Table 18.3. Health Standards (Section B of the Job Advertisement Record)


  WORKING CONDITIONS                  HEALTH STANDARDS
                           BODY SYSTEMS              SCREENING METHODS 
___________________________________________________________________________                 


1.0 LOCATION             The specifics of the    These are listed elsewhere
                         job and the locations   under specific working 
    Office/field         in combination will     condition sections.
    /lab/service         indicate the systems 
    centre/plant         to be assessed.
    /service centre

    Offshore rigs
    /supply boats

    Expatriate
    Indoors/Outdoors



2.0 HOURS OF WORK

    Shifts:              CVS, CNS, ENDO, GI,     Health History by R.N.
    - rotating shifts,   GU, HEMAT, MENTAL       Lab - Hemoglobin
      excessive          STATUS, MS                  - Urinalysis 1
      overtime,                                           
      12 hour shift, 
      on call or 
      emergency call
      out.

    Lunch Breaks:
    - unscheduled           ENDO, GI             Health History by R.N.
      meal hours                                 Lab - Urinalysis 1



3.0 OCCUPATIONAL SAFETY HAZARDS

3.1  Safety              CVS, CNS, ENDO,        Health History by R.N.
                         HEARING HEMAT,         Physical assessment by R.N.
     Working near        MENTAL STATUS,         (balance, eye/hand/foot
     (within 3 feet)     MS, VISION             co-ordination, manual
     or operating                               dexterity, ROM)
     moving or                                  Lab - Audiogram
     dangerous                                      - Hemaglobin
     equipment                                      - Urinalysis 1
                                                    - Vision 1, peripheral
                                                      vision and
                                                      depth perception

     Working in tanks    CVS, CNS, ENDO,        Health History by R.N.
     and vessels         HEARING HEMAT,         Physical assessment by R.N.
                         MENTAL STATUS,         (balance, eye/hand/foot
                         MS, RESP, VISION       coordination, facial 
                                                structure assessment for
                                                use of breathing apparatus,
                                                flexibility, ROM)
                                                Lab - Hemoglobin
                                                    - Rinne, Weber tests
                                                    - Urinalysis 1
                                                    - Vision 1, peripheral
                                                      vision


     Working at          CVS, CNS, ENDO,       Health History by R.N.
     heights             HEMAT, MENTAL         Physical assessment by R.N.
                         STATUS, MS, VISION    (balance, eye/hand/foot
                                               co-ordination, ROM)
                                               Lab - Hemoglobin
                                                   - Urinalysis 1
                                                   - Vision 1, depth
                                                     perception and
                                                     peripheral vision
  
     Walking over        CVS, CNS, MS,         Health History by R.N.
     rough terrain       RESP, VISION          Physical assessment by R.N.       
     and/or slippery                           (ballance, eye/hand/foot
     surfaces                                  co-ordination, ROM, strength
     (more than                                and endurance) 
      3 times/year).                           Lab - Vision 1,depth
                                                     perception


3.2 Ergonomics

     Lifting, carrying, pushing        CVS, CNS, HEMAT, MS, RESP, VISION 
          Health History by R.N.
     and pulling over 30 lbs.                                            
          Physical assessment by R.N.
                                                                         
          (balance, eye/hand/foot
                                                                         
          co-ordination, flexibility, ROM,
                                                                         
          strength and endurance)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Vision 1

     Bending, stooping,                CVS, CNS, HEMAT, MS, RESP         
          Health History by R.N.
     twisting, pushing and                                               
          Physical assessment by R.N.
     pulling (more than                                                  
          (balance, eye/hand/foot
     1 hr./day)                                                          
          co-ordination, flexibility, ROM,
                                                                         
          strength and endurance)
                                                                         
          Lab - Hemoglobin

     Climbing to heights               CVS, CNS, HEMAT, MENTAL STATUS,   
          Health History by R.N.
                                       MS, RESP, VISION                  
          Physical assessment by R.N.
                                                                         
          (balance, eye/hand/foot
                                                                         
          co-ordination, flexibility, ROM,
                                                                         
          strength and endurance)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Vision 1, depth perception

     Working in awkward                CNS, MENTAL STATUS, MS, VISION    
          Health History by R.N.
     positions or cramped                                                
          Physical assessment by R.N.
     quarters                                                            
          (balance, eye/hand/foot
                                                                         
          co-ordination, flexibility, ROM)
                                                                         
