Document jm2ajmJeDp1ZZgkpqLgpkOv7Q

SM-32 (BCV. S-7S) Shell Oil Company Interoffice Memorandum FEBRUARY 1, 1990 FROM: L. C. WADDELL, JR., M.D. TO: DR. ROBERT HUGHES, MEDICAL DIRECTOR DEER PARK MANUFACTURING COMPLEX SUBJECT: PULMONARY REGISTRY REVIEW EMPLOYEE NUMBER This case is reviewed because of possible pleural plaques. began employment at Shell in 1952, and has worked as a pipe fitter, a general helper, a pumper gauger and craft foreman since that time. He retired in 1988. I have had an opportunity to review the chest x-rays that are contained in his film folder. The chest x-rays show bilateral lateral wall opacities that are compatible with combination of profile pleural plaques and on-face pleural plaques as well. The contour at the apex of the left hemidiaphragm is irregular which is consistent with - but certainly not diagnostic of diaphragmatic pleural plaque formation. There is also a suggestion of pleural plaques on the oblique views. The chest x-rays have been reviewed by two radiologists, both of whom are NIOSH certified B-Readers. They agree that there are non-calcified pleurarT plaques bilaterally. Neither film reader indicated that there were radiographic findings of parenchymal fibrosis. His spirometry as reported on his asbestos surveillance physical examination sheet dated 9/1/87 shows a forced vital capacity and a FEV,. Both were greater than 100% of predicted. In summary, this is a person who is retired from with a job history that is consistent with having had some occupational exposure to asbestos with chest x-ray changes that are compatible with bilateral pleural plaques. I would suggest that he be entered on the OSHA 200 Log as bilateral pleural plaques. If he has not already been advised about the presence of plaques, he should be. Judging from the physical examination report of 9/1/87, it would appear that he has already been informed about the findings. LAM 032098 CD9002301 ABS-055-49X 2 Along with this consultation report we are enclosing a copy of the Pulmonary Registry Form with out portion completed. After the OSHA 200 Log record entry is made, please indicate that in the appropriate box on the form and return a copy to us for our files. Thank you for your continuing help with this program. If you have any questions, please give me a call. Enclosure CD9002301 ABS-- LAM 032099 S-1320O(4/S9) 006061 i\ PULMONARY REGISTRY CONFIDENTIAL-MEDICAL NAWEOFEM^jOyEE EMPLOYEE REASON FOR REVIEW -- - 1. CHEST X-RAY REPORT INDICAuTiInNGu:: .. a) Possible pleural abnormality j / hf Q /"-V I /sliMfAtLi-hOA___ (l fjmjrL_____ LOCATION OJP/VC- T" - l 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 ol the lung, (e.g., Silica, etc.)? If so. list ,--. __ I YES 1 NO -- 1--1 2. PULMONARY FUNCTION TEST ABNORMALITY: a) FVC less man 75% of predicted______________ b) Other. 3. Other reason lor review 8. PLEASE LIST JOB TITLES AND NO. OF YEARS IN THAT POSITION 9- is there any history of other respiratory Illness that could account for (he X-ray abnormalities under consideration? If so, list |--| v__ i--i I___ IYtb I |N<-) Time of service S. 