LPT or equivalent test is offered as a part of a preplacement medical examination for new hires (i.e., accepted applicants) prior to beginning an assignment in a beryllium work area or regulated beryllium work area.

B.3 Reassignment Options

Described below are LLNL workers' options for reassignment from beryllium work.

B.3.1 Temporary Reassignment

The LLNL Medical Director (or designee) may recommend to the individual, in a written medical opinion based on one or more positive Be-LPT results, CBD diagnosis, an examining physician's recommendation, or any other signs or symptoms that the Medical Director deems medically sufficient, that he or she be temporarily removed from beryllium exposure. When such a determination is made, the employee is offered temporary reassignment (pending a final medical determination) to a non-beryllium worker position with equivalent employment benefits, pay, and other terms and conditions of employment. The Medical Director shall provide the worker a copy of 10 CFR 850, its preamble, and other appropriate information regarding beryllium exposure in discussing the benefits of removal.

The worker may also be offered the option of continuing to work in the current position with beryllium. If the worker chooses to do so, he or she shall sign an acknowledgement of disclosure of health effects, and his or her participation in ongoing medical surveillance, as determined by the Medical Director, shall be mandatory. If a worker who has been confirmed positive for beryllium sensitivity chooses to be placed in an alternative assignment, LLNL management will use its best efforts, working with the worker's organization and with the Health Services and Human Resources Departments, to identify an alternative work assignment. If no temporary reassignment can be found, the worker shall maintain equivalent employment benefits, pay, and other terms and conditions of employment, as specified in 10 CFR 850.35, until a position becomes available or for 1 year, whichever comes first.

B.3.2 Permanent Reassignment

The Medical Director or designee shall make a recommendation to the individual, in writing, regarding permanent removal for individuals with beryllium-related conditions. If a final medical determination for permanent medical removal has been made, alternate placement shall be made in the same manner as temporary medical removal. If a position is not available, permanent medical removal protection benefits expire after 2 years. The worker shall also have the option of continuing in his or her original position. A worker who chooses to do so shall sign an acknowledgement of disclosure of health effects, and agreement to participate in ongoing medical surveillance, as determined by the Medical Director, shall be mandatory.

B.3.3 New Hires from Outside LLNL

New hires (i.e., accepted applicants) who have a confirmed positive sensitivity test have the option of accepting the beryllium assignment or having the employment offer withdrawn and applying for open, non-beryllium work positions through the LLNL employment process. If a new hire has a confirmed positive sensitivity test and decides to accept the beryllium work assignment, the applicant shall sign, prior to beginning the assignment, an acknowledgment form that the Medical Director has provided the worker a copy of 10 CFR 850 and other appropriate information regarding the health effects of beryllium exposure The signed form shall be included with his or her medical record. Participation in the medical surveillance program shall be mandatory.

B.3.4 Other LLNL or UC Employees