Oil Spill Response Resources: Medical Pre-Placement Evaluation Indicators

Medical Pre-Placement Evaluation Indicators for Health Professionals

This guidance provides health professionals with important elements of a pre-placement evaluation for Deepwater Horizon response workers. It lists conditions that may indicate a need for further medical attention or for work restrictions or modifications. The evaluation should be used to provide information to the worker about his/her health status and its potential impact on health and safety. It should not be used to determine employment. Personal information, particularly about health, should be collected, maintained, and shared in a manner consistent with applicable laws such as Health Insurance Portability and Accountability Act (HIPAA). Information to an employer, such as work restrictions or modifications, may only be provided as permitted by the Americans with Disabilities Act (ADA) and other applicable law. It should not reveal medical or other information that could be used in a discriminatory manner.

The health professional should ask the employee about medications, medical conditions, and risk factors that may compromise worker health and safety. The following list is presented as guidance and might not be complete for the purpose of the pre-placement evaluation. Clinical judgment is necessary and should consider the following:

  • Workers may be asked to perform moderate to heavy physical work in extreme heat and humidity.
  • Workers may be asked to work: long hours; on vessels/boats; in locations remote to medical care; in unfamiliar settings with changing or multiple supervisors; with changes in usual eating/sleeping routines.
  • Worker’s physical and psychological capacity could affect the health and safety of coworkers.
Evaluation Indications of need for more information and/or further evaluation
  • Antihistamines
  • Cardiac medications and anti-hypertensive agents
  • Anticholinergic agents
  • Antiepileptic medications
  • Insulin or oral hypoglycemic agents
  • Antibiotics
  • Tranquilizers, antidepressants, mood stabilizers, anxiolytics, stimulants, and other psychotropic medications
  • Medications that can result in photosensitivity (e.g., doxycycline, ciprofloxacin)
  • Use of multiple medications
Medical Conditions
  • Cardiovascular, e.g., dysrhythmia, heart failure, cardiac disease, high blood pressure, chest pain
  • Respiratory, e.g., asthma, chronic obstructive pulmonary disease (COPD), wheezing, shortness of breath
  • Neurologic, e.g., seizures, dizzy spells, loss of balance
  • Musculoskeletal, e.g., arthritis; back, shoulder, or knee pain; surgery
  • Dermatologic, e.g., eczema, irritant or allergic contact dermatitis
  • Metabolic, e.g., diabetes (high sugar), history of hypoglycemia
  • Mental health, e.g., anxiety, depression, mood disorders
  • Visual or hearing impairments
  • Current infections or illness
Potential Risk Factors
  • Age > 65 years
  • Poor physical conditioning
  • Alcohol use, illicit substance use
  • Heat intolerance, history of heat stress
  • Motion sickness
  • Current pregnancy
Physical Examination
Sub table
Heart rate, resting < 60 or > 100 beats per minute; irregular heart beat
Respiratory rate < 12 or > 20 breaths per minute
Blood pressure Systolic > 160 mm Hg and/or diastolic > 100 mm Hg
Body mass index (BMI)† ≤30

*These indicators should be used in conjunction with the guidance document, “Medical pre-placement evaluation for workers engaged in the Deepwater Horizon response: Recommendations from CDC/NIOSH “[

https://www.cdc.gov/niosh/topics/oilspillresponse/preplacement.html ].

†Charts/calculators are available to calculate BMI (e.g.,

https://www.cdc.gov/healthyweight/assessing/bmi/). The formula for weight in pounds and height in inches is: (weight [lb] X 703)/(height [in] x height [in]).

Page last reviewed: May 15, 2018