Document 0gYBXqx7LNaEbeD54pOjO4DoV

DR. BRIAN BRADLEY AND DR. DAVID STEIN BOARD CERTIFIED IN INTERNAL. PULMONARY. PREVENTIVE. OCCUPATIONAL GERIATRIC AND CRITICAL CARE MEDICINE 4003 WOOD LAWN PASADENA. TX 77504 TELEPHONE: (7131 041-0088 August 5, 1990 R. A. Hughes, M.D. Deer Park Manufacturing Conplex P. 0. Box 100 Deer Park, Texas 77536 Dear Dr. Hughes: Thank you for referring I reviewed his work history. He joined Shell in 1953, initially as a helper and then the next year as a boiler maker, and for eighteen years he did this. His work involved exposure to asbestos-insulated vessels from which he had to remove asbestos on occasion, necessarily generating dust. He has also done some welding. He had a brief employment in an industrial pain crew. He has not done sandblasting. He has been a volunteer firefighter for forty years and is required to wear an SCBA appara tus. Hie has been a smoker up until the 1970s. He has had a past history of ulcer disease, hypertension, hepatitis. He has had thyroid treated with radioiodine. He has had hernia repair and appendectomy. He presently uses Skol tobacco. He has no symptoms at the present time. He has no remembered lung illness. He is in good shape. He is required to climb ladders, which he does without difficulty. Review' of systems is essentially negative. Physical examination is negative. I reviewed his accompanying lab which shows cholesterol varying between 230 and 275. He was advised to follow a low cholesterol diet. I reviewed his lab, which is otherwise normal. His pulmonary function is also normal. His chest x-rays of 1985 and 1988 are similar shewing pleural plaques on the lateral walls of minimal width and extent. There are also calcified granulomas. There is no evidence of malignancy or pulmonary fibrosis. In sunmary, this man is in good general health. He has had significant medical illnesses in the past including smoking, hypertension, and ulcer disease. He has had asbestos exposure during his work as a boilermaker and as a marker of this, he has pleural plaques. There is no evidence of any other active disease in his chest. He has been advised to follow a low cholesterol diet. Thank you for this referral, and I will be happy to report further as required. Yours B. Bi BB:sss LAM 032146 JIDD-UOOOOS s-i3aao(ya<i) PULMONARY REGISTRY CONFIDENTIAL - MEDICAL REASON FOR REVIEW 1. CHEST X-RAY REPORT INDICATING: a) Possible pleural abnormality ^ 7. Has the employee had a Job where it Is possible, or likely. that he has been exposed to some other agent known to cause a dust disease of the lung, (e.g.. Silica, etc.)? If so, list <--. .--, __ IYES 1 NO b) Possible fibrosis 2. PULMONARY FUNCTION TEST ABNORMALITY: a) locc than cA proriirfpri 8. PLEASE UST JOB TITLES AND NO. OF YEARS IN THAT POSITION iLr t h) Other 9. Is there any history of other respiratory Illness that could account for me X-ray abnormalities under consideration? If so, list | | w.. n~U,n 1__ 1Ytb , Other reason tor review n/ jL. . ..............Qrn**t.Lr}*r-___I--------------------------------------------------------- S. Has the employee worked In a facility that used asbestos so that It is possfole that a pleural plaque could be related to Job exposure? 6. Has the employee worked at a job (e.g., bricklayer, insulator, etc.) lor a sufficient time (usually at least 10 years) for It to be likely that asbestosls could have developed? RESULT OF REVIEW^^J^ --\--i O tES 1__ INO 10. Is there a history of exposure to a pneumoconiosis producing agent outside of employment at Shell (prior to working at Shell or associated with a parttime job, or avocation)? If so, list ,--, ,--. . YES L-fNO 1--1 1--1 / r~V__ i--\ . |__ )NO ,, ' ' , rl'w r Wil/}\er/ C/H-C !