Document mvzEx80Dp7QQ4MEvw04pJEDQ

1" Robert A. Hughes, M.D. Shell Oil Company Deer Park Manufacturing Complex P.0. Box 100 Deer Park, Texas 77536 RE: EmpIovee Dear Bob: Thank you so much for asking me to see I examined him on the 16th of January. Review of his history indicates that he is a 62 year old white man who smoked less than a package of cigarettes a day for more than AO years, quitting about four years ago. He has not had respiratory symptoms and denies cough, wheezing, shortness of breath, and chest pain. In his early years he worked for Diamond Shamrock from 1952 to 1976 and for Shell from 1976 to the present, working as an insulator. During his early years he was exposed daily to visible dust in the air and was involved in cutting asbestos board which produced large amount of dust. He worked largely indoors early on. Since working for Shell, he has had very little dust exposure, if any. His general health has been good. He had surgery to remove his tonsils and adenoids and has had a hiatal hernia repair. He has had multiple lipomata. On physical examination, there was no clubbing or edema. He had no adenopathy. Multiple lipomata were present. The tonsils were absent and he had an abdominal surgical scar consistent with a surgical history. Mid to late inspiratory rales were audible over the inferior portion of his lower lobes, predominantly on the left. There was no wheezing. LAM 032109 ABS-055502 2- - Review of his chest x-rays demonstrate en fase shadows consistent with uncalcified pleural disease which is compatible with his history of asbestos exposure. In addition, the presence of late inspiratory rales may well represent early asymptomatic pulmonary fibrosis, also consistent with a history of asbestos exposure. As noted above, he remains asymptomatic. No further evaluation is indicated (although a CT scan of his chest would document the pleural changes to a better degree and would help to identify intra-pulmonary abnormalities, if present). He should remain in the asbestos surveillance program, of course, and be evaluated clinically, with spirometry and by x-ray on an annual basis. Again, many thanks for asking me to see him with you. With best regards. Stanton P. Fischer, M.D., F.A.C.P. Physician In Chief Cliincal Professor of Medicine Baylor College of Medicine SPF/gf LAM 032110 AUS-055503 NAME Of EMP S-13280 (4/80) 006061 PULMONARY REGISTRY EMPLOYEE number TIVOU zbe- CONFIDENTIAL - MEDICAL REASON FOR REVIEW 1. CHEST X-RAY REPORT INDICATING: a) Possible pleural abnormality L~l7lU1 rtnj- ft &T ff b) Possible fibrosis 2. PULMONARY FUNCTION TEST ABNORMAUTY: a) FVC less than 75% of predicted______________ 1 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 1--1 8. PLEASE UST JOB TITLES AND NO. OF YEARS IN THAT POSITION ^r~___________________________________________ ______ b) Other. 3. Other reason lor review 9. Is there any history of other respiratory illness that could account for (he X-ray abnormalities under consideration? If so. list yes NO 4 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 Job 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 that asbestosis could have developed?____________ r--I--I | C-fYSS | NO 10. Is there a history of exposure to a pneumoconiosis producing agent outside of employment at Shell (prior to working at Shell or associated with a parttime job, or avocation)? If so, list E'yesQ NO yes NO REVIEWED W BY f pmn/ A 'VVW /EexW' n</ OSMZ NOTE: (check list of actions to be completed by the Company doctor end returned to registry in Houston, with one copy to be retained in employee's chart) jEURAL change IF POSSIBLE FIBROSIS DATE Patient counseled: OS HA Form 200: Worker's Compensation: EMPLOYEE REFERRED TO DR. (Please send copy of consultation when available) orrs NAME Cjf) Patient counseled: OSHA Form 200: Worker's Compensation: COMMENTS; (j&Uijdt. CONTEMPLATED FOLLOW-UP 4 PERIODIC exam INSTRUCTIONS: PART 1 - WHITF COPY - I OCATION MPniOAl HFPARTMFNT I I OTHER ABS-055504 LAM 032111 T S-12972 (11-88) ILO PULMONARY SURVEILLANCE WORKSHEET EMPLOYEE NAME (Fim. UiddH. Lmslf COMPANY {--I SHELL 1--* OIL COMPANY I--J SHELL CHEM. 1--1 COMPANY 1"] SHELL DEV 1--1 COMPANY EMPLOYEE NUMBER DATE OF X-RAY REAOING U-28-89 OTHER TYPE OF EXAMINATION 1--| /c. ASBESTOS SILICA 1--1 f Specify*---------------------------------------------------- OTHER (Spec,A,. 1 A. OATE OF X-RAY MONTH OAV __I__ I 1B. FILM QUALITY 2A. ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 28. SMALL OPACITIES a. SHAPE/StZE SECONDARY b ZONES it Not Grade t 1C. IS FILM COMPLETELY NEGATIVE? YES I I Proceed to 1--1 Section S NO Proceed to Section 2 YES I I COMPLETE I-----* 20 and 7C NO fs/l proceed to SECTION 3 c. PROFUSION %% % 7 7. 7a V- 7j Vt V* 7j 7* 2C. LARGE OPACITIES SIZE 0 A IB C PROCEED TO SECTION 3 3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? 36. PLEURAL THICKENING a. DIAPHRAGM (piaquel 3C. PLEURAL THICKENING a CIRCUMSCRI6ED (piaquel pYES COMPLETE 38. 3C and 30 Chest Wall NO Q PROCEED TO SECTION 4 I lx]SITE o | R b COSTOPHRENIC ANGLE SITE 1QIY11 30. PLEURAL CALCIFICATION SITE IN PROFILE r WIOTH ii EXTENT FACE ON m. EXTENT <l" 0I I B |C 2h 0 12 3 o| A | B 1 iY 3 H'yl a DIAPHRAGM t>. WALL ........... c. OTHER SITES lx R 0 0 0 EXTENT '12 3 112 3 '12 3 < o < O SITE IN PROFILE i WIOTH ... EXTENT face on <m EXTENT a|c o| I 2Ll O AI3 C 0i I 0 i ' I?! 31 | QI 1 |2!3 1 a (Diaphragm b WALL................. c OTHER SITES L EXTENT : 0 1 | 2| 3 0 1 | 2| 3 0 1 | 2| 3 PROCEED TO SECTION 4 4A. ANY OTHER ABNORMALITIES9 4B. OTHER SYMBOLS (OBLIGATORY) YES U COMPLETE 46 and 4C NO PROCEED TO SECTION S O ax bo | cn co | co j cv | di j e< j em jes j !r t m j no j to Report ttems which may to*'*'- of present clinical signili- . i {SPECIFY od i cance in this section .1 f ; M ! P* P 'P j lb Oate Personal Physician notified9 1 CLINICAL INTERPRETATION 2 8-READING COMMENTS Previous films are not availai >le for comparison. Judging from previous reports, the appearai ice of the chest is most likely unchanged. PLEASE TYPE OR PRINT NAME OF PHVSlC.AN AOORESS city/state/zip cooe PHYSICIAN S SIGNATURE /4---- SlGNEO r n-H-h OATE SIGNcO > INSTRUCTIONS: WHITE COPY - FOR CORPORATE MEOlCAL DEPARTMENT vci i o*.\f rnov cno i nrnTinM ucnrm ncoftBTMCMT