Attachment 001 Statement of Work Occupational Medical Surveillance Program College Station TX.pdf

Attachment 001 Statement of Work Occupational Medical Surveillance Program College Station TX

(a) SCOPE OF CONTRACT

The contractor shall furnish all personnel, management, equipment, materials, and other resources necessary to perform occupational medical evaluations, program guidance, expert occupational medical advice, data acquisition, management, and storage to the Agricultural Research Service at College

Station, Texas, in accordance with the Statement of Work, terms and conditions contained herein.

(b) SCHEDULE: Base Period with four option periods. See clauses for FAR 52.217-9 information.

BASE PERIOD - CONTRACT AWARD DATE THROUGH OCTOBER 31, 2021, SERVICE TO

BE COMPLETED BY SEPTEMBER 30, 2021 *Note less than 1 year

Item No. Item Estimated

Quantity

1 Physical Examination 30

2 General Lab Tests

(Blood chemistry, hematology, and Urinalysis)

3 Chest X-ray (one view) 6

4 Spironmetry (Lung Function) 10

5 Cholinesterase Determination 10

6 Specific Cancer Tests

A) Sputum cytology 1

B) Urinary sediment cytology 1

7 Audiometric examination 8

8 Thyroid 2

9 Sodium 2

10 Potassium 2

11 Histoplasma 2

12 Additional Tests as approved

13 Ergonomics & Evaluation 2

14 Vaccination: Tetanus Shot 2

15 Respirator Evaluation 4

16 Administrative Services 6

17 Consultation for chemical exposure response 1

OPTION PERIOD 1 - 11/1/2021 THROUGH 10/31/2022. SERVICE TO BE COMPLETED BY

SEPTEMBER 30, 2022

1 Physical Examination 28

2 General Lab Tests

(Blood chemistry, hematology, and Urinalysis)

3 Chest X-ray (one view) 6

4 Spironmetry (Lung Function) 9

5 Cholinesterase Determination 10

6 Specific Cancer Tests

A) Sputum cytology 1

B) Urinary sediment cytology 1

7 Audiometric examination 8

8 Thyroid 2

9 Sodium 2

10 Potassium 2

11 Histoplasma 2

12 Additional Tests as approved

13 Ergonomics & Evaluation 2

14 Vaccination: Tetanus Shot 2

15 Respirator Evaluation 4

OPTION PERIOD 2 - 11/1/2022 THROUGH 10/31/2023. SERVICE TO BE COMPLETED BY

SEPTEMBER 30, 2023

1 Physical Examination 28

2 General Lab Tests

(Blood chemistry, hematology, and Urinalysis)

3 Chest X-ray (one view) 6

4 Spironmetry (Lung Function) 9

5 Cholinesterase Determination 10

6 Specific Cancer Tests

A) Sputum cytology 1

B) Urinary sediment cytology 1

7 Audiometric examination 8

8 Thyroid 2

9 Sodium 2

10 Potassium 2

11 Histoplasma 2

12 Additional Tests as approved

13 Ergonomics & Evaluation 2

14 Vaccination: Tetanus Shot 2

15 Respirator Evaluation 4

OPTION PERIOD 3 - 11/1/2023 THROUGH 10/31/2024. SERVICE TO BE COMPLETED BY

SEPTEMBER 30, 2024

1 Physical Examination 28

2 General Lab Tests

(Blood chemistry, hematology, and Urinalysis)

3 Chest X-ray (one view) 6

4 Spironmetry (Lung Function) 9

5 Cholinesterase Determination 10

6 Specific Cancer Tests

A) Sputum cytology 1

B) Urinary sediment cytology 1

7 Audiometric examination 8

8 Thyroid 2

9 Sodium 2

10 Potassium 2

11 Histoplasma 2

12 Additional Tests as approved

13 Ergonomics & Evaluation 2

14 Vaccination: Tetanus Shot 2

15 Respirator Evaluation 4

OPTION PERIOD 4 - 11/1/2024 THROUGH 10/31/2025. SERVICE TO BE COMPLETED BY

SEPTEMBER 30, 2025

1 Physical Examination 28

2 General Lab Tests

(Blood chemistry, hematology, and Urinalysis)

