Document wgXZL7q7eQ7voDd40wNeq9m4V

* , ,r**' fc * January 12, 1972 HtncrtriJwi for tha Record Review of Dr. Hurst's Medical Study of the Tyler Plent Employees January 6, 1972 The subject review took place at the East Texas State Chest Disease Hospital and tha following participated: Dr. Ceorge Hurst Dr. Richard Spiegel Mr. Richard Lesea Dr. tee Crane Hospital Director NIOSK KIOSH Medical Consultant to Pittsburgh Corning Corporation The tedleal data reviewed was that obtained by Dr. Hurst's group and by KIOSK on approx:=etely 60 Tyler Plant eesloyees. Also available were additional chert X-rays takes on sose c: these employees in 1969. The standards used in evaluating the pulnontry function data la attached. The blood gases standards used are se follows: P.R. PCOj POj 7.4 33-43 85-90 NI05H used the following criteria in staking an epldeslological diagnosis of asbestosla. Three of these criteria aust ba positive to make tha diagnosis. X. FVC (4 if obsarvad la less than 80S of prediettd) XX. Dyspnea (4 if Dyspnea occurs while walking with peopla of.own age on tha level) XXI. Xales (4 if at least one srea of persistent rales is observed) * XV. Clubbing. (4. if all of following are present: dcnlng of n4S, floating.of .nail and flattening of the bass or T ?ss of angle) V. X-rey <4 if l* or core classification for pneumoconiosis la read by.KIOSH experts) j 1 J ( 2 Oi(ft| the tv< itiadirJi end.criteria the foilowing lunury of finding* vat cads: -> An epidemiological diagnosis of asbeatosis vat mad* on cevan employees thut far* Additional such diagnoeit cay develop at a result of th* X-ray review by the KIOSK panel of experts. Six of these seven shoved a "mild teduction" in carbon cosoxid* diffusion capacity. Th* seventh shoved a normal diffusion capacity. Only one other employe* shoved a "mild reduction". Thera erpeared to be an increase in the number of ecployeea shoving ebnorca. findings sssoclated vith the lungs in the employee group who have worked 10 or core year* in unibeatoa manufacturing, l.e., 15 of 17 employees, than those who have worked lets than 10 years, i.e., 14 of 42 employees. 'The workers with 10 or sore years in uribestos unufacturing had an average eg* about 10 years greater then the average age of those with less than 10 years in vnibestes oanufacturfng. Abnormal fincings associated vith the lungs increased in suober vith increasing age. All of the employees with abnormal findings had a long history of cigarette rooking. Sixteen of these ecployeea shoved a cild and two a noderate obstructive defect la * their putoonary/function studies. Aa obstructive defect is felt to be ^ associated ex inly with the effects of smoking, h'ine employees shoved a slid and three a coderate restrictive defect in their pulmonary function studies. Interstitial fibrosis In asbestos!* it one of several poeaibla ceusea of a restrictive detect. However, it this study the restrictive defect occurred in only four of the 17 employees vith 10 or core years in unibeatoa manufacturing, while it occurred in 8 of 34 ecployees vith leas thaa 5 years *in tabes tosia manufacturing. fight ecployeea had abnoraal findings not associated vith th* lungs such at hypertension or obesity. It vat detercined that 23 esployeet will be-counseled or exaained further by Or. Curst based upon the review of the cedieal data. Six of these employees will, in addition, be re-examined by Or. Burst In 2 years and on* *111 be re-exsained in 1 year. * ihen the counseling is completed, Or. Burst will prepare a report on itch of the employees including th* pedicel data obtained, an interpretation >f th* data and the nature of the counseling provided. As requested by Ir. Steven Vodka, Citizenship-Legislative Department of the Oil, Cheaical nd Atonic Workers International Union, these employees* eedlcal reports 'ill be sent.to the employees. hen KIOSK receives^!}* results of the reading of the X-rays by the neuaoceniosis panel of experts, it will notify those ecployees who have bnor&al findings advising them either to see Dr. Hurst for lung - v j # -3- abnoraalltles or their ovn personal physician for other abnormalities. A copy of the letter, along with e report of their findings, vill be cent to the eaptoyee's personal physician on the employee** request and to doctors Hurst and Grant. Dr. Grant vill send letters to all esployees without abnormalities advising them of this /act. He vill not send this until after receiving the result* of the N10SH pneumoconiosis panel readings. IKilh Copies to: W. FarV.os . K. Kolsan C. Hurst R. Leaen R. Spiegel C. E. Van Horne H. C. Vufcatcb Lee B. Grant, K.D. Medical Director