Initial Evaluation

sec_arr Diagnostic Testing
SECTIONS

Recommended Routine Tests

“Routine” tests are those performed without a specific medical indication.

Vision Testing
Visual acuity, far vision: OS/OD/OU with and without correction
Visual acuity, near vision: OS/OD/OU with and without correction

Color vision
Acceptable tests include Ishihara (first 11 plates), Farnsworth D15, and HRR (Hardy, Rand, and Rittler, 4th ed.). The examiner must follow the directions of each test for appropriate lighting during the exam. (See also Eyes and Vision chapter.)

Field of vision, horizontal

Hearing Testing

Audiograms should be performed in a sound booth compliant with the most recent version of ANSI S3.1 (Criteria for Permissible Ambient Noise during Audiometric Testing) with equipment calibrated to the most recent version of ANSI standard S3.6 (Specification for Audiometers). If a booth is unavailable, the test room sound pressure levels should not exceed those specified in the federal OSHA “Audiometric test rooms” standard (29 CFR 1910.95, Appendix D). Testing of applicants wearing hearing aids should be done using sound field testing (see Hearing chapter).

Each ear should be tested separately at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz. Hearing aids should be used during testing if the applicant will use them while working.

Electrocardiogram (12 lead)

The following guidelines on interpretation of electrocardiograms as a screening tool can be found at:

Blood Tests

Complete metabolic panel, fasting
Complete blood count with differential
Optional routine tests
“Routine” tests are those performed without a specific medical indication.

  • Hemoglobin A1c
  • Gamma glutamyl transferase (also called transpeptidase)
  • Lipid panel (fasting)
  • Urinalysis (dipstick)
  • Lead and zinc protoporphyrin (ZPP)
  • Immunization titers (e.g., measles, mumps, rubella, varicella)
  • TB screening (depending on tuberculosis prevalence/risk in the community)
  • HCV antibody
  • HBV anti-HBc antibody
  • HIV antibody

Tests for Specific Indications
Cardiac Stress Test
Depending on past medical history and risk factors (see Cardiovascular Disease Chapter).

Pulmonary Function Tests
These tests may be ordered if a lung disease has been diagnosed or is suspected.

Blood Lead (Not Serum) and Zinc Protoporphyrin (ZPP)
For the lateral transfer applicant and/or applicant with military, hunting, or shooting experience.

Echocardiogram
For clinical suspicion of pathological heart murmur (if not previously performed) and for longstanding hypertension, especially if in stage 2 or 3.

Respirator Evaluation
Pulmonary function tests and cardiac stress test may be indicated depending on the type of respirator and personal cardiac and pulmonary risk factors.

Other Tests
Other tests may be ordered by the police physician depending on specific medical indications.