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? Q YES Q NO to. Is there a history of exposure to a pneumoconia producing agent outside of employment; (prior to working at Shell or associated time job, or avocation)? II so. list i--1^-_ i--i., I___ IYfcb I__ INU YES| )NO . RESULT OF REVIEWtp^ pyg \Jf /fclU-jlT/ V -V ' 7c, Recommendation: l--/-t--v------C- U... - 'ty - T) Rei cous,' tuk h r Ji ),, /TTklXL I \pr U J ttrr /jri- 1/SJ 47 - /.ciYp ' ?/7; /l/f^ fan ns J ,rAOTE (chock list ol actions to be completed by the Cbmpanyfdoctor and urriturned to registry in Houston, with one copy to be retained in employee's than) IF PLEURAL CHANGE DATE IF POSSIBLE FIBROSIS DATE Patient counseled: OSHA Form 200: hr Worker's Compensation: EMPLOYEE REFERRED TO DR. (Please send copy ol consultation when available) 3 OflS NAME Patient 9i counseled: OSHA Form 200: Worker's Compensation: COMMENTS: CONTEMPLATED FOLLOW-UP Q PERIODIC EXAM INSTRUCTIONS: PART 1 - WHITF COPY - LOCATION MEDICAL DEPARTMENT Q OTHER ABS-055493 LAM 032100 s-i7j(n.i ILO PULMONARY SURVEILLANCE WORKSHEE1 EMPLOYEE NAME (Fint. UhMH. U<0 COMPANY r--j SHELL 1--1 OIL COMPANY 1--1 SHELL CHEM. 1--1 COMPANY 1--1 SHELL DEV LJ COMPANY EMPLOYEE NUMBER Da l E OF X-RAY READING 11-29-89 OTHER TYPE OF EXAMINATION r-j (__ 1 (Specifyf----------------------------------------------- J3 ASBESTOS SILICA OTHER Q (Specdri ---------- 1A. DATE OF X-RAY n mwj IB. FILM QUALITY JS u/ 2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 28. SMALL OPACITIES a. SHAPE/SIZE SECONDARY PS q ?< ru me If Not Grade 1 Give Reason: YES c PROFUSION %%* '/o '/. /. V? V, v2 Vj j/y 1C. IS FILM COMPLETELY NEGATIVE? YES Proceed lo Section S NO [5?1 Proceed 10 K-jJ Section 2 C0MPLETE 2B and 2C no Q 2C. LARGE OPACITIES PROCEED TO SECTION 3 SIZE c| PROCEED TO SECTION 3 3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? YES 3B. PLEURAL THICKENING a OiAPHRAGM (plaque) 3C PLEURAL THICKENING . . Chest Wall a CiRCUMSCRiBEO (plaque) complete 38. 3C and 30 NU b OIFFUSE PROCEED TO SECTION 4 Site EL b COSTOPHRENIC angle site i 30 PLEURAL CALCIFICATION SITE IN PROFILE i WlOTH m EXTENT f ACc On in EXTENT a DIAPHRAGM 0 WALL C other sites n /0 0 0 EXTENT 123 123 123 SITE IN PROFILE 4 WtOTH m EXTENT FACE ON in EXTENT R 0A 8C 0t 23 23 %\<- 0 a|b|c 01 23 a DIAPHRAGM b WALL C OTHER SITES 2L L 0 0 0 EXTENT t 23 t 23 1 23 PROCEED TO SECTION 4 4A ANY OTHER'aBNORMAUTIES9 YES M f^^L^E NO [_J sef,oj?5T 4B OTHER SYMBOLS (OBLIGATORY) jo a* bu ca cn j co | cp c* di el em | es | Reoorl items which mar <> o( present clinical signili- ---- (specify od I cance m this section L._J | n< ( no J *d tn J hi | p* | lb I Date Personal Physician notified9 MQNIh Day VM li1 1l^LeNI<h/^alr1t^ s'Ne11?^ normal. There appeal 2sBtS>AWTl^!^ elevation of the left diaphragm and there is some thicl ;ening and depression of the minor fissure. There are minimal small opac: ties in the lower lung fields. I believe that there are some noncalcifiec 1 pleural plaques bilaterally which are seen to better advantage with this ; technique as_compared with last year PLEASE TYPE OR PRINT NAME OF PHYSICIAN ADDHESS . - - - -^ KJbJ-Ji-.S, M.D. CITY/STATE/ZIP CODE ~ 1 ' 0. DC A 100 f /sPK Tf;Yfic `nu-in PHYSICIAN S SIGNATURE /(''.A' flx^dLO^-c SIGNED //-tf gP? date signeo _____ __ _______ ___ ABS-055494 INSTRUCTIONS: WHITE COPY FOR CORPORATE MEDICAL DEPARTMENT LAM 032101