          Lab - Vision 1



        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  


      Prolonged periods of             MS, CNS                           
          Health History by R.N.
      continuous sitting 
      (more than 4 hours)

      Prolonged periods of             CVS, CNS, MS                      
          Health History by R.N.
      continuous standing                                                
          Physical assessment by R.N.
      (more than 2 hrs./day)                                             
          (balance, endurance)

      Prolonged periods of             CVS, CNS, HEMAT, MS, RESP, VISION 
          Health History by R.N.
      continuous walking                                                 
          Physical assessment by R.N.
      (over 1 hr./day)                                                   
          (balance, eye/hand/foot
                                                                         
          co-ordination, ROM, strength and
                                                                         
          endurance)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Vision 1

      Using repetitive motions         CNS, MS                           
          Health History by R.N.
                                                                         
          Physical assessment by R.N.
                                                                         
          (eye/hand or eye/hand foot
                                                                         
          co-ordination, manual dexterity,
                                                                         
          strength and endurance)
                                                                         
          Lab - Vision 1

      Using equipment                  CNS, MS, VISION                   
          Health History by R.N.
      - VDT/Word Processor                                               
          Physical assessment by R.N.
        (continuous use over                                             
          (eye/hand co-ordination, manual
         1 hr./day)                                                      
          dexterity, ROM)
                                                                         
          Lab - Vision 1

      - hand tools                     CNS, HEARING, MS, VISION          
          Health History by R.N.
                                                                         
          Physical assessment by R.N.
                                                                         
          (eye/hand/foot co-ordination,
                                                                         
          manual dexterity, strength)
                                                                         
          Lab - Vision 1

      Performing                       CNS, HEARING, MS, VISION          
          Health History by R.N.
                                                                         
          Physical assessment by R.N.
                                                                         
          (manual dexterity, ROM)
                                                                         
          Lab - Rinne, Weber tests
                                                                         
              - Vision 1


        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  


4.0  OCCUPATIONAL HEALTH HAZARDS

4.1  Physical Hazards

     Exposure to:
  
     Extremes of temperature   

        - cold                         CVS, CNS, ENDO, INTEG, MS, RESP   
          Health history by R.N.
                                                                         
          Lab - Urinalysis 1

        - heat                         CVS, CNS, ENDO, INTEG, MS         
          Health history by R.N.
                                                                         
          Lab - Urinalysis 1

     Humidity                          INTEG, RESP                       
          Health history by R.N.

     Radiation (Ionizing)              ENDO, HEMAT, INTEG, VISION        
          Health history by R.N.
                                                                         
          Lab - CBC and Diff.
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1

     Noise > 85 dBA                    CNS, HEARING                      
          Health history by R.N.
                                                                         
          Lab - Audiogram

     Vibration                         CNS, MS                           
          Health history by R.N.
                                                                         
          Physical assessment by R.N.
                                                                         
          (hand assessment)

     Increased Atmospheric             CNS, CVS, ENDO, GI, HEARING,
HEMAT           Health history by M.D.
     Pressure                          MENTAL STATUS, MS, RESP, VISION   
          Physical examination by M.D.
                                                                         
          Lab - Audiogram
                                                                         
              - CBC and Diff, SMA 12
                                                                         
              - Electrocardiogram
                                                                         
              - Pulmonary Function
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1 & 3, depth
                                                                         
                perception, periperhal vision

4.2  Chemical Hazards                  Depends on the specific action
                                       or characteristics of the agent
                                       exposed to and the route of
exposure -
                                       inhalation, skin, or eye contact,
                                       ingestion and injection.  See
Appendix IV
                                       for the specific chemicals or
appropriate
                                       Material Safety Data Sheets.


        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  

4.3  Biological Hazards

     Exposure to:
  
     Bacteria, Molds, Fungi            IMMUN, INTEG, RESP                
          Health history by R.N.
                                                                         
          Lab - Pulmonary Function


5.0  SPECIAL REQUIREMENTS

     Operating Mobile Equipment

       - driving heavy equipment       CVS, CNS, ENDO, GI, GU, HEARING,  
          Health history by M.D.
         or trucks (larger than        HEMAT, MENTAL STATUS, MS, RESP,
VISION       Physical examination by M.D.
         one ton)                                                        
          Lab - Audiogram
       - servicing or flying                                             
              - CBC and Diff, SMA 12
         Company planes                                                  
              - Electrocardiogram
                                                                         
