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California Law Enforcement I I I If you have issues viewing or accessing this file contact us at NCJRS.gov. , I i\lCJlRS NOV 2 19~4 ACQUfiSKTDONS MEDICAL SCREENING MANUAL i For I CALIFORNIA LAW ENFORCEMENT I I I - 1993 - (Revised July, 1994) I) .: " . " ~4;~ t'~£..'\~t? Ot1:ft§e;:t~£~ $llAr~rIdAn![M;AN© ll~ARf<S·~N(1 , '-;~ ·l. () . 5~'A'Vt: ©s:: 1l::,,~'lur.on.i;\3aA ' " I j) . f I ,,;\' 1 • MEDICAL SCREENING MANUAL For CALIFORNIA LAW ENFORCEMENT 1993 (Revised July, 1994) R. Leonard Goldberg, M.D. City of Los Angeles Stephen G. Weyers, M.D. • California State Personnel Board Shelley Weiss Spilberg, Ph.D. Commission on POST • CALIFORNIA COMMISSION ON PEACE OFFICER STANDARDS AND TRAINING 150799 U.S. Department 01 Justice National Institute of Justice • This document has been reproduced exactly as received from me person or organization originating it. Points of view or opinions stated In this document are those of the authors and do not necessarily represent the official position or policies of the National Institute of Justice. Permission to reproduce this copyrighted material has been grante9 9Y. ., p Cal1.forma Comm.ss1.on on eace Officer Standards and Traming to the National Criminal Justice Reference Service (NCJRS). Further reproduction outside of the NCJRS system requires permission of the copyright owner. Copyright California Commission on Peace Officer Standards and Training 1994 Published 1993 Revised July, 1994 Reprinted April, 1994 • For information about copies of this publication, contact: POST Media Distribution Desk 1601 Alhambra Boulevard Sacramento, CA 95816 • (916) 227-4856 COMMISSIONERS • Marcel L Leduc Sergeant Chairman San Joaquin County Sheriff's Department Devallis Rutledge Deputy District Attorney Vice Chairman Orange County District Attorney's Office Sherman Block Sheriff Los Angeles County Sheriff's Department Co Ilene Campbell Public Member Jody Hall-Esser Chief Administrative Officer, City of Culver City Ronald Lowenberg Chief of Police Huntington Beach Police Department Daniel E. Lungren Attorney General Raquel Montenegro Professor of Education • (Retired) Manuel Ortega Chief of Police Placentia Police Departm~nt Bernard C. Parks Assistant Chief Los Angeles Police Department Cois Byrd Sheriff Riverside County Sheriffs Department George W. Kennedy District Attorney Santa Clara County Lou Silva Officer Oakland Police Department Dale Stockton Detective Sergeant Carlsbad Police Department Norman C. Boehm Executive Director • POST Revised 7/94 iii • TABLE OF CONTENTS CommiSSioners . .. iii Preface ....................................................... v Acknowledgments ................................................ vii Table of Contents ................................................ ix List of Tables .................................................. xiii List of Figures. .. xxi Introduction ........... Q • • • • • • • • • • • • • • • • • • •.• • • • • • •• • • • • • • • • • • • • •• 1 BACKGROUND INFORMATION • Project Goals and Methodology . .. 3 Pre-Employment Medical Screening and the Law . .. 9 Patrol Officer Job Demands: Their Implication for Medical Screening ........ 29 General Guidelines for Using the Medical Screening Manual . .. 