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Overview of Occupational Pneumoconiosis. Jack Kinder, M.D. Basic Function of the OP Board. Evaluate for presence or absence of disease Determine level of impairment Protest hearing testimony. Evaluation of Claimant. Work history Medical history X-Ray PFTs Physical exam of the chest.
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Overview of Occupational Pneumoconiosis Jack Kinder, M.D.
Basic Function of the OP Board • Evaluate for presence or absence of disease • Determine level of impairment • Protest hearing testimony
Evaluation of Claimant • Work history • Medical history • X-Ray • PFTs • Physical exam of the chest
Exposure History - Coal • Type of work- Underground- Surface
Exposure History - Asbestos • Industrial • Private employment
Medical History • Respiratory- Illness - Surgery • Medications- Beta Blockers- Pulmonary Meds
X-Ray Evaluation • Pleural Disease • Parenchymal Disease
Pulmonary Function Testing • FVC • FEV1 • FEV1/FVC Ratio • Diffusion • ABGs
Physical Exam of the Chest • Abnormal breath sounds • Cardiac Disease • Chest wall deformities
Special Considerations • Malignancy • Cardiac Dysfunction • Transplantation
Pulmonary Malignancy • Primary Parenchymal Cancer • Mesothelioma
Primary Lung Cancer • Coal Exposure • Asbestos Exposure- Tobacco Influence
Mesothelioma • Special Type of Pleural Disease • Without Parenchymal Disease • Tobacco Exposure
Cardiac Disease • Role in Pulmonary Dysfunction • Cor Pulmonale
Coronary Atherosclerosis • Primary Disease of the Heart • Myocardial Infarction
Cor Pulmonale • Right Ventricular Size • Emphysema or Pneumoconiosis
Cardiac Transplantation • Rare Event • Multiple Factors
Type of Transplant • Single Organ • Double Organ
Examples of Claimants • 42 year old Coal Miner • 12 years surface mine- Blaster / Drill • Non Smoker • PFTs- FVC 62%- FEV1 67% - FEV1/FVC Normal
Examples of Claimants • 78 year old Plant Worker • 40 years Pipe Fitter • 45 years – 1 ppd smoker • PFTs- FVC 70%- FEV1 50%- FEV1/FVC 45%- Diffusion 50%
Examples of Claimants • 70 year old Coal Miner • 35 years underground roof bolter • 40 years – 1 ppd smoker • PFTs- FVC 60%- FEV1 30%- FEV1/FVC Total Impairment • Right Lung Mass