OCCUPATIONAL HEALTH CLINICAL SERVICES

Pre-Placement Evaluation

UCSF Medical Center and UCSF Campus Employees Working in Clinical Programs

Employees working in healthcare settings such as UCSF Medical Center, San Francisco General Hospital, and San Francisco VA Medical Center are required to complete a medical evaluation prior to the start of their employment. The appointment should be scheduled at least a week prior to the anticipated start date. Employees must bring the following to this appointment:

• Immunization records (measles, mumps, rubella, varicella, hepatitis B
• Copies of any TB skin testing done within the last 12 months
• Copies of any chest x-ray reports done within the last 12 months
• Medical documentation if requesting work restrictions and/or accommodations

UCSF Campus

New campus faculty, post-doctoral students, and employees may have an occupational health assessment as needed based on risk factors, work environment, and OSHA regulations.

How to Make an Appointment
The supervisor or Human Resources representative should complete a Request for Service form for any employee being referred to the UCSF Occupational Health Service.  Fax this form to 415-771-4472 then call OHS at 415-885-7580 to confirm the appointment.   The supervisor or HR representative will be notified of clearance for work.

Vaccinations

Hospital-based Health Care Workers must meet the requirements of Title XXII and the California Department of Public Health Guidelines for immunity to the following:

• Measles, Mumps, and Rubella
• Chickenpox
• Hepatitis B vaccine is offered to all employees at risk for exposure to blood, body fluids, and tissues.
• The vaccination services listed above are available at the Mount Zion and Parnassus TB and Vaccination Drop-In Clinics. See Hours of Operation for information.

Flu Shots
The Fall 2008 Flu Shot Program Outreach Schedule is now available. Hospital-based staff and faculty at UCSF Medical Center must also meet the requirements of CA Senate Bill 739 and be immunized annually for influenza or complete a Declination Form. (This form can only be accessed from a computer on the UCSF network.) Hospital-based UCSF staff and faculty located at SFGH, SF VA, or LPPI should complete the declination forms provided by those facilities.

Other Vaccinations
Employees who have been determined to be at risk for particular infectious diseases related to their work environment or work responsibilities will receive immunizations and/or titers appropriate to their occupational risk. The supervisor or Human Resources representative can complete a Request for Service form for an existing (e.g. not new) employee and the employee may bring the Request for Service form to a drop-in TB skin test and Vaccination Clinic. An appointment should be scheduled for vaccinations not otherwise available at the drop-in clinics.

Specific Laboratory Research Vaccination Policies
UCSF requires every laboratory worker and LARC employee working with or exposed to wild type polio in the laboratory show evidence of immunity to the polio virus or receive the polio virus vaccination.  The UCSF Polio Immunization Policy contains information regarding laboratory safety, risks, adult immunization and post exposure information.

UCSF requires every laboratory worker and LARC employee working with or exposed to yellow fever virus 17D (Vaccine Strain) in the laboratory be vaccinated for yellow fever virus or sign a declination form (UCSF Yellow Fever Immunization Policy). Information about the yellow fever vaccine can be found at CDC Recommendations of the Immunization Practices Advisory Committee (ACIP) Yellow Fever Vaccine .

UCSF Vaccinia Policy requires people who directly work with and handle vaccinia virus in the research laboratory to receive counseling and educational information and (if it is medically appropriate) be offered Vaccinia (Smallpox) vaccine by Occupational Health Services (OHS) prior to initiating work with vaccinia virus. UCSF follows national guidelines issued by the Centers for Disease Control and Prevention.

TB Surveillance

UCSF Medical Center

UCSF Medical Center employees with patient contact and those working inpatient care areas or areas where they may be exposed are required to participate in the TB Surveillance program. Newly hired employees must complete the TB screening process prior to their start of employment date. All other employees must participate annually. Employees who have tested "positive" in the past are required to have one baseline chest x-ray and then Annual Symptom Review. Chest x-rays will not be performed annually, but only if indicated based on the clinical presentation. At any time, if any employee has symptoms of TB (persistent cough, low grade fevers, unexplained weight loss, night sweats) further evaluation must be done. Please refer to Occupational Health Services.

UCSF Campus Employees

Occupational Health Services is responsible for pre-placement TB Surveillance for UCSF employees and housestaff located at San Francisco General Hospital. San Francisco Veterans Administration Medical Center provides TB surveillance for UCSF personnel at that location. Student Health Services is responsible for UCSF students. OHS is also responsible to provide TB skin testing to UCSF personnel who are required to have this test in order to work in selected occupational areas

Other identified campus employees at occupational risk for tuberculosis or who require screening according to laboratory research protocol, will participate in pre-placement TB screening and will receive regular re-assessment.

TB Skin Testing is also available on a drop-in basis at the following times and locations:

Respirator Medical Clearance

Occupational Health Services assesses health conditions and physical attributes that may influence the effectiveness of or contraindicate a latex respirator mask. The Medical Clearance form is available here. Existing employees may fax this form to 415-771-4472.

Respirator Fit-Testing

Occupational Health Services completes the Medical Clearance and respirator fit-testing for new employees that receive a pre-placement screening. The annual fit-testing renewal is provided by the Office of Environmental Health & Safety. Call 476-1300 to make an appointment for annual fit-testing.

Existing employees who require Medical Clearance and fit-testing complete the Medical Clearance form and fax it to Occupational Health Services at 415-771-4472. Once it is approved, the employee contacts Environmental Health and Safety at 476-1300 for a fit-testing appointment.

Workers Compensation

Any UCSF employee who sustains a work-related injury or illness must immediately notify their manager or supervisor. The manager will then complete a Supervisor's Report of Injury (SRI). The employee should then contact Occupational Health Services at 415-885-7580 to make an appointment. If the injury requires emergency care, the employee should either call 9-911 or if able, report to the Emergency Department (ED). Employees who are injured after normal clinic hours may be seen in the Long ED if the injury requires immediate attention. Non-urgent conditions (e.g. repetitive motion injuries, dermatitis) should normally be evaluated in the OHS during clinic hours.

If an injury occurs:

• Notify manager/supervisor
• Contact Occupational Health Services
• Report any change in work status (off work, transitional work, medical appointments) to manager

Return to Work Evaluation

UCSF Medical Center employees who are absent more than ten (10) days or meet other criteria listed in the Return-to-Work Policy are required to make an appointment in Occupational Health Services prior to returning to work. Employees must provide a written release from their health care provider. Please refer to the UCSF Medical Center Administrative Policy Manual for exact details. Exceptions to this policy are employees out for maternity leave.

Travel Health

At this time, UCSF Occupational Health Services does not offer Travel Health consultations or immunization services. UCSF travelers are advised to contact their private physician or the San Francisco Department of Public Health's Adult Immunization and Travel Clinic.

UCSF Students may receive travel health services from UCSF Student Health Services Travel Clinic.

UCSF Risk Management and Insurance Services offers additional travel planning, travel insurance, and safety management information.