41 MEDICAL EXAMINATION AND EVALUATION PROTOCOLS CHAPTER I: Cardiovascular System ................................ 1-1 Diagnosed Heart Disease - Symptomatic ......................... 1-3 Diagnosed Heart Disease - Asymptomatic ........................ 1-5 No Condition Diagnosed, but Abnormal Findings or Risk Factors ........ 1-5 Hypertension ............................................. 1-8 • Revised 7/94 in ----_._------------- Page • CHAPTER II: Dermatology: . .. 11-1 Conditions of Concern . ..... ,. 1\-1 Evaluation of Common Clinical Syndromes . .. 11-4 CHAPTER III: Endocrine System .................... , ............ 11/-1 Diabetes Mellitus ................ " " .................. " ..... 111-2 Parathyroid Disorders ...................... ", .... " .......... 111-9 Hyper and Hypothyroidism ...................................' 111-9 Adrenal Disorders ........................................ 111-9 CHAPTER IV: Gastrointestinal System ............................. IV-1 Hernias ................................................ IV-2 Hemorrhoids ............................................. IV-3 • Ulcerative Colitis ..... " .................................... IV-3 Irritable Bowel Syndrome .................................. , IV-6 Peptic Ulcers ........................................... IV-8 Hepatitis . .. IV-10 Symptomatic Gallstones ................................... IV-14 CHAPTER V: Hematology ...................................... V-1 Iron-Deficiency Anemia ..................................... V-2 Thalassemia .................... " ........................ V-3 Bleeding Disorders/Anticoagulants .. .. V-3 CHAPTER VI: Oncology ........................................ VI-1 Evaluation of a Candidate with a History of Tumor or Malignancy ....... VI-2 • Revised 7/94 x • CHAPTER VII: infectious Diseases 0 0 0 0 0 0 0 0 0 0 • 0 0 •••••••••• 0 0 •• 0 • •• VII-1 ~~IV .. 0 • 0 0 • 0 0 • 0 0 0 0 0 0 0 0 0 0 0 0 •• 0 • 0 0 0 0 0 •• 0 0 0 0 • 0 0 • 0 0 0 •••• o. VII-3 Chronic Viral Hepatitis 0 0 0 0 • 0 0 • 0 • 0 • 0 • 0 0 ••• 0 •• 0 0 0 0 0 0 • 0 •••••• 0 VII-10 Tuberculosis 0 0 0 0 0 0 0 0 0 • 0 • 0 • 0 0 0 • 0 • 0 0 • 0 0 0 • 0 0 ••• 0 0 • 0 0 • 0 0 • 0 •• VII-15 CHAPTER VIII: Musculoskeletal System ... 0 0 • 0 • 0 0 0 0 0 0 0 •• 0 0 0 0 •• 0 0 0 0 VIII-1 Neck: Cervical Pain, Radiculopathy, and Instability . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 VIII-5 Back: Lumbar Pain, Radiculopathy, and Disc Surgery. 0 • 0 0 0 •• 0 0 0 •• 0 VIII-9 Spondylolisthesis 0 • 0 0 0 0 0 0 0 0 0 0 0 0 • 0 0 0 0 •••• 0 0 •• 0 ,. 0 ••• 0 0 VIII-13 Scoliosis 0 0 • 0 • 0 0 0 •• 0 0 •• 0 0 • 0 0 0 0 0 • 0 •• 0 •••• 0 • 0 •• 0 0 0 0 0 VIII-15 Miscellaneous Back Abnormalities 0 0 • 0 ••• 0 • 0 0 ••• 0 0 •• 0 •• 0 VIII-18 Knee: Meniscus Injuries 0 0 0 • 0 0 0 • 0 0 0 0 0 0 0 • 0 • 0 • 0 0 • 0 • 0 • 0 0 0 • 0 •• VIII-19 Loose Body in the Knee 0 0 0 0 0 • 0 • 0 0 •• 0 0 0 0 • 0 • 0 0 0 • 0 •• 0 0 0 VIII-22 Patellofemoral Problems 0 0 0 0 •• 0 0 •• 0 0 0 0 0 0 • 0 • 0 0 0 •••• 0 o. VIII-23 Anterior Cruciate Ligament Instability 0 0 0 0 • 0 0 0 0 0 • 00 0 • 0 0 0 0 0 VIII-30 Collateral Ligament Instability 0 0 0 0 0 0 •••• 0 0 0 0 • 0 0 •• 0 0 0 0 • 0 0 VIII-47 Acromioclavicular (AC) Separation 0 0 0 0 0 0 • 0 0 • 0 • 0 • 0 • 0 0 0 0 0 0 VIII-48 • Upper Extremity: Shoulder Subluxation and Dislocation 0 •• 0 •• 0 0 0 • 0 • 0 • 0 0 0 • o. VIII-49 Finger Amputations/Arthrosis 0 0 0 • 0 0 0 • 0 ••••• 0 • • • • • • • • • •• VIII-56 Misc: Retained Hardware .. 