Interstitial Lung Disease. Tee L. Guidotti , MD, MPH, DABT National Medical Advisory Services OEMAC 2010. Benchmarks. ACOEM Practice Guidelines Authoritative guidance, updated, evidence-based Lung Disease Guidelines in progress Occupational Interstitial Lung Disease Airways Disorders
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Tee L. Guidotti, MD, MPH, DABT
National Medical Advisory Services
Chest film, CT
Biopsy (Ca, IPF, granulomatous disease)
Provocative testing (rare)
Serology (for HP)
Cardiopulmonary exercise testingMedical Evaluation of Occupational Lung Diseases - Modalities
Chest wall deformity
Clothing or external device (e.g. corset, cuirass)
Restrictive Defects are usually identified by reduced Forced Vital Capacity (FVC) during spirometry
However, FVC is effort dependent
More conclusively measured by Total Lung Capacity (TLC)Restrictive Patterns
It’s the other way around with airways disease.
However, causes of ILD may also cause some airways dysfunction.
If any occupational physician in this room cannot recognize this as advanced asbestosis, please recognize that you are in trouble!
HP Panel CPT
Micropolyspora faeni IgG
Thermoactinomyces vulgaris IgG
Aspergillus fumigatusIgG 86606
Penicillium Chrysogenum/notatum IgG
Alternaria tenuis/alternata IgG
Tricoderma viride IgG
Aureobasidium pullulans IgG
Phoma betae IgG
Related Tests & Panels:
Bird Fancier’s Precipitin Panel I
Bird & Mold Precipitin Panel II
Bird Fancier’s Profile Panel III
Other protein antigens & haptens
Not Rare but Uncommon