Who We Are:
The Building Trades National Medical Screening Program (BTMed) is administered by CPWR – The Center for Construction Research and Training, the health and safety research center of North America’s Building Trades Unions, in partnership with Stoneturn Consultants, Duke University Medical Center, University of Maryland School of Medicine, and Zenith-American Solutions. BTMed is funded by a cooperative agreement from the Department of Energy.
Contact Information:
Toll-Free Number: 1-800-866-9663 / 1-888-464-0009
Email: [email protected]
Website: www.btmed.org
Facebook: www.facebook.com/BTMed/
What We Do:
The Building Trades National Medical Screening Program (BTMed) provides free, ongoing medical screening services to construction workers previously employed at thirty-five (35) U.S. Department of Energy (DOE) nuclear weapons sites. Over its quarter-century of work, BTMed has completed 47,500 screening exams, as well as 11,000 CT scans for early detection of lung cancer. These exams are provided by over 200 medical clinics across the country.
Construction workers have been exposed to toxic substances and hazardous conditions for decades, increasing their risk for occupational illnesses. The screenings—which workers are eligible for every three years—help identify work-related health conditions at an early, more treatable stage and contribute to these workers’ overall health and well-being. BTMed has saved lives, helped workers and their families with compensation, and demonstrated to DOE that construction workers need better safety and health protections. The program is well appreciated by its participants and currently records a perfect 100% satisfaction rating.
BTMed covers former construction workers from 35 Department of Energy sites across the country and maintains nine outreach offices.
Reaching Workers
This year BTMed staff remained busy enrolling new participants and engaging existing ones. Highlights from the past year include:
- Participating in 108 in-person events—building trades meetings, retiree meetings, and community fairs.
- Attending and staffing a booth at the Savannah River Site Safety Expo; the Brookhaven National Laboratory Safety & Wellness Expo; the Fluor-BWXT Portsmouth Safety and Health Fair; Oak Ridge Y-12 Health, Safety, and Benefits; and the ORNL Benefits & Wellness Fair.
- Being featured in an article and on display artwork that appeared in the International Association of Heat and Frost Insulators and Allied Workers national publication—The Insulator’s Journal—that is mailed monthly to its 30,000 members.
What We Have Found:
Important Occupational Health Findings
a. Conventional Medical Screening Exams
- Chest x-rays (N=24,684, participants receiving at least one CXR): 19 percent of participants demonstrated findings consistent with work-related lung disease.
- Pulmonary function tests (N=24,228 participants receiving at least one PFT): 22.9 percent of participants demonstrated findings consistent with obstructive disease.
- Beryllium Lymphocyte Proliferation Tests (BeLPT) (N=23,369 participants receiving at least one BeLPT): 2.1 percent of participants had at least one abnormal BeLPT.
- Audiometry (N=22,715 participants receiving at least one audiogram): 67.6 percent of participants demonstrated hearing loss for normal speech tones.
b. Early Lung Cancer Detection Program Exams
Former DOE construction workers are at very high risk for lung cancer. Those who meet specified risk criteria are eligible for BTMed’s Early Lung Cancer Detection (ELCD) Program. BTMed uses low-dose CT scans to detect lung cancer at an earlier, more treatable stage. BTMed partners with 14 CT providers to deliver these services. Among them is a national provider, which will enhance participant access by offering a wider network of scanner locations.
Among 2,026 participants tested to date:
- 67 have been diagnosed with primary lung cancer.
- 52 of the 67 (77.6 percent) had an early-stage lung cancer (carcinoma in situ, Stage I or Stage II non-small cell cancer. or limited small cell cancer) at the time of diagnosis.