              - Urinalysis 2
                                                                         
              - Vision 2, depth perception,
                                                                         
                peripheral and colour vision

       - driving care or truck         CNS, CVS, ENDO, HEARING, HEMAT,   
          Health history by R.N.
         (less than one ton)           MENTAL STATUS, MS, VISION         
          Physical assessment by R.N.
         while on Company business                                       
          (eye/hand/foot co-ordination, ROM)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Rinne, Weber Tests
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 2, peripheral vision

    Offshore Survival Training         CVS, CNS, ENDO, GI, GU, HEARING,  
          Health history by M.D.
    and work in an offshore            HEMAT, IMMUN, INTEG, MENTAL
STATUS,          Physical examination by M.D.
    environment                        MS, RESP, VISION                  
          Lab - Audiogram
                                                                         
              - CBC, SMA 12, GGT
                                                                         
              - Electrocardiogram
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1 and 3,
                                                                         
                depth perception,
                                                                         
                peripheral vision

   Fire Fighting Training              CNS, CVS, ENDO, HEARING, HEMAT,   
          Health history by R.N.
                                       MENTAL STATUS, MS, RESP, VISION   
          Physical assessment by R.N.
                                                                         
          (balance, eye/hand/foot
                                                                         
          co-ordination, facial structure
                                                                         
          assessment for use of breathing
                                                                         
          apparatus, flexibility, strength
                                                                         
          and endurance)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Rinne, Weber Tests
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1 and 3


        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  

     Respond physically to             CVS,, CNS, ENDO, HEARING, HEMAT,  
          Health History by R.N.
     emergency situations              MENTAL STATUS, MS, RESP, VISION   
          Physical assessment by R.N.
                                                                         
          (eye/hand/foot co-ordination,
                                                                         
          ROM, strength)
                                                                         
          Lab - Hemoglobin
                                                                         
              - Rinne, Weber Tests
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 3

     Travel

       - overseas plane travel         CNS, CVS, ENDO, GI, GU, HEMAT,    
          Health history by R.N.
                                       MENTAL STATUS, MS, RESP           
          Lab - Hemoglobin
                                                                         
              - Urinalysis 1

       - by helicopter                 CVS, MENTAL STATUS                
          Health history by R.N.
         (more than 3 trips/year)

     Special Tasks:

       - differentiating between       VISION                            
          Lab - colour vision
         colours

       - performing detailed,          CNS, MS, VISION                   
          Health history by R.N.
         close-up work                                                   
          Physical assessment by R.N.
                                                                         
          (eye/hand co-ordination,
                                                                         
          manual dexterity)
                                                                         
          Lab - Vision 1, phorias

       - working directly or           CNS, INTEG, MS, RESP, VISION      
          Health history by R.N.
         closely with food                                               
          Physical assessment by R.N.
                                                                         
          (eye/hand co-ordination, manual
                                                                         
          dexterity, personal hygiene, ROM)
                                                                         
          Lab - Chest x-ray (within the
                                                                         
                past year)
                                                                         
              - Nasal swab for C & S
                                                                         
              - Stool culture for C & S
                                                                         
              - Vision 1, depth perception

      - conducting aerobic            CNS, CVS, ENDO, HEARING, HEMAT,    
          Health history by M.D.
        fitness classes               MS, RESP, VISION                   
          Physican examination by M.D.
                                                                         
          Lab - Audiogram
                                                                         
              - Electrocardiogram and
                                                                         
                submaximal stress test
                                                                         
              - Hemoglobin
                                                                         
              - Pulmonary function
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1


        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  

     Personal Protective               CVS,, CNS, ENDO, HEARING, HEMAT,  
          Health History by R.N.
     Equipment:                        MENTAL STATUS, MS, RESP, VISION   
          Physical assessment by R.N.

        - Wearing a breathing          CVS, CNS, ENDO, HEARING, HEMAT,   
          Health history by R.N.
          apparatus                    INTEG, MENTAL STATUS, MS, RESP,
VISION       Physical assessment by R.N.
                                                                         
          (eye/hand co-ordination, facial
                                                                         
          structure assessment for use of
                                                                         
          breathing apparatus, ROM,
                                                                         
          strength and endurance)
                                                                         