3 Chest X-ray (one view) 6

4 Spironmetry (Lung Function) 9

5 Cholinesterase Determination 10

6 Specific Cancer Tests

A) Sputum cytology 1

B) Urinary sediment cytology 1

7 Audiometric examination 8

8 Thyroid 2

9 Sodium 2

10 Potassium 2

11 Histoplasma 2

12 Additional Tests as approved

13 Ergonomics & Evaluation 2

14 Vaccination: Tetanus Shot 2

15 Respirator Evaluation 4

DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

(c.) BACKGROUND

The main campus of USDA, ARS, Southern Plains Agricultural Research Center (SPARC) is located at

2881 F&B Road in College Station, Texas.

The SPARC provides to its employees a structured Occupational Maintenance and Surveillance Program

(OMSP) designed to detect and document work related health safety anomalies. The physical examinations provided by the OMSP are to be based on potential workplace hazard exposures and are not intended to substitute for the care delivered by employee’s personal physician. The Center is located in

College Station, Texas, performing research involving approximately 80 employees including chemists, microbiologists, plant physiologists, and various technician and technologist categories that support these disciplines, and maintenance /janitorial staff. All of these groups are eligible to participate in the OMSP but not everyone does (normally around 28 persons participate). Some employees of this location are involved in the use of various herbicides, fungicides, insecticides, and other pesticides that can cause neurological, systemic, and chronic health problems. Some employees are also involved with agricultural equipment (tractors and implements) and the lifting associated with these duties. While other employees work various animals such as poultry, sheep, swine, and/or cattle.

Other groups of toxic substances include mutagens and carcinogens such as polycyclic aromatic hydrocarbons, foodstuffs potentially contaminated with aflatoxin, etc. Various hormones and plants and insect growth regulators can also manifest potential toxic effects on employees. Work is done with live organisms such as bacteria, fungi, and viruses that can also cause disease in humans; work involves only

Biohazard Level 1 & 2 materials such as salmonella and e. Coli, etc. Some employees are subject to repetitive motion tasks; these mainly involve work at computer stations.

The largest group of potentially toxic substances are found in all laboratories that use laboratory chemicals such as organic solvents, methyl chloride, chlorinated hydrocarbons, ethyl acetate, etc. Almost any such chemical can cause peripheral neuropathy, or liver or kidney damage that may be cumulative if the body cannot properly detoxify and excrete the chemical. Employees may also have allergic reactions to specific chemical or biological substances. It is, therefore, essential that a Health Maintenance

Program be established to aid in the protection of laboratory workers at College Station whose work regularly poses the possibility of exposure to these compounds.

(d) SPECIFIC REQUIREMENTS

The contractor will have a local provider take necessary lab samples and perform physical examinations

(and any other required tests). Contractor’s provider must be within 20 miles and/or 30 minutes of the Government’s site or utilize a mobile facility. The use of a mobile facility on site is acceptable provided all necessary tests can be conducted. If a mobile facility is brought on site, the contractor is responsibility for the safety and security of the mobile facility. Routine testing will begin May to June with all testing completed prior to September 30. Actual start date of test will be determined by the

Government.

The following specifications are set up in an effort to provide maximum flexibility in tailoring a Health

Maintenance Program for each employee according to his or her specific potential workplace exposure.

The contractor shall assign a cost for each test.

The OMSP medical service requirements are individually described below. Participants in the OMSP

(enrollees) complete the enrollment form and the medical history form provided through the Program.

Appropriate clinical tests shall be designated through the Program (by the government) and forwarded to the Contractor for implementation. When the clinical test results are complete, the physical examination will be scheduled to allow the examiner's impressions to be recorded on the physician's form provided through the Program. All forms, charts, test results, etc., shall then be mailed to the Agency's

Occupational Medical Consultant who will be identified at time of contract award (mailed within 14 days of the completion of each examination). The services listed below represent the minimal requirements that must be performed by the Contractor.

CONSULATION

- Response to chemical exposure from a spill (within 4 hours) = 15 min of consult

- Pre and Post consultation with Occupational Medical Physician to discuss the program (1hour maximum each).

GENERAL LABORATORY TESTS

The contractor shall provide laboratory screening. A certified laboratory shall accomplish all screening.

• All laboratory samples will be labeled with each patient name and date of sample taken in the presence of the patient.

• Hand washing will be available and operational in the restrooms used to collect specimens from employees.

• If fasting is required for testing, employee will be scheduled for testing no later than 10am.

