Entities Required to Submit Information

Section 840 Section 840.300  Entities Required to Submit Information a)         The Department requires the following facilities to report occupational disease incidence information: 1)         Clinical laboratories and hospital laboratories registered, permitted or licensed by the State of Illinois for blood lead level testing and data collection.  Clinical laboratories are required to submit: A)        Date of report, including month, day and year the report is completed, in the format mo/day/year, using two digits for month and day and four digits for year; B)        Last name of the case; C)        First name of the case; D)        Middle initial of the case; E)        Maiden name of the case, if applicable; F)         Complete address where the case resides on a permanent basis (refers to domicile, i.e., the address from which the case may lawfully register to vote if proper age is attained), including number, direction, street name, apartment number, type of street, city, state and ZIP code; G)        County where the case currently resides; H)        Telephone number of the case, including area code; I)         Date of birth of the case, using two digits for the month, two digits for the day and four digits for the year; J)         Gender: the appropriate number for the gender of the case, if available, as 1=male, 2=female, 3=other (includes persons with both male and female reproductive organs and persons who have  undergone sex change) or 9=unknown; K)        Social security number of the case; L)        Name of submitting party, including  the name of the person, industry, physician, hospital, laboratory, clinic or other facility submitting the blood lead sample to the laboratory to be analyzed; M)       Title, if applicable, of the person submitting the blood lead sample to the laboratory to be analyzed; N)        Telephone number of the submitting party (area code and seven digit number); O)        Submitting party type: as either physician, industry (employer), hospital, laboratory (private or public), clinic or other (e.g., nurse, other health care professional, judge); P)         Testing facility name:  name of the laboratory analyzing the blood lead sample; Q)        Testing facility address:  address of the laboratory analyzing the blood lead sample, including number, street name, direction and type of street, city, state and ZIP code; R)        Testing facility phone number, including area code; S)         Test results:  blood lead level of the sample in micrograms per deciliter (mcg/dL); T)         Date of sample collection, using two digits for month and day and four digits for year; U)        Date of sample receipt by the laboratory, using two digits for month and day and four digits for year; V)        Date of sample analysis by the laboratory, using two digits for month and day and four digits for year; W)       Specimen type provided to the laboratory, as either venous, capillary or unknown; X)        Methodology used to analyze the blood lead sample, as either delves cup, extraction-atomic absorption spectrometry, carbon rod-atomic absorption spectrometry, graphite furnace-atomic absorption spectrometry, anodic stripping voltammetry, hematofluorometry or other. 2)         Local health authorities and other facilities for blood lead level testing and data collection shall be required to provide information on cases of elevated blood lead levels as contracted by or upon request of the Department. 3)         Physicians' offices or clinics shall be required to provide information on cases of elevated blood lead levels upon request of the Department. b)         The Department requests that clinical or hospital laboratories maintained by the federal government or other facilities within the United States report all incidence of the occupational disease being collected from the facility or from other data base sources to the Department.  An agreement will be established between the Department and the facility for the purpose of collecting data on Illinois residents known to have the specified occupational disease determined by the Department to be reported or collected for the Registry.  These facilities, hospitals or clinical laboratories include all those out-of-state certified by the Department or by the Occupational Safety and Health Administration (OSHA) to conduct elevated blood lead levels.