Document eXL73jX865eoG749RZyLN3M9
GARY K FRIEDMAN. M D
OCCUPATONAL UOON CONSULTANT DISEASE Of TH CHEST PRESOENT
TEXAS LUNG INSTITUTE
11200 WESTHEIMER SUITE 414
HOUSTON. TEXAS 77042
(713) 9756021
July 31, 193?
Re:
SS# Independent Medical Evaluation
Dear
I have had the opportunity to see your client, in pulmonary consultation on .July 31, 1939 at the Texas Lung Institute, Occupational and Enviromental Medicine Clinic at UT Med School/Hermann Hospital for the purpose of assessment :> f possible occupational lung disease.
As you know,
is a 62-year--old white male who retired this
year. He was accompanied by his wife at the time of examination.
had been employed at the Shell Oil Refinery-Deer par 1: where he went to work in 1932 as a boilermaker. He also worked in the Bui 1 Gang. In 1944, he worked as a tael welder at the Todd Shipyard and, in 1947, worked as a millwright until 1932. During the course of almost all of his occupations, he has had significant exposures to asbestos while either working with the material himself, re-moving the material or being exposed to other workers who were either applying or
r e iti v i n g t h e material.
The patient describes his asbestos exposure as significant, frequently being ab1e to see the dust.
The patient has done some welding, primarily iron, steel and stainless we 1dln g.
The patient has never sandblasted or been over com* by noxious fumes. He 'did become somewhat short of breath when working with rosins and pheno 1 .
The patient had a brief smol inq history, starting at age X-' and
stopping smoking at age 23. He enly smoked one --hal f pack a day arid is
computed to have about a .3--pack -year history or less.
He has never
been diagnosed with asthma, emphysema, IB, lung cancer or ether
serious pulmonary disease. He was found to have a "spot" on his lung
by Shel 1 Oil but was not told t h _ nature of the spot. Subsequently,
h e h a d f' e r i o die c h e s t ; -rays.
LAM 032153
ABS-055546
Mr. F*?:
... SS#
Page 7/31/8?
The patient denies significant respiratory symptoms at this his exercise tolerance is reasonably well preserved.
time and
Except for a broken nose, he does not have any significant priormedical history arid his review of systems is negative at this time.
PHYSICAL EXAMINATION:
On physical examination, he was a very plea
sant, wel 1 --no'jri shed white male, in no distress.
Height was 6?
inches, weight 155 pounds, blood pressure was 146/93. Head, eyes,
ears, nose and throat were essentially unremarkable, except for his
prior broken nose. Neck was supple, .JVP not elevated. The chest was
clear- to auscultation and percussion. The heart had a regular- rhythm,
no gal lop, rub or murmur-. The abdomen was soft, 1 iver and spleen not
enlarged.
The extremities showed no clubbing, cyanosis or- edema.
Neurologic examination was grossly intact.
CHEST X-RAY:
PA, lateral and oblique s'iews of the chest were re
viewed. There is significant linear calcification within both hemi --
diaphragms. Extensive en face plagues which are calcified are noted
ori the left. Pleural thickening along the left lateral chest wall is
observed as well.
SPIROMETRY: The patient s spirometry is within normal limits,
vital capacity of 4.16 liters is 947. of predicted.
There
significant change following bronchodi lator-s. FF.V-1 is normal
liters. The FEV-l/FVC ratio is normal at 347..
For ced is n o at 3.50
OPINION:
It is my opinion that your
has
benign asbestos-related pleural disease without significant impairment
of lung function. At this time, there is no evidence of lung cancer,
mesothelioma or other as bestos --re 1 ated malignancy.
The patient has been fully advised as to the consequences of his prior
asbestos exposure arid is recommended to return in one year.
He is to
Ij ay attention t o this s t oo1s f o r p os sib1e b1ood d ue to increased r is k
>: f G I ma 1 ignancy.
Thank you for allowing me to participate in his care.
S i n cere 1\y y o u r s ,
G1 F: ge f\: :-:/< i.'/G ' T: 3/11/3?