          Lab - Audiogram
                                                                         
              - Hemaglobin
                                                                         
              - Pulmonary function
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 3

      - Wearing a breathing           CVS, HEARING, MENTAL STATUS, MS,   
          Health history by R.N.
        apparatus in an               RESP, VISION                       
          Physical assessment by R.N.
        emergency situation                                              
          (eye/hand co-ordination, facial
                                                                         
          structure assessment for use of
                                                                         
          breathing apparatus, ROM and strength)
                                                                         
          Lab - audiogram 
                                                                         
              - Vision 1 & 3

   Isolation:

     - in insolation                  CNS, CVS, ENDO, GI, GU, HEMAT,     
          Health history by R.N.
       (geographical)                 MENTAL STATUS, MS, RESP, VISION    
          Lab - Hemoglobin
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1

     - alone                          CNS, CVS, ENDO, HEARING, HEMAT,    
          Health history by R.N.
                                      MENTAL STATUS, MS, RESP, VISION    
          Lab - Hemoglobin
                                                                         
              - Rinne, Weber Test
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1


6.0  PSYCHOSOCIAL DEMANDS

     Moderate/high level of           CVS, GI, MENTAL STATUS             
          Health history by R.N.
     responsibility and
     decision making

     Very high level of               CVS, ENDO, GI, HEMAT, MENTAL
STATUS           Health history by M.D.
     responsibility and                                                  
          Physical examination by M.D.
     decision making                                                     
          Lab - CBC and Diff, SMA 12
                                                                         
              - Electrocardiogram
                                                                         
              - Urinalysis 2


        WORKING CONDITIONS                                          
HEALTH STANDARDS
                                                    BODY SYSTEMS         
                      SCREENING METHODS                  


     Dealing or working with          HEARING, MENTAL STATUS             
          Health history by R.N.
     others                                                              
          Lab - Rinne, Weber Test

     Workload:

       - intensive                    CVS, ENDO, GI, HEMAT, MENTAL
HEALTH,          Health history by R.N.
                                      MS                                 
          Lab - Hemoglobin
                                                                         
              - Urinalysis 1

     Respond emotionally to           CVS, ENDO, HEARING, MENTAL STATUS, 
          Health history by R.N.
     emergency situations             STATUS, RESP, VISION               
          Lab - Rinne, Weber Test
                                                                         
              - Urinalysis 1
                                                                         
              - Vision 1
                                 285
                              DEFINITIONS

Audiogram - an audiometric test which establishes pure tone air
conduction thresholds at 500 to 8000 Hz for each ear.

CBC and Differential - a venous blood test which includes hemoglobin,
hematocrit, total white cell count and white cell differential count.

Chest X-ray (CXR) - a standard Posterior Anterior (PA) film.

Electrocardiogram (ECG) - a resting, standard 12 lead.

Electrocardiogram (ECG) - Submaximal Stress Test - an exercise
electrocardiogram performed while the subject exercises until the
target heart rate is reached.

     Target heart rate range = 70 - 85% x 110 - age

Health History - a thorough history relating to the designated body
systems outlined on the Job Advertisement Record Form.  Any positive
response to the health history taken by the nurse should be referred to
the physician upon discretion.

Hemoglobin Test - a finger prick blood test measured by using a
Hemoglobinometer.

Mental Status - an examination which includes observation of general
appearance and behaviour, mood and affective reactions, thought flow
and content, fears, perceptions, orientation, memory (recent and
remote), intelligence, judgement and insight.
                                286

Physical Assessment - a minimum examination includes measurements of
height, weight and blood pressure.

Pulmonary Function Test - a spirometric testing including FVC and FEV.

Rinne and Weber Tests - tuning fork hearing tests to evaluate air and
bone conduction in each ear.

Range of Motion (ROM) - appropriate range of motion for each joint
under consideration.

SMA 12 - an automated multiple biochemical blood analysis which usually
includes:  total protein, cholesterol, spot blood sugar, BUN, clacium,
phosphorous, uric acid, bilirubin - total and direct, alkaline
phosphotase, LDH and SGOT levels.

Urinalysis 1 - an Ames multistix or other similar reagent test.

Urinalysis 2 - a laboratory urinalysis that includes microscopy.

Vision 1 - a test of visual acuity in both eyes with or without
corrective lenses.  Minimal expected standards:  near - 20/30; far -
20/40 corrected.

Vision 2 - a test of visual acuity in both eyes with or without
corrective lenses.  Minimal expected standards:  near - 20/30; far -
20/30 corrected.

Vision 3 - a test of visual acuity in both eyes without corrective
lenses.  Minimal expected standards:  far - 20/100 in one eye.