Site Code - doe-std-1187-20050009

DOE-STD-1187-2005

10.

Death Date

Date of death

Text abstracted from death certificate, immediate

Immediate Cause

cause

11.

Text abstracted from death certificate, first "Due to

First Cause

or as a consequence of" section

12.

Text abstracted from death certificate, second

13.

Second Cause

"Due to or as a consequence of" section

Other significant conditions contributing to the

Other Cause

death

14.

15.

*Old Unique ID

Unique ID from previous site, if applicable

Text field that contains the name of the previous

site where the worker was employed as a

16.

*Previous Site

beryllium worker

3.1.1. Site Code: A unique code that identifies a site. The Beryllium

Registry Data Center will provide a site code to each Registry

coordinator. Sites currently participating in the IISP should use their

current site codes.

3.1.2. Unique ID: This is an encrypted identification number unique to each

beryllium-associated worker. It is assigned by the site and is used to

link multiple records to one worker. Every record submitted to the

Data Center must include the Unique ID. Sites enrolled in the IISP

should use the workers' IISP identifiers as the Unique ID.

3.1.3. Status Code: Indicates whether this is a new record (N) to be added

to the roster or a delete record (D) for a worker already in the roster.

Only a new record (N) should be submitted for workers first entering

the roster. To make changes to information for workers already in the

roster, the site should submit both a delete (D) and a corresponding

new record (N) that will replace all previous roster data for the worker.

3.1.4. Year Born: Only the year of birth is requested in the Roster data set.

This is a measure to help ensure privacy and prevent identification of

individuals by using a specific date of birth.

3.1.5. Gender: Provide the code for the gender of the worker as either male

or female.