Document a1G5dB5pRzgdyDKo5kMqR53eb

SM-32 (REV. 5-78) Shell Oil Company Interoffice Memorandum FEBRUARY 10, 1993 MOST CONFIDENTIAL FROM: L. C. WADDELL, JR., M.D., MEDICAL DIRECTOR CLINICAL MEDICINE, CORPORATE MEDICAL DEPARTMENT TO: A. THOMANN, M.D., MEDICAL DIRECTOR DEER PARK MANUFACTURING COMPLEX SUBJECT: PULMONARY REGISTRY REVIEW EMPLOYEE NUMBER This case is reviewed because of a chest X-ray report that suggested possible pleural thickening on the left mid-lung field consistent with a possible pleural plaque. was employed at the Shell Deer Park Manufacturing Complex from 1952 to 1987. The only chest X-ray in the folder is PA and lateral view taken March 13, 1985. The radiologist Dr. M. S. Soosaipillai stated "there is an ill-defined area of density overlying the left mid lung field in the perihilar region. This could be due to some pleural thickening. Suggest old films in order to compare this area." The PA film of that date shows an area of increased opacity with poorly defined borders the general size of which is approximately 4 cm. in width and 3.5 cm. in its superior inferior axis. This has the general appearance of a pleural or extra pleural shadow rather than a parenchymal density. This radiographic finding is consistent with the type of pleural thickening that can occur with asbestos exposure. There are obviously other possible causes as well. The Pulmonary Registry form indicates in its answer to question 5 that the employee has worked in a facility that used asbestos, so it is at least possible that a pleural plaque could be related to his job exposure. Judging from the time frame in which he worked at Deer Park, it is certainly possible as well on that basis. The Pulmonary Registry form indicates that Shell Oil service in 1987. left ABS-055376- LAM 031983 If OSHA regulations require recording on the 200 Log occupational conditions 6 years in the past, then this should be recorded. However, I am not the person with whom to consult concerning the exact time cutoff requirements for OSHA 200 Log recording. That would be best handled by the OSHA Log keeper at your location. However, this shadow is consistent with an asbestos related pleural plaque and should be recorded on the OSHA 200 Log unless it is the case that the time elapsed is sufficiently long so that requirement no longer applies. Thank you for sending this case for review. ABS-055377 LAM 031984 S-13260 <4/89) 000061 CONFIDENTIAL - MEDICAL NAME 06 cua s \ - ', .' , w, *t ' %> ?wN>' *''' RE-SON FOR REVIE1 / 1. CHEST X-RAY REPORT INDICATING: >* ' v a) Possible pleural abnormality ^ v y-W ' ' ',* v ' '. . f v ' . S.N* 'C* -. *\ /< r*>t >- a<a'<ns - * s'/' ' ' 7. Has me employee had a Job where it is possible, or likely, mat he has been exposed to some oiher agent known to cause a dust disease of me lung, (e.g.. Silica, eta)? If so. Hst ,--, ,--. YES NO p) Pn<;<ahl<i fihrn<a<? 2. PULMONARY FUNCTION TEST ABNORMALITY: a) Fvo loss man 75% of prorlirtod h) Othor f~C1/ 1 "7 A ^ i % Other reason (or review 8. PLEASE LIST JOB TITLES ANO NO. OF YEARS IN THAT POSITION 9. Is mere any history of other respiratory illness mat could account for me X-ray abnormalities under consideration? If so, list I j vcc i--i 1__ 1 Ytb 1 I N(-> * jTM ( vo a c) 10. Is mere a history of exposure to a pneumoconiosis producing agent outside of employment at Shell ----------------------------------- 1_=----- 1 -------------------------------- (prior to working at Shell or associated with a part- time job, or avocation)? If so. list 5 Has tne employee worked In a facility mat used i--i i--i asbestos so mat it is possible mat a pleural plaque | | YES |___ | NO could be related to )o6 exposure? 