Document 1YrD99rjaqN3gO205LxZB34E
SM-32 (r
)
Shell Oil Company
Interoffice Memorandum
FEBRUARY 13, 1990
TO: DR. ROBERT HUGHES, DEER PARK MANUFACTURING COMPLEX
FROM:
LOUIS C. WADDELL, JR., M.D.
SUBJECT: PULMONARY REGISTRY REVIEW,
, EMPLOYEE
This case is reviewed because of possible pleural plaque changes on the chest X-rays.
is currently retired (March 1987). He began employment in 1953 with Shell and was classified at the time of his retirement as a foreman in the Aromatics unit.
His spirometry that was done in December of 1986 was normal.
All of the film readers have interpreted the lung parenchymal as normal. However, the two radiologists. Dr. M. A. Mullican and Dr. P. M. Conoley, both NIOSH certified B-reader radiologists, have indicated that the radiograph is consistent with findings of bilateral diaphragmatic pleural plaques. Dr. Conoley, for example in his 1986 film interpretation which reviewed films form 1984, 1985, and 1986 said, "In the initial study, there is minimal lobulation of the superior surface of each diaphragm without evidence of calcification or effusion." Dr. Mullican in the film reading of 03/19/86 said, "Again some diaphragmatic irregularity noted which may be a normal variation or could represent non-calcified pleural
plaques."
Because these X-ray changes are consistent with the radiographic findings related to the pleural manifestations of asbestos exposure and because he was in the asbestos program with the presumption of at least "bystander" exposure sufficient to cause pleural plaque type radiographic findings, I would recommend that this case be considered a "pleural plaque" case.
"Bilateral pleural plaques" should be the entry for the OSHA 200 log. Presumably there is already documentation in the clinical record that
has been informed about his X-ray findings. If it has not been done then it should be.
We are enclosing along with the consultation report the pulmonary registry form with our portion completed. After the OSHA 200 log entry is made and after a check is made in the charts to see-if there is documentation concerning his counseling about the X-ray then the appropriate portions of the form should be completed and returned to us for our files.
CA9003702 - 0001.0.0
lam 032012
ABS-055405
Once again thank you for your continuing cooperation. If you have any questions about this case please call me.
Enclosures
CA9003702 - 0002.0.0
LAM 032013
ABS-055406
S-13200 (4/89) 00S061
t *PULMONARY REGISTRY
CONFIDENTIAL - MEDICAL
NAME OF EMPLOYEE
.
, __________
EMPLOYEE NUMBER
!t .'
j LOCATION
V
^
-
. . . . 0 /'/t?-
REASON FOR REVIEW 1. CHEST X-RAY REPORT INDICATING:
a) Rouble pleural abnormality
7. Has the emoloyee 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 Tie lung, (e.g., Silica, etc.)? if so, list
J -- ___ i
YES OfJO I
----
h) Possible fihrnsis
/i 8. PLEASE LIST JOB TITLES AND NO. OF YEARS IN THAT POSITION I
2. PULMONARY FUNCTION TEST ABNORMALITY:
|
a) FVC less than 75% of predicted
bl Other
. Other reason lor review
Uf
X L-'/ <" V
9. Is there any history of other respiratorVillness that 7 could account for tne X-ray abnormalities under 1 consideration? If so, list
ii I
___
__ -- " ___N0
i
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j
4 Time of service
10. Is there a history of exposure to a pneumoconiosis y --
producing agent outside of employment at Shell
<
(prior to working at Shell or associated with a part-
--
5. Has the employee worked in a facility that used 7 --
--
time pb. or avocation|? If so. list
asbestos so that it is possible that a pleural plaaue
YES
NO
could 0e 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 asbestosis could
7
_
'--i ___!
vcc Yti>
1;_--__1\
uc NU
have developed?
