overview of occupational pneumoconiosis jack kinder, m.d
TRANSCRIPT
Overview of Occupational Overview of Occupational PneumoconiosisPneumoconiosis
Jack Kinder, M.D.Jack Kinder, M.D.
Basic Function of the OP BoardBasic Function of the OP Board
Evaluate for presence or absence of diseaseEvaluate for presence or absence of disease Determine level of impairmentDetermine level of impairment Protest hearing testimonyProtest hearing testimony
Evaluation of ClaimantEvaluation of Claimant
Work historyWork history Medical historyMedical history X-RayX-Ray PFTsPFTs Physical exam of the chestPhysical exam of the chest
Exposure History - CoalExposure History - Coal
Type of workType of work- Underground- Underground- Surface- Surface
Exposure History - AsbestosExposure History - Asbestos
IndustrialIndustrial Private employmentPrivate employment
Medical HistoryMedical History
RespiratoryRespiratory- Illness - Illness - Surgery- Surgery
MedicationsMedications- Beta Blockers- Beta Blockers- Pulmonary Meds- Pulmonary Meds
X-Ray EvaluationX-Ray Evaluation
Pleural DiseasePleural Disease Parenchymal DiseaseParenchymal Disease
Pulmonary Function TestingPulmonary Function Testing
FVCFVC FEVFEV11
FEVFEV11/FVC Ratio/FVC Ratio
DiffusionDiffusion ABGsABGs
Physical Exam of the ChestPhysical Exam of the Chest
Abnormal breath soundsAbnormal breath sounds Cardiac DiseaseCardiac Disease Chest wall deformitiesChest wall deformities
Special ConsiderationsSpecial Considerations
MalignancyMalignancy Cardiac DysfunctionCardiac Dysfunction TransplantationTransplantation
Pulmonary MalignancyPulmonary Malignancy
Primary Parenchymal CancerPrimary Parenchymal Cancer MesotheliomaMesothelioma
Primary Lung CancerPrimary Lung Cancer
Coal ExposureCoal Exposure Asbestos ExposureAsbestos Exposure
- Tobacco Influence- Tobacco Influence
MesotheliomaMesothelioma
Special Type of Pleural DiseaseSpecial Type of Pleural Disease Without Parenchymal DiseaseWithout Parenchymal Disease Tobacco ExposureTobacco Exposure
Cardiac DiseaseCardiac Disease
Role in Pulmonary DysfunctionRole in Pulmonary Dysfunction Cor PulmonaleCor Pulmonale
Coronary AtherosclerosisCoronary Atherosclerosis
Primary Disease of the HeartPrimary Disease of the Heart Myocardial InfarctionMyocardial Infarction
Cor PulmonaleCor Pulmonale
Right Ventricular SizeRight Ventricular Size Emphysema or PneumoconiosisEmphysema or Pneumoconiosis
Cardiac TransplantationCardiac Transplantation
Rare EventRare Event Multiple FactorsMultiple Factors
Type of TransplantType of Transplant
Single OrganSingle Organ Double OrganDouble Organ
Examples of ClaimantsExamples of Claimants
42 year old Coal Miner42 year old Coal Miner 12 years surface mine12 years surface mine
- Blaster / Drill- Blaster / Drill Non SmokerNon Smoker PFTsPFTs
- FVC - FVC 62%62%- FEV- FEV11 67%67%
- FEV- FEV11/FVC /FVC NormalNormal
Examples of ClaimantsExamples of Claimants
78 year old Plant Worker78 year old Plant Worker 40 years Pipe Fitter40 years Pipe Fitter 45 years – 1 ppd smoker45 years – 1 ppd smoker PFTsPFTs
- FVC- FVC 70%70%- FEV- FEV11 50%50%
- FEV- FEV11/FVC/FVC 45%45%
- Diffusion- Diffusion 50%50%
Examples of ClaimantsExamples of Claimants
70 year old Coal Miner70 year old Coal Miner 35 years underground roof bolter35 years underground roof bolter 40 years – 1 ppd smoker40 years – 1 ppd smoker PFTsPFTs
- FVC- FVC 60%60%- FEV- FEV11 30%30%
- FEV- FEV11/FVC/FVC Total ImpairmentTotal Impairment
Right Lung MassRight Lung Mass