Laboratory screening includes blood chemistries, hematology, and urinalyses. Each of these laboratory operations shall include (but are not limited to) the following parameters:

Blood Chemistry

To include all of the following, but not limited to: Glucose, blood urine nitrogen (BUN), creatinine, sodium, potassium, chloride, uric acid, calcium, phosphorus, cholesterol (HDL,LDL and total), triglycerides, total protein, albumin, globulin, A/G Ratio, alkaline phosphase, total bilirubin, serum glutamic pyruvic transaminase (SGPT), and serum glutamic oxalacetic transaminase (SGOT).

Hematology (Complete Blood Count)

To include all of the following, but not limited to: Red cell count, red cell indices (MCV, MCH, MCHC), hemoglobin and hematocrit, reticulocyte count, platelet count, white cell count and differential.

Urinalysis

To include all of the following, but not limited to: Specific gravity, pH, microscopic examination, protein-albumin, glucose, ketones, occult blood, bile (optional).

Chest X-RAY

When so directed, the contractor shall provide a full-size chest x-ray (one view) of the enrollee.

X-rays will be used judiciously, and all State and Federal regulations pertaining to leakage, scatterings, etc., will be strictly adhered to. Contractor must have ready access to x-ray equipment and all x-rays will be performed at the proper medical facilities. Board-certified radiologists will interpret the x-ray films.

Spirometry (Lung Function)

The contractor shall demonstrate the capability to provide measurements of enrollee lung function and capacity. Test methods shall comply with OSHA requirements and results shall be interpreted and reported by experienced, qualified personnel. Tests to be performed and parameters to be measured include:

Forced Vital Capacity (FVC)

Forced Expiratory Volume Timed for One Second (FEV)

Ratio of FEV/FVC

Cholinesterase Determination

Several approved methods for the determination of cholinesterase levels in the serum and in RBC's exist. The contractor shall justify the choice of a particular laboratory method and adhere to it throughout the course of this contract. Regardless of the particular analytical technique selected, the contractor will perform cholinesterase testing for both serum and RBC cholinesterase levels or for

RBC levels alone. The determination of only serum cholinesterase levels is unacceptable. Results and normal comparative values shall be reported uniformly and accurately for each cholinesterase determination. Cholinesterase determination may be required monthly for individuals involved in pesticides spraying applications.

Specific Cancer Screening Tests

We believe that there are four applicable laboratory screening procedures for detection of a limited number of types of cancer in large populations. These tests are Prostate Specific Antigen (PSA) for men, PAP Smear (for women), sputum cytology, and urinary sediment cytology. The PAP Smear and PSA are not within the scope or intent of this program; therefore, the contractor shall provide the two latter procedures for enrollees who have been designated eligible. Specimens shall be carefully processed, and slides shall be examined and interpreted by experienced, qualified personnel.

The contractor may provide suggestions and rationale for the inclusion of additional screening procedures in this section.

Audiometric Examination

Audiometric examinations shall consist of baseline and annual audiograms. The contractor shall provide a sound shielded facility in which any loss of hearing may be determined for each ear. Each ear shall be tested at the frequencies of 500, 1000, 2000, 3000, 4000, 6000, and 8000 HZ. Standards of the

International Standards Organization (ISO) apply. Hearing loss shall be identified and categorized as to probable cause to the extent possible.

Tests at each frequency must be taken separately for each ear. Audiometric tests must be conducted with equipment that meets the specifications of, and is maintained and used in accordance with, ANSI

Specifications for Audiometers S3.6-1969. Pulsed-tone and self-recording audiometers must meet the requirements specified in 29 CFR 1910.95 Appendix C.

Audiometric examinations must be administered in a room meeting the requirements listed in 29 CFR

1910.95 Appendix D. Audiometer calibration must be checked acoustically at least annually according to

29 CFR 1910.95 Appendix E.

Records of all audiograms must include the following: the employee's job classification, date of the audiogram, the examiner's name; date of last acoustic or exhaustive calibration of the audiometer, and results of the audiogram.

Insect Scale Sensitivity

Several individuals work with moths, flies, or other insects that may necessitate the need for insect scale sensitivity testing. Contractor will evaluate these individuals’ medical condition as related to their exposure.

Screening Analysis

The results of all tests are to be initially evaluated by the contractor’s physicians and professional staff.

Those abnormal parameters identified as being occupationally related or likely to be aggravated by continued similar occupational exposure will be brought to the attention of the appropriate government personnel (to be designated upon award of the contract). All data will then be forwarded by the contractor to Agency’s Medical Review Officer.

