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Overview of Occupational Pneumoconiosis

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

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  1. Overview of Occupational Pneumoconiosis Jack Kinder, M.D.

  2. Basic Function of the OP Board • Evaluate for presence or absence of disease • Determine level of impairment • Protest hearing testimony

  3. Evaluation of Claimant • Work history • Medical history • X-Ray • PFTs • Physical exam of the chest

  4. Exposure History - Coal • Type of work- Underground- Surface

  5. Exposure History - Asbestos • Industrial • Private employment

  6. Medical History • Respiratory- Illness - Surgery • Medications- Beta Blockers- Pulmonary Meds

  7. X-Ray Evaluation • Pleural Disease • Parenchymal Disease

  8. Pulmonary Function Testing • FVC • FEV1 • FEV1/FVC Ratio • Diffusion • ABGs

  9. Physical Exam of the Chest • Abnormal breath sounds • Cardiac Disease • Chest wall deformities

  10. Special Considerations • Malignancy • Cardiac Dysfunction • Transplantation

  11. Pulmonary Malignancy • Primary Parenchymal Cancer • Mesothelioma

  12. Primary Lung Cancer • Coal Exposure • Asbestos Exposure- Tobacco Influence

  13. Mesothelioma • Special Type of Pleural Disease • Without Parenchymal Disease • Tobacco Exposure

  14. Cardiac Disease • Role in Pulmonary Dysfunction • Cor Pulmonale

  15. Coronary Atherosclerosis • Primary Disease of the Heart • Myocardial Infarction

  16. Cor Pulmonale • Right Ventricular Size • Emphysema or Pneumoconiosis

  17. Cardiac Transplantation • Rare Event • Multiple Factors

  18. Type of Transplant • Single Organ • Double Organ

  19. Examples of Claimants • 42 year old Coal Miner • 12 years surface mine- Blaster / Drill • Non Smoker • PFTs- FVC 62%- FEV1 67% - FEV1/FVC Normal

  20. 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%

  21. 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

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