Incidental findings detected through occupational health surveillance program

BACKGROUND: The U.S. Department of Energy (DOE) Former Worker Medical Screening Program (FWP) provides medical screenings for occupational health conditions resulting from work at DOE facilities. In addition to testing for occupational lung diseases and radiation-induced cancers, former workers are also evaluated for non-occupational conditions such as anemia, diabetes, hypertension, hypercholesterolemia, and thyroid, liver and kidney disease.

METHODS: From 2001–2010, over 2,500 former DOE workers from the Iowa Army Ammunition Plant (IAAP) and Ames Laboratory received general blood tests. Comparisons of self-reported health history and prevalence of abnormal disease markers as well as correlations by age, gender, race, smoking and duration of employment are presented.

RESULTS: The medical screenings detected 16% with anemia, 5% with hyperglycemia, 4% each with hyperthyroidism or hypothyroidism, 6% with elevated sedimentation rate, 33% with high cholesterol, and 20% with hypertension. Significant differences in rate of disease markers between the two sites existed for the following: anemia (IAAP: 23.6%, Ames: 8.6%, OR=3.3, 95%CI:2.6-4.1), hyperglycemia (IAAP: 7.5%, Ames: 2.0%, OR=3.9, 95%CI:2.5-6.0), hypothyroidism (IAAP:5.7%, Ames: 3.2%, OR=1.9, 95%CI:1.3-2.8), elevated ESR (IAAP: 8.1%, Ames: 2.2%, OR=3.9, 95%CI:2.2-7.0), and hypertension (IAAP:30.3%, Ames:11.9%, OR=3.2, 95%CI:2.2-4.6).

CONCLUSION: Diagnoses of chronic conditions discovered through these general health screenings leads to improved knowledge of health status and may lead patients to seek treatment sooner. Many of these conditions can be readily treated and early detection may significantly improve one's longevity and quality of life. Possible explanations and implications of the differences between the communities will be explored.