-&'d /0/faj(/<i Recommendation^)/)r/^L L6<\ ^ ~ ( P h S Af(]f JijJdf, T*'I*v)^ REVIEWED k by f V^ X ZOj^x /si xV / ,}Iq j /--\ / 1 NOT&- (check list of actions to be completed by the Company doctor and ( jyrgttmed to registry In Houston, with one copy to be retained m employee's '^-u^pleWal change DATE / IF POSSIBLE FIBROSIS DATE Patient counseled: OSHA Form 200: Worker's Compensation: EMPLOYEE REFERRED TO DR. )(Please send copy of consultation when available (li/Xi (f 1 1^jAJ ha /M i orsname ' Patient counseled: OSHA Form 200: Worker's Compensation: COMMENTS: - CONTEMPLATED FOLLOW-UP PERIODIC EXAM | | OTHER INSTRUCTIONS: PART 1 - WHITE COPY - LOCATION MEDICAL DEPARTMENT 2 - YELLOW COPY - CORPORATE MEDICAL DEPARTMENT ^ . OIKIM' r-riOV . PYAUIWIAJO PMV^irtAW^ CM C ABS-Of35540 _ LAM 032147 EMPLOYEE NAME (Pint ILO PULNk ARY SURVEILLANCE WORKSHE, ** .*rj EMPLOYEE NUMBER i DATE OF X-RAY REAOING COMPANY | 1 SHELL 1--1 OIL COMPANY r--i SHELL CHEM. |--l SHELL DEV. l-J COMPANY l--J COMPANY othEr n aA r TYPE OF EXAMtNATION i--l X) P tV> l_l (Specify)---- -ZJ-------- -------------------- Kl ASBESTOS SILICA JOTRER^t)----------------- fSoecrfY. 1 A. DATE OF X-RAY 1B. FILM QUALITY EC % 2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 2B. SMALL OPACITIES a. SHAPE/SlZE seconoary b ZONES 11 No. Grade i 1C. IS FILM COMPLETELY NEGATIVE? YES Proceed to Section 5 NO 13 Proceed to Section 2 YES I j complete I-----1 2B end 2C NO R) Y-~* PROCEGO TO SGCTION 3 c. PROFUSION %% % Vo '/, 7a V. 7* 7a v2 7j 7- 2C. LARGE OPACITIES SIZE OA 8C PROCEED TO SECTION 3 3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? pYES COMPLETE 38, 3C and 30 3B. PLEURAL THICKENING 3C. PLEURAL THICKENING . . . Chest Wat! a DIAPHRAGM (plaque) a CIRCUMSCRIBED (piaque) NO . PROCEED TO SECTION 4 SITE lIKM b. costophrenic angle MUSITE SITE IN PROFILE . WIDTH ii. EXTENT FACE ON lit EXTENT yn 0A 8C 01 23 0 12 3 & 0A e C 01 23 0 12 3 3D. PLEURAL CALCIFICATION a. DIAPHRAGM .. b. WALL ............... c OTHER SITES 0 >y EXTENT 01' y X| ' 2 X|. 2 / 3 3 3 4A. ANY OTHER ABNORMALITIES? YES 4B. OTHER SYMBOLS (OBLIGATORY) SITE IN PROFILE i. WIOTH ii. EXTENT FACE ON lit. EXTENT R 'o A B | C 0 t 23 yL 0 A|B|C 0 1 2|3 I 1112131 h 111213 X0 EXTENT a. DIAPHRAGM .... b WALL........................... 0 X3 0 1 2 lx xLic. OTHER SITES ........... 0 1 PROCEED TO SECTION 4 COMPLETE 46 and 4C NO Q PROCEEO TO SECTION 5 EE ax~~j~bu | ca j cn | co j cp j cv j di | el j em | es | fr | hi j ho j id | <h j kl [ pi | pn j rp j tb [ Report items which may be of present clinical signifi cance in this section Date Personal Physician notified9 month OAT __I__ I 1. CLINICAL INTERPRETATION 2. 8-READING COMMENTS The heart size is normal. There is calcified plaque in the aortic arch. There are bilateral calcified pleural plaques involving the diaphragms, left chest wall and the left lateral cardiac margin. No significant interval change is appar ent since the previous film of 5-13-88. PLEASE TYPE OR PRINT NAME OF PHYSJCIAN c Q-jcopcp M n /R A HIIOHFP M D AOORESS $H*_L OiL COMPANY, F. 0. BOX 100 PHYSICIAN'S SIGNATURE ' J'ld?JLi SIGNGO /#) j oTY/sts,Tc^)i>?:<?gE\Kf\I 1 tXAS 7/b36 OATE SIGNED *" ftBS-Ohbt-^r INSTRUCTIONS: WHITE COPY - FOR CORPORATE MEDICAL DEPARTMENT YELLOW COPY - FOR LOCATION MEDICAL DEPARTMENT 'La COPY - EX AMI NING FH YoiC < A ' L _- LAM 032148