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UNITED STATES NUCLEAR REGULATORY COMMISSION OFFICE OF NUCLEAR REACTOR REGULATION WASHINGTON, D.C. 20555 February 5, 1991 Information Notice No. 91-08: MEDICAL EXAMINATIONS FOR LICENSED OPERATORS Addressees: All holders of operating licenses or construction permits for nuclear power, test and research reactors. Purpose: This information notice is intended to alert addressees to recent problems identified in the administration and documentation of medical examinations for licensed operators and operator license applicants. It is expected that recipients will review the information for applicability to their facilities and consider actions, as appropriate, to avoid similar problems. However, suggestions contained in this information notice do not constitute NRC requirements; therefore, no specific action or written response is required. Description of Circumstances: During recent inspections at the Palo Verde Nuclear Generating Station and the Trojan Nuclear Plant, the staff of the U.S. Nuclear Regulatory Commission (NRC) identified concerns regarding the administration and certification of medical examinations for licensed operators and operator license applicants. The NRC staff reviewed the facility licensees' documentation and determined that the licensees' examining physicians had in several instances not performed some of the tests specified by American Nuclear Society Standard ANSI/ANS 3.4-1983 to meet the NRC's requirements for operator medical qualifications (e.g., standard urinalysis, electrocardiogram, depth perception, and stamina tests). In other cases, operators were performing licensed duties with disqualifying medical conditions without the licensee having provided NRC notification as required by Section 55.25 of Title 10 of the Code of Federal Regulations (10 CFR). The inspections also indicated that some medical examinations were not performed within the required 2-year period resulting in some operators performing licensed duties without having a current medical examination. When those operators with incomplete or lapsed medical examinations were examined, several were determined to have medically disqualifying conditions. The inspection findings indicate that these facility licensees had provided insufficient management guidance or oversight to the examining physicians to ensure complete, accurate, and timely medical examinations. Both facility licensees had attested on the Certificates of Medical Examination (Form 9101300033 . IN 91-08 February 5, 1991 Page 2 of 3 NRC-396) submitted with their applications for operator licenses that the guidance contained in ANSI/ANS 3.4-1983 was followed, when in fact it was not. Discussion: 10 CFR 55.21 requires each applicant for an operator license to have a medical examination by a physician as a precondition for licensing and every two years thereafter. The physician must determine that the licensed operator or license applicant meets the requirements of 10 CFR 55.33(a)(1), such that the applicant's [licensed operator's] medical condition and general health will not adversely affect the performance of the assigned operator duties or cause operational errors endangering public health and safety. The facility licensee must certify the license applicant's medical fitness by submitting Form NRC-396, "Certification of Medical Examination by Facility Licensee," in accordance with 10 CFR 55.31(a)(6) or 55.57(a)(6), for initial and 6-year license renewal applications, respectively. Form NRC-396 specifically identifies American Nuclear Society Standard ANSI/ANS 3.4-1983, "Medical Certification and Monitoring of Personnel Requiring Operator Licenses for Nuclear Power Plants," or ANSI/ANS-15.4-1977(N380), "Selection and Training of Personnel for Research Reactors," as the criterion to be used for the medical examination of individuals applying for initial or renewal licenses. Regulatory Guide 1.134, "Medical Evaluation of Licensed Personnel for Nuclear Power Plants," endorses ANSI/ANS 3.4-1983 as an acceptable method for determining that the medical condition and general health of nuclear operators will not cause operational errors and for determining whether an applicant or operator has an abnormal health condition that could result in disqualification. If, during the term of a license, an operator's medical condition changes and no longer meets the standards set forth in ANSI/ANS 3.4-1983 or ANSI/ANS-15.4-1977(N380), as certified to the NRC with the individual's license application, then the facility licensee must notify the Commission pursuant to 10 CFR 55.25 within 30 days of learning of the diagnosis. If the examining physician indicates that the condition can be accommodated as noted in Section 5.1 of ANSI/ANS 3.4-1983, then an authorized representative of the facility licensee may request a conditional license by submitting Form NRC-396 with the supporting medical evidence for NRC evaluation. The facility licensee may return the operator to licensed duties before obtaining the NRC's permission, provided the examining physician, using the guidance in ANSI/ANS 3.4-1983 or ANSI/ANS-15.4-1977(N380), has recommended to the facility's management that the operator can return to duty. This recommendation of medical qualification must be documented and retained for future NRC inspection. The NRC's regulations do not require Form NRC-396, which invokes the medical examination criteria established in ANSI/ANS 3.4-1983 or ANSI/ANS-15.4-1977(N380), to document an operator's medical condition and general health during the second and fourth years after the initial or renewal license is issued. However, the facility licensee must continue to conduct those biennial medical examinations in accordance with the ANSI Standard to detect any changes in the operator's medical condition. The facility licensee is responsible, pursuant to 10 CFR 55.27, to document and maintain the results . IN 91-08 February 5, 1991 Page 3 of 3 of medical qualifications data, test results, and the medical history of each operator and senior operator for the current license period and to provide the documentation to the Commission upon request. It is important to note that the deficiencies identified during NRC inspections and described herein may provide some insight into the adequacy of addressees' medical examination programs for licensed operators and license applicants. The NRC is concerned that some facility programs may not be receiving sufficient management oversight to ensure that all license applicants and licensed operators are medically qualified to safely perform their assigned operator duties. The NRC cautions facility licensees to ensure the completeness and accuracy of the medical examinations performed by their physicians prior to certifying the fitness of their license applicants to the NRC on Form 396. This information notice requires no specific action or written response. If you have any questions about the information in this notice, please contact one of the technical contacts listed below or the appropriate NRR project manager. Charles E. Rossi, Director Division of Operational Events Assessment Office of Nuclear Reactor Regulation Technical Contacts: D. J. Lange, NRR R. M. Gallo, NRR L. F. Miller, RV (301) 492-3171 (301) 492-1031 (415) 943-3869 T. A. Peebles, RII G. C. Wright, RIII J. L. Pellet, RIV (404) 331-5541 (708) 790-5695 (817) 680-8159 L. Bettenhausen, RI (215) 337-5291 Attachment: List of Recently Issued NRC Information Notices .
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