G. F- Friedmaxi, M.D.
LAM 032154 ABS-055547
S-13290 (4/89) 006061
PULMONARY REGISTRY
CONFIDENTIAL - MEDICAL
EMPLOYEE NAME (First,
S-12972 (11-86)
ILO PULMOk. JRY SURVEILLANCE WORKSHEET
Last)
EMPLOYEE NUMBER
#
DATE OF X-RAY REAOlNG
COMPANY
i--1 SHELL 1--1 OIL COMPANY
1--1 SHELL CHEM. I--1 SHELL DEV.
1--1 COMPANY
1--1 COMPANY
OTHER
TYPE OF EXAMINATION
11 CD 0I--| ISpocify)----------------------------------------------------
ASBESTOS
SILICA
OTHER
0 rSpee.l^J|ftr'|Nf-)CJc;
1 A. DATE OF X-RAY
H &5bi7
IB. FILM QJUUftfcffS | \ 3 |u/~
2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
2B. SMALL OPACITIES
a. SHAPE/SIZE
SECONOARY
b. ZONES
If Not Grade i Give Reason:
1C. IS FILM COMPLETELY NEGATIVE?
YES 1 i Proceed 'o i--1 Section 5
NO I
f~lYES
complete
I--* 28 and 2C
NO
PROCEED TO SECTION 3
C. PROFUSION
% % /l '/o '/, '/z V, */z 7 V2 Vj V-
2C. LARGE OPACITIES
size | o A~|~ajc
PROCEEO TO SECTION 3
3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
YES
38. PLEURAL THICKENING
a Diaphragm (plaque)
3C. PLEURAL THICKENING . . . Chest Wall
a. CIRCUMSCRIBED (plaque)
complete
30. 3C and 30
NO
b. DIFFUSE
PROCEEO TO SECTION 4
6SITE
R|I
b COSTOPHRENIC ANGLE, SITE \&\R | L |
30. PLEURAL CALCIFICATION
SITE IN PROFILE
. WIDTH ti. EXTENT FACE ON lii EXTENT
0 I rt"
0I B C
03
SUTT
0
0
a' f
C
0 r2 3
l h2H
SITE IN PROFILE
i. WIDTH
ii. EXTENT
FACE ON lii. EXTENT
SITE
a. DIAPHRAGM ....... b. WALL .................... C OTHER SITES
o' 0 0 0
EXTENT 1 23 1 23 1 23
a DIAPHRAGM.. b. WALL ............... c. OTHER SITES
4A. ANY OTHER ABNORMALITIES'* 48. OTHER SYMBOLS (OBLIGATORY)
YES
COMPLETE 4Q and 4C
0|A e C Oil 2 3
11 12131
0| L
0jA S c 0 1 Li. 3
1011 1213
'0 L 0 0 0
EXTENT t 23 1 23 1 23
PROCEEO TO SECXiON 4
NO ET
PROCEED TO SECTION 5
bu ca cn CO cp cv di ef | em es fr hi ho <d ih kl
Report items which may be of present clinical significance in this section
------- 1 |_____|
(SPECIFY Od )
pi P* rp tb
Date Personal Physician nod?
OAY
I_
1. CLINICAL INTEFIPRETATION PA chest, lateral and oblique views:
2 B-READING comments
3-view chest dated 11/20/87 with a PA study dated 9/30/87.
The examination demonstrates the presence of widening of the pleural stripe along each.
lateral thoracic wall without evidence of ca Lcification or effusion. The finding is
essentially stable since 1978. It is unlike Ly to be due to asbestosis but continued
please type or PRiNTar^nua-I foilow-up is recommen i^NYSfCl}AN-'f SIGNATURE / 7
NAME OF PHYSICIAN
Patrick M. Conoley, M.D.
AOORESS
6624 Fannin
TTY <TA7= P
;
; Houston, "I \
'it!)
SIGNED
IT/27/87
-;
ADC ACrr ^ 11AJO
LAM 032156