6. Has the employee worked at a job (e.g., bricklayer, insulator, etc.) tor a sufficient time (usually at least 10 years) for it to be likely mat asbestosis could have developed? |--| ,, |--| 1___1 Ytb !__ 1NU .--. .-- -YES ^Tno --1 1--1 RESULT OF REVIEW; Recommendation; 'iKll'i L*J~hn______ WC jjwi'ftWvwC pki6^L.p/^u/L lr iACSM^aA REVIEWED ^ f)-P kt U'kf 'Kff' hMiA. NOTE: (chock list of actions tdbe completed by the Company doctor and returned to registry in Houston, with one copy to be retained in employee's chert)_________________ DATE IF POSSIBLE FIBROSIS DATE P3tient B y Dr - S counseled: 7v/e OSHA Form 200: Worker's Compensation: ov^ 1 - 1 --^ ^^ i^cZi & i^C-^ ' Patient counseled: Me MH4a OSHA Form 200: Worker's Compensation: EMPLOYEE REFERRED TO DR. (Please send copy ol consultation when available) w owy` f As COMMENTS: ---AZAjsNZ.I-^2--+1---^ -Li l^..ijlJ r ft** t-t ^ %mv.nh*+ 7 CONTEMPLATED FOLLOW-UP PERIODIC EXAM | | OTHER ABS-055378 LAM 031985 s-t2972 (11-46) ILO PULMONARY SURVEILLANCE WORKSHEET EMPLOYEE NAME (First. Middle. fit) COMPANY 11--1 SHELL __ 1 OIL COMPANY I 1r--1 SHELL CHEM. -- COMPANY 1 1rn SHELL OEV. -- COMPANY EMPLOYEE NUMBER OATE OF X-RAY REAOING OTHER TYPE OF EXAMINATION 1 1 (X)( nf--I _ -- ISpaeity)----------------------------------------------------- ASBESTOS SILICA /X- /J. -fb OTHER n tsnerrty. 1 A. DATE OF X-RAY NTH pAY VP L-l 4i ni p IB. FILM QUALITY F 2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 28. SMALL OPACITIES a SHAPE/SlZE PRIMARY SECONDARY b. ZONES if noi Grade i 1C. IS FILM COMPLETELY NEGATIVE? YES |__[ io Section 5 NOpfl Proceed to Section 2 YES I i complete I-----1 20 and 2C NO PROCEEO TO SECTION 3 C. PROPUStON % Vo % Vo V. /?_ V. V; Vo V* Vo V* 2C. LARGE OPACITIES |O A | 3 C| PROCEED TO SECTION 3 3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 38 PLEURAL THICKENING a. DIAPHRAGM (ptaquel 3C. PLEURAL THICKENING a CiRCUMSCRtBEO (plaque) EYES COMPLETE 3B. 3C and 30 Chest Wall NO Q PROCEED TO SECTION 4 S,TE I o | ! Y) b COSTOPHRENiC:ANGLE SITE l|vVtt KI *-1 30 PLEURAL CALCIFICATION SITE <N PROEfLE < wioth H EXTENT FACE ON n. EXTENT a OiaPhRaGm b wall c OTHER SITES *1 R 0 0 0 EXTENT i 23 123 123 4A. ANY OTHER ABNORMALITIES? 4B OTHER SYMBOLS (OBLIGATORY) SITE IN PROFILE . wioth t< extent FACE ON m EXTENT a OlAPHRAGM b. WALL c OTHER SITES YES COMPLETE 48 and 4C L 0 0 0 EXTENT 1iJ '! * ' i2 3 3 3 PROCEEO TO SECTION 4 NO PROCEEO TO SECTION 5 bv cl cn co Report iiems which may be. Ol present clinical S'Qnifr- | 1 i (SPECIFY od) cance m ths section |____ J cv I di e< I em j es j fr hi ho h kl 0< I D I *P Oate Personal Physician notified9 OAY -I-- 1. CLINICAL INTERPRETATION 2. B-READING COMMENTS There are arteriosclerotic changes of the aor ta. There is a small calcified granuloma at the right lung base. There is a focal con ./exity of the left diaphragm which is if anything a little less pronounced than on pre irious films of 2-3-87. ABS-055379 PLEASE TYPE OR PRINT No*MCtdw-?cP j SHELL Of!. CCPA.r-Y PnM Taa5 77536 city/state/zip cooe " PHYSICIAN S SIGNATURE Pa, c f oSiCNEO /;v;- OATE SIGNED LAM 031986