BTMed and Research:
Using Research to Improve Health. This year, our researchers published one peer-reviewed journal article based on BTMed participants’ data and one peer-reviewed commentary in the American Journal of Industrial Medicine:
Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites: Follow‐up through 2021. BTMed researchers conducted this follow-up study—using data from 1998 to 2021, which includes 8,367 deaths—and found that mortality among former DOE construction workers is significantly elevated compared to non-construction DOE workers. This includes mortality from all cancers, lung diseases, and injuries. The study also showed that this significant elevation in occupational mortality risk applies not only to former DOE construction workers employed during the Cold War, but also to those employed after 1990.
Occupational lung cancer screening: A Collegium Ramazzini statement. BTMed researchers, in co-authorship with a collegium of occupational medical doctors from various institutions, published a commentary on the efficacy of low dose computed tomography (LDCT) screening among individuals at high risk of lung cancer. The commentary stated that, based on results from various LDCT screening programs, eligibility should include individuals with occupational exposure to lung carcinogens, provided their cumulative risk of lung cancer approximates the level of risk endorsed by the guidelines promoted by the United States Preventive Services Task Force (USPSTF) in 2021 and the National Comprehensive Cancer Network (NCCN) in the United States in 2021.
Visit www.btmed.org/cms/publications/published-medical-findings/ to read the full papers. BTMed has completed and published twenty-five (25) studies in scientific literature.
BTMed Medical Team
Knut Ringen, DrPH, MHA, MPH
Principal Investigator, BTMed
With more than 50 years of experience in public health administration, Dr. Knut Ringen is considered one of the founders of the field of occupational high-risk management. He is an expert in construction safety and health. In 1996, he established the first medical screening program for former DOE construction workers, which evolved into the BTMed (www.btmed.org).
Using the data collected from these medical screenings, Dr. Ringen and others have showed how effective this model of medical screening and assistance was and why it should be applied to construction workers on DOE sites. This experience helped encourage Congress to enact legislation in 1993 that forms the basis for DOE’s Former Worker Medical Screening Program. Subsequent scientific analyses of BTMed data helped support the inclusion of construction workers in the Energy Employees Occupational Illness Compensation Program Act and DOE to adopt a special focus on construction in its core safety and health rule.
Patricia Quinn, Program Director, BTMed
Since its inception, Ms. Quinn has been an integral part of the BTMed program, contributing decades of expertise and dedication to worker health and safety. As a member of the BTMed leadership team, she oversees day-to-day operations and directs the administration of all aspects of the program, including key areas such as screening services, outreach, and quality assurance. Her leadership has been instrumental in the program’s success and its unwavering commitment to serving former DOE workers. Through her dedication to excellence, Ms. Quinn has ensured the delivery of high-quality services that meet the needs of this important community.
Marianne Cloeren, MD, MPH, FACOEM, FACP, Co-Medical Director, BTMed
Dr. Marianne Cloeren has decades of experience managing teams of clinicians, serving as Medical Director for a variety of private and government programs. Her work experience includes interacting with remote nurse case managers, managing quality assurance and audits, and delivering effective and well-reasoned case reviews in a federal program. She has written and overseen the production of tens of thousands of such reviews.
Sammy Almashat, MD, MPH, Co-Medical Director, BTMed
Dr. Almashat is trained in both Preventive Medicine and Occupational Medicine, with a background in public health advocacy. His work experience includes clinical occupational medicine and advocacy work with Public Citizen, including research to support establishing occupational beryllium rules.
Melissa McDiarmid, MD, MPH, Senior Medical Advisor, BTMed
Dr. Melissa McDiarmid is a clinical toxicologist who is board-certified in Internal Medicine and Occupational Medicine; she heads the University of Maryland Division of Occupational and Environmental Medicine. A seasoned clinician and researcher, she is an expert in medical surveillance programs and cancer related to occupational exposures.
William Grier, MD, Senior Medical Advisor, BTMed
Dr. Grier is an academic pulmonologist with clinical and research interests focusing on increasing enrollment in lung cancer screening, improving rates of follow-up Low Dose CTs, pulmonary nodules, and impact of exposure history on lung cancer. His research includes work on mesothelioma and military exposure risks.