0 • 0 0 • 0 • 0 • • • • • • • • • • • • • • • • • • • • • •• VIII-56 Leg Length Discrepancy ................... 0 • • • • • • • •• VIII-57 CHAPTER IX: Neurology ....... 0 •••••••••••••••• 0 •••••••••••••• IX-1 Cranial Defect ... , ........................................ IX-2 History of Seizure 0 ••••• 0 ••••••••••••••••••••••••••••• 0 •••• IX-3 Head Trauma Without History of Seizure ............ 0 0 • 0 •• 0 • 0 •• IX-20 Primary Headache Disorders ....... 0 0 ••• 0 •• 0 • 0 ••••••••• 0 • 0 • 0 IX-23 CHAPTER X: Respiratory SYstem ... 0 ••• 0 ••• 0 0 ••••••••••••• 0 0 0 • 0 • 0 X-1 Obstructive Disease ..... 0 •••••••• 0 •••••••• 0 ••••• 0 ••••••••• X-5 Restrictive Disease ...... 0 • 0 0 0 •••••• 0 0 0 •••••• 0 ••• 0 0 • 0 0 0 0 •• 0 X-9 • Miscellaneous Conditions .. 0 • 0 •• 0 ••••••••••••••••••• 0 •• 0 0 0 • 0 X-10 Revised 7/94 xi Page • CHAPTER X: Vision Guidelines .................................. XI-1 General Screening Recommendations .......................... XI-4 Far Acuity Deficiency ..................................... xI-a Methods of Correction ............................ ,..... XI-14 Glasses ........................................... XI-15 Contact Lenses . ................... " XI-23 Orthokeratology . .. XI-30 Far Acuity Summary .......... , ........................ X/-31 Recommended Evaluation Protocol , . .. XI-32 Radial Keratotomy ........................ , . .. XI-38 Visual Field Deficiency ................................ , .. XI-43 Binocular Fusion Deficiency ............................ ,.. XI-45 Color Vision Deficiency ........... , ......... ,............ XI-47 Summary of Vision Guidelines ........ ' ................................................ to tt .. XI-57 APPENDICES • Appendix A: Medication-Related Impairment Appendix B: Participating Medical Specialists Appendix C: Medical History Statement Appendix D: Medical Examination Report • Revised 7/94 xii • LIST OF TABLES BACKGROUND INFORMATION Table 1 Patrol Officer Training Periods and Tenure Rates from 1980 - 1991 .................. 21 Table 2 Patrol Officer Duties and Task Groups (1979) ........ 33 Table 3 Patrol Officer Physical Job Demands (1985) ......... 36 Table 4 Patrol Officer Rates of Critical Physical Activities by Type of Activity (1992) . .. 37 Table 5 Environmental Factors and Working Conditions That Can Be Associated With Patrol Officer .:Job Duties. .. 38 Table 6 Role of the Physician and the Employer in the Medical Screening Process . .. 42 • MEDICAL EXAMINATION AND EVALUATION PROTOCOLS CHAPTER I: Cardiovascular System Table 1-1 New York Heart Association Cardiovascular Classification Sys~$m, Functional Classification . .. 1-4 Table 1-2 New York Heart Assoc;ation Cardiovascular Classification System, Therapeutic Classification . .. 1-4 Table 1-3 Relationship of METS and Functional Class According to 5 Treadmill Protocols ................ 1-7 CHAPTER II: Dermatology Table 11-1 Description of Primary Skin
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