'
| ___
no
--
|
. RESULT OF REVIEW: ^^
d*rJjki/bnii d Recommendation: i
REVIEWED v
gY
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NOTE: (check list ol actions to be competed by the Com cany oocor ana -iiij
returned to registry in Houston, with one copy to be retained Tn emaoyee s
WPLEURAL CHANGE
Patient counseled:
OSHA Form 200:
4----f
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1 Iwvum*/v-_^v l^0l
Worker's Compensation:
EMPLOYEE REFERRED TO DR. (Please send copy ot consultation when available)
COMMENTS:
'/ DATE
<e> rtAr- 7 2
| 1
1 drsname
'
IF POSSIBLE FIBROSIS
Patient counseled: OSHA Form 200:
Worker's Compensation:
DATE
i j
j
CONTEMPLATED FOLLOW-UP
I I PERIOOIC EXAM
I | OTHER
ABS-055407
LAM 032014
S-12972 (11-86)
ILO PULMONARY SURVEILLANCE WORKSHEET
EMPLOYEE NAME (first. Middle. Last)
EMPLOYEE NUMBER
OATE OF X-RAY R6A0ING
COMPANY
r--1 SHELL 11 OIL COMPANY
1--1 SHELL CHEM. --1 COMPANY
f--i SHELL OEV 1--1 COMPANY
OTHER
TYPE OF EXAMINATION
r--| Q ASBESTOS Q SILICA 1--1 (Specity)---------------------------------------------------------
OTHER fl rSoeo/v)
1 A. DATE OF X-RAY
MONTH
I?
OAY
YR
T| R
IB. FILM QUAU-TY
HI u/<4
2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
2B SMALL OPACITIES
a. SHAPE/SIZE secondary
If Not Grace 1 Give Reason
1C. IS FILM COMPLETELY NEGATIVE9
YES I I
<o
<----- 1 Section 5
no i n pfoceed to 1 1 Section 2
YES I I COMPLETE
1----- 1 28 and 2C
C3--iNO
PROCEED TO SECTION 3
c PROFUSION
/- /o % /0 v. Vi
V, Vi Vi
Vi Vi V-
2C LARGE OPACITIES
size I 0 I A I B [ C I
PROCEED TO SECTION 3
3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
38. PLEURAL THICKENING
a DIAPHRAGM {plaque)
3C. PLEURAL THICKENING
a CIRCUMSCRiBEO (plaque)
YES Chest Wall
5MPLETE 3B 3C and 30
no'L3^' PROCEEO TO SECTION 4
SITE I/O R L
b COSTOPHRENIC ANGLE
S|TE
|R|L|
30. PLEURAL CALCIFICATION
SITE IN PROFILE
i width I, EXTENT FACE ON m EXTENT
*& \ fl
O| A
0 213 1011 l;M
o
CD
o
A
31
0 | `Y'l B c 3
101 H 2131
SITE IN PROFILE
i. WIDTH h EXTENT FACE ON n. EXTENT
o' R
0AB C 0t23
0 12 3
O- r 0 A|B
c
0 1 H3 0 12 3
a OiaPhRAGM b WALL c OTHER SITES
o' R
0
0
0
EXTENT
' 1 2I 3 'M 3 'M 3
a DIAPHRAGM b WALL c other sites
'6 L
0 0 0
EXTENT t 23 1 23 \ 23
PROCEEO TO SECTION 4
4A. ANY OTHER ABNORMALITIES9 4B- OTHER SYMBOLS (OBLIGATORY)
O a* bu ca j cn co cp cv Oi ei err
Report items which may be ot present clinical s<gn*hcance m this section
<-------A (Specify od 1 ^1
"p | <
YES
GT COMPLETE 48 an<3 4C
NO Q
PROCEED TO SECTION 5
1 j ho [ iQ | .h j hi | pi j pn | rp | lb [
Date Personal Physician notified'7
1TVSI7Y
1 CLINICAL INTERPRETATION
2 B-READING COMMENTS
The examination dsr.orotr.ites the presence of
pleura 1 abnomiltv seen uarhcnlari;
'. nodular ch.ar.re in t've riyht lr'-:er coost
a Iona. +hc- left her!the rax tib toe le:c
Tcstcri orIy suspicious for r.er.nlas; i. Cc~ute ' i-.emiciiaphracm which r:ay he related te
tcTCcraphy is supqested for further evaluate:; ; plearal plaque* formatio:i possibly cjm to
this lesion. This also ray help to character Lae asbestos ini'.alatiou. The lure rarl inas a
PLEASE TYPE OR PRINT NAME OF PHYSICIAN
PHYSICIAN S SIGNATURE
Wltl'iLP. HCr.lll L Il?li
TATTICT M. COhfLFY, : d.
A00R6SS
v --" v
SIGNEO
H
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LAM 032015
r ; v:;., nit'ioo
3-17-7.')
City-state zip CCCE vr-; r. n ' '
ATESIGND
ABS-055403