Document rpvxJm0z9ryLR74vNZZGqBNQq

SH-32 (REV $-781 Shell Oil Company Interoffice Memorandum FEBRUARY 13, 1990 TO: DR. ROBERT HUGHES, DEER PARK MANUFACTURING COMPLEX FROM: LOUIS C. WADDELL, JR., M.D. SUBJECT: PULMONARY REGISTRY REVIEW, This case is reviewed because of possible pleural plaque. was born in 1926 and joined Shell in July 1948. He is classified as a pipefitter. Of concern for this review is the chest X-ray which shows possible bilateral pleural plaques. As early as on the chest X-ray dated 09/04/84, there are some suspicious changes in the right lateral chest suggestive of a pleural plaque. By the chest X-ray, dated 09/15/88, these changes are much more prominent and there is also an indication on the left lateral chest wall of both in profile and en face pleural plaques. Dr. M. A. Mullican classified these changes in the film report dated 09/26/88 as showing in profile plaques bilaterally of width A, extent 1 and face en extent 1 bilaterally. There is also a film interpretation by Dr. Patrick M. Conoley, also a NIOSH certified B-reader radiologist, on four-way views of the chest dated 09/29/87. On that film reading, with the ILO classification, Dr. Conoley gave exactly the same classification as Dr. Mullican. I have also had the opportunity to review the chest X-rays and agree with these two radiologists that there are changes that are consistent with the radiographic findings of asbestos exposure seen on both lateral chest walls and consist of a pattern that is seen when there is a combination of both in profile and en face pleural plaques. Accordingly, I would recommend that this case be considered as a "bilateral pleural plaque" case and recorded as such on the 0SHA 200 log and if has not already been counseled about his chest X-ray findings and their implications then he should be. I am assuming that he has been because there is a copy of a pulmonary consultation that Shell arranged with Dr. Stan Fischer of the Kelsey Sebold Clinic which is dated January 7, 88 and in which he gives his diagnosis of bilateral pleural plaques. After the 0SHA 200 entry had been accomplished, please indicate that on the appropriate portion of the pulmonary registry form and return a copy CA9003701 - 0001.0.0 ABS-055441- LAM 032048 to us for our files. Please also indicate on the form if counseled concerning the chest X-ray findings. was Thank you for your continued help if you have any questions please give me a cal 1. CA9003701 - 0002.0.0 ABS-055442 LAM 032049