Document B80zRV63wv4QEJ5yQaXzB1VmL
Kelsey-Seybold Clinic, P.A.
6624 Fannin Street Houston, Texas 77030 (713)797-1551
Dear Dr. Hughes:
Thank you so much for asking me to see
I have enclosed
a copy of your October 27th letter for reference. As you know,
smokes two packages of cigarettes daily, but has few symptoms other than
for some shortness of breath and occasional early morning cough. Through
the years, he has worked in areas adjacent to insulators, pipefitters, and
has been involved in scraping insulation off of old pipes. But, he does
not have the consistent, intense exposure to asbestos as commonly seen.
The pleural densities have been present since 1978 and have changed very little.
On physical examination there are no rales to suggest early pulmonary fibrosis.
Although a diagnosis of asbestosis cannot be made with certainty, it is certainly
possible that the pleural densities are related. I have urged that he stop
smoking at once, since it is the combination of cigarette smoking and asbestos
exposure which leads to the most hazards so far as health is concerned.
I believe that it would be wise to continue him in an annual surveillance program
consisting of a PA and lateralchest x-ray sFncfToETsTcT spiYometry.
LAM 032160
ABS-055553
SPF/gf Enclosure
Medical Director
Clinical Professor of Medicine Baylor College of Medicine
i i
LAM 032161 ABS-055554
k
S-13260 (4/89) 006061
PULMONARY REGISTRY
CONFIDENTIAL - MEDICAL
NAME OF EMPLOYEE
v ....
- EMPLOYEE NUMBER --*----- ------------ ---------------------------- ---- -
LOCATION
- -----
\ A /--\
\pfrQ.
**
... .
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
.--, ,--.
__ YES
NO
b) Possible fibrosis,
7
2. PULMONARY FUNCTION TEST ABNORMALITY:
a) FVC less than 7.S% of predicted
f)
8. PLEASE LIST JOB TITLES AND NO. OF YEARS IN THAT POSITION PZf
b) Other . Other reason
lor review
)/ ^
9- Is there any history of other respiratory jllness that could account for the X-ray abnormalities under consideration? If. so. list
| | vcc | i l 1Tt& 1 1
4 Time of ' service
5 Has the employee worked In a facility that used asbestos so that It is possible that a pleural plaque could be related to Joo 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 have developed?
i--y/ i--i [A] YES |__ | NO
10. Is there a history of exposure to a pneumoconiosis producing agent outside of employment at Shell (prior to wondng at Shell or associated with a parttime job, or avocation)? If so, list___
E/TCco 1--1 lU Ytb 1___1
,--, ,--, YES NO
RESULT OF REVIEW:
O/rfitfaflJ /
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^
Recommendation:'
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NOTE: (check list of actions to be completed by the Company doctor and returned to registry in Houston, with one copy to be retained in employee's criartj
IF PLEURAL CHANGE
DATE
IF POSSIBLE FIBROSIS
DATE
Patient counseled: Form 200:
(l
^v- 1 ffrpi
Worker's Comoensation:
1
EMPLOYEE REFERRED TO DR. (Please send copy of consultation when available)
i dasname '
Patient counseled: OSHA Form 200: Worker's Compensation:
COMMENTS:
AB3-05 5555
_____________________________________________________ zl________________________________________________________________
CONTEMPLATED FOLLOW-UP
[^PERIODIC EXAM
Q OTHER
INSTRUCTIONS: PART 1 - WHITE COPY - LOCATION MEDICAL DEPARTMENT
LAM 032162
_
EMPtjQYEE NAME fFSrat M*** ' --M
COMPANY
SHELL OIL COMPANY
l--l SHELL CHEM. I I SHELL OEV.
l--l COMPANY
l--l COMPANY
OTHER
f--I , l--l fSpeedyJ_
JemIiPLOYEE NUMBER
DATE OF X-RAY READING
5-18-89
[TYPE OF EXAMINATION In ASBESTOS SIUCA
OTHER (Spctfy)_
1A. DATE OF X-FIAY
IB. FILM QUALITY
I < I fcf| 3 fVR|
2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
2B. SMALL OPACITIES
a. SHAPE/SIZE
PRIMARY
SECONDARY
b. ZONES
RL
If Not Grade 1 Give Re
1C. IS FILM COMPLETELY NEGATIVE?
YES S?'
NC>3 Proceed lo Section 2
YES Q COMPLETE
2B and 2C
NO 0
PROCEED TO SECTION 3
c. PROFUSION
% s/o % '/a 7. '/* V. Vi */ V* Vj V+
2C. LARGE OPACITIES
SIZE | O | A~ 8 | C
PROCEED TO SECTION 3
3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
YES 'Q COMPLETE 3Q,3Clfld30
N
3B. PLEURAL THICKENING
a. DIAPHRAGM (plaque)
3C. PLEURAL THICKENING . .. Chest Wall
ft. CIRCUMSCRIBED (plaque)
b. OIFFUSE
PROCEED TO SECTION 4
SITE | O jx-l |y[ b. COSTOPHRENIC ANGLE
SITE fflf R ~L~|
30. PLEURAL CALCIFICATION
SITE IN PROFILE
i. WIOTH ii. EXTENT FACE ON i. EXTENT
0A
0* B C
0 23
0
*0 8 C
0 23
Li 2 1
SITE IN PROFILE
i. WIOTH ii. EXTENT FACE ON iii. EXTENT
,0 R 0AB C 01 23
L
0A 8 C 01 23
SITE [o s8 EXTENT
ft. DIAPHRAGM ___ 0 <j 2 3
b. WALL
____ 0 1 V? 3
c. OTHER SITES______ 0 1 V* 3
E <
niAPWRAftM b. WALL
0 0
c. OTHER SITES______ ' JO
EXTENT
1
14
12
3 3 3
PROCEEO TO SECTION 4
4A ANY OTHER ABNORMALITIES? 48. OTHER SYMBOLS (OBLIGATORY)
YES
NO 0
PROCEED TO SECTION S
O ax bu ca cn CO cp cv d< ef em e$ if hi ho id ih kl
Report items which may be of present clinical signifi cance in this section
(SPECIFY od.)
P< P* rp
Date Personal Physician notified?
OAY
1
1. CLINICAL INTERPRETATION
2. B-READING COMMENTS
There are- bilateral calcified ciaqv. aa relatively uncaaajer. v.ncfi t'.e
eroviou-: fi 1 & of 4-23-37.
PLEASE TYPE OR PRINT nameofpv^HEPPERi m d / R A HUGHES, M.D.
PHYSICIAN'S SIGNATURE
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aooress SnELL OiL Uerlvll AN !, t . U. DEER PARK, TEXAS 77536
CITY/STATE/ZIP CODE
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SIGNEO
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OATE SIGNED
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INSTRUCTIONS: WHITE COPY - FOR CORPORATE MEDICAL DEPARTMENT YELLOW COPY - FOR LOCATION MEDICAL DEPARTMENT
/
^BS--055556 LAM 032163