(e) ADDITIONAL TESTS

Additional tests other than the screening procedures listed above may be required or warranted. The contractor is invited to recommend additional requirements and shall have the capability to perform screening tests prescribed. Approval of these tests must be attained prior to conducting any additional tests. Cost for these tests must be approved prior to conducting any such additional tests.

Ergonomics - Repetitive Motion Tasks

Enrollees who perform repetitive motion tasks; i.e., computer data entry tasks, microscope or fine instrument manipulation, or hand tool work may require a grip test evaluation.

Vaccinations

Contractor shall provide tetanus vaccinations for enrollees who are potentially exposed to puncture wounds, stepping on nails, and/or cuts.

Respirator Evaluations

Contractor will evaluate persons required to wear respirators. Evaluation will include a review of a standard medical respirator questionnaire (provided by the contractor) completed by the enrollee. All questionnaires are to remain confidential between the enrollee and the physician. Contractor will provide other tests as deemed necessary upon review of medical questionnaire (chest X-ray, lung function test).

Contractor will assign tests if necessary, to determine enrollee’s ability to wear a respirator. Contractor will provide a certificate for each enrollee who meets the health requirements to wear a respirator. The certificate will be sent directly to the appropriate personnel at the site (to be designated upon award of the contract). These evaluations are required annually for persons wearing a respirator. Respirator uses may change periodically throughout the year and the contractor must be able to perform this service within 10 days of request.

Physical Examination

The contractor shall provide a Board Certified Licensed practicing physician, preferably specializing in occupational health, who will perform an annual physical examination of each enrollee. The examining physician shall be experienced in the field of occupational medicine and industrial health or be a board-certified internist. He or she shall be capable of assessing the work-relatedness of an abnormal finding. The physician will have the clinical test results available at the time of the physical examination.

The physician will note work related irregularities and abnormalities which would jeopardize the health status of the enrollee. These and other findings will be reported by the contractor as part of the enrollee's health status report and for incorporation into the Agency's computer data bank. Non-work-related life-threatening anomalous conditions will be reported expeditiously and directly to the enrollee.

The examining physician will send all completed forms to the ARS Medical Review Officer to be identified at the award of the contract.

(f) MEDICAL RECORDS

In accordance with 5 Code of Federal Regulations (CFR) 293 and 5 CFR 297, the enrollee’s medical records shall be maintained in a classified data handling system, administered in such a fashion as to ensure confidentiality. Only the ARS Medical Review Officer, the contractor's physician, and medical staff (and those authorized in accordance with 29 CFR 1960) shall have access to the results of the medical screening. However, serious work-related anomalies will be immediately reported to the government’s representative (to be designated upon award of the contract).

(g) SCHEDULING & REPORTING

The Location Site Monitor (LSM) is the designated contact for questions regarding scheduling and reporting. The completed ARS Forms 182A/B (indicating intent of participation by the enrollee and enrollee exposure information) will be forwarded to the Contractor by the LSM. The enrollee’s health history (Form ARS 182C) will be hand delivered by the employee at the time of his/her clinical tests.

The Contractor shall then consolidate and set up a systematic and repeatable schedule for the enrollees.

The enrollees shall be scheduled in a manner that can be repeated in subsequent contract years.

Scheduling of the medical evaluations shall be established to assure that the clinical test results are received and verified prior to the scheduled physical examination. All laboratory test results shall be completed within twenty (20) working days. Physical examinations are to be performed within sixty (60) days of the clinical test being performed. Contractor will schedule testing as to minimize the

Government’s employees time away from work (e.g., pulmonary lung function, hearing, lab work, x-ray should be all done during the same visit). Contractor is to forward all information to the ARS Medical

Review Officer within fourteen (14) days of completion of the physical examination of each employee.

The entire process, therefore, from scheduling to submission of all test results and physical examination findings shall not exceed ninety (90) days.

Scheduling and notification for those enrollees involved with monthly clinical testing (i.e., cholinesterase) shall take place prior to spraying season.

A complete package that consists of all original forms, charts, test results, etc., all of which are the property of ARS, shall be mailed to the Contractor who is the Agency's Occupational Medical Consultant.

A copy of all lab test results will be provided to the employee at the time of their physical examination.

Once the Annual Program is underway and enrollees are scheduled for tests/examinations, the Contractor shall submit to the LSM a Monthly Summary of the number and types of examination given, the names of the enrollees tested, and verification that copies of these records have been sent to ARS Occupational

Medical Consultant. These monthly Summaries shall continue until the Annual Program is completed.