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1

RF_OH_6_SUDHA

®

VITALOGRAPH
TEST RECORD

Ref. Nos.:

Date: 6. /// / 73

Patient’s Name

.............................................................................................................

Sex

Address

..................

.............................................................................................

Height... J..7.S.C.<n^..

.............................................................................................

Body Surface Area.....

Room Temperature

Time of Test ....3...^...P.r?

Potion of patient (e.g. standing, sitting)

1

Xi

2

3 9

3

3

tP
.

FEV,.......

FVC

?..&.............

Weight... 5.

M2

7.5.^................. Barometric Pressure

.............................................................................

After Bronchodilation

Measured Values in ml
Tests

Age

% FEV/FVC

FEV.......

FVC

% FEV/FVC

3 -^5

3<ic

4

5

Mean

Other Tests, Remarks, etc.:

Form 19

Printed in England * Vitalograph Ltd., Buckingham

Re-order No 100 249

J-DIVIS

PREDICTIONS

(VC ) ; ? For cod Expiratory Vplume in 1

Vital Capacity

Forced Expiratory Volume
Expiratery Peak

(1

;ow Rate

sec)/Vital Capacity

sec

(FEV);

(FEV/VC);

(PF).

VC = 5.2011 -0.022Y -3o60

(1)

(M)

(1)

(F)

o
VC = ^o!7H -0J21Y ~2O87
A.

FEV

= 3 „ 711 - 0.028Y -• 1,= 59

(1)

(M)

FEV^

= 2O5H -

0.022Y - 0,.62

(1)

(F)

FEV/VC = 9108 -

Oo373Y

FEV/VC = °2o1

O„261Y

-

(M)
(%)

(F)

= h(395 - 1.51Y)

(1/min)

(M)

PF = 37^n - 2.12Y - 113

(1/min)

(F)

pf

f

Note;
M: Male
Y:

Age

1:

litres

(years)

percentage

F:

Female

H:

Height

1/min:

(motors)

1itres/minute

FACTORS TO CONVERT GAS VOLUMES FROM' ROOM TEMPERATURE
SATURATED TO 3 7 °C,

C on vcr sion Factor

SATURATE])

Gas Temperature

1 o1 02

20

1.096

21

1.091

22

1.085

23

1 . 080

24

1.075

25

1.068

26

1.063

27

1.057

28

1.051

29

1 . 0^5

30

(°6)

CLINICAL FEATURES

ELDER. L, J.
Male, 49 years, Height 1.72 m. , weight 7 Kt.

Smoking-

15 cigarettes per day until 1965 when he stopped.

Provisionally diagnosed as isocyanate asthma in 1972 with 30% disability.

Exposed to methyl di-isocyanate between 1963 and 1969.
No history of chest trouble until 1972.

cough and scanty clear sputum.

rhonchi throughout both lungs.

He now is Grade III SOB, slight

No cyanosis, finger clubbing or crepitations,

RESULTS OF TESTS ON:
EXAMINED ON-

AGE

EXPOSED TO-

29th October, 1973

HEIGHT-

49

1.72 m.

Isocyanate

WEIGHT:

70 kgs.

After Bronchodilator

All volumes expressed in litres BTPS.

OBS.

Dr. McLaughlin

EXAMINED FOR;

ELDER Lawrence J.

% of PRED.

OBS.

% of PRED

Fast Vital Capacity (FVC)

4.25

100

4.70

110

Slow Vital Capacity (370)

-

-

-

-

Forced Expiratory Volume
(FEV,)

2.00

59

2.40

71

FLV/FVC%

47

64

51

69

Peak Flow Rate (1/min)

He Dilution
OBS.

% of Pred.

Residual Volume (RV)

2.65

131

Total Lung Capra ity (TT. C)

6.99

109

RV/TLC%

38

113

CBS.

% of Pred.

Transfer Factor (Deo)
Ml/min x mm Hg.

3C.0)
28.8? 27.6>
23.3)

R

Index finger

Hyponychial angle;

Body Plethysmograph
OBS.

7o of Pred.

97

184°

No clubbing

REMARKS

The FVC is normal:
obstruction.

the ^EV. an<^ FEV^/FVC ratio are reduced indicating airway

The change after bronchodilator denotes some bronchospasm.

The R7 is above normal.

The T1 is normal.

These findings are consistent with, di-isocyanate asthma.

CLINICAL FEATURES
Harper, F. A.

Smoking-

Male, 53 years,

Ht,

1.71 m., wt. 72 kgs.

stopped 4 yeara ago.

Certified asbestosis 1959.

Now 60% disability.

1951 - 1959 asbestos sprayer in cinemas, power stations etc.
asbestos.

All kinds of

1946 Al in the Forces.

SOB Grade IV (MRC Scale)

There was no cyanosis.

both bases.

Cough ++ .

Scanty sticky sputum.

He had severe finger clubbing and crepitations round

HARPER Frederick A.

RESULTS OF TESTS ON:

EXAMINED FOR: Dr. McLaughlin

EXAMINED ON: 29th October, 1973
AGE:

53

EXPOSED TO: Asbestos

HEIGHT:

1.71 m.

All volumes expressed in litres BTS

Fast Vital Capacity (FVC)

>Slow Vital Capacity (SVC)
Forced Expiratory Volume
(FEVp

FEV/FVC7.

Residual Volume (RV)

Total Lung Capacity (TLC)
RV/TLC7.

10.6)
Transfer Factor (Deo) 9.2)
Ml/min x mm Hg.
7.1)

Hyponychial angle:

71.8 kgs.

After Bronchodilator

OBS.

7c. of PRED

1.65

46

-

OBS

% of PRED
........... ........................

...................

1.30

40

79

109

Peak Flow Rate (1/min)

WEIGHT:

.............. ...................

........... ........................

••••■
........... ........................
• ••••

........................

He. Dilution

Body Plethysmograph

OBS.

7o of PRED

OBS

2.19

106

3.66

58

60

171

OBS.

% of PRED

9.0

33

R. Index finger

206°

% of PRED

........... ........................
.....

........................

.....

• • • ................

Gross finger clubbing

REMARKS:
The FVC and TLC are greatly reduced. The FEV-^ is also much reduced but
the FEVji/FVC ratio is above normal indicating proportionate reduction. There
is therefore no evidence of airway obstruction.
The RV/TLC is greatly increased but this is due to the fall in TLC
rather than a rise in RV; this indicates restrictive defect. The T1 is only
one third of that predicted.

These findings are typical of moderately severe diffuse pulmonary fibrosis
presumably asbestosis, in.’.view of^the history.

Tl.

Since Feb. 1972 there is slight increase in FVC and insignificant fall in
Mr. Harper's function shows little change over the years.

c*.

7.

SEPTEMBER 1973

L

{frsso CHEMICAL LIMITED

Current
Month

Year to
Date
[i
j .

Last
Year to
Date

2

37

53

0

7

14

0

5

2

<<
.........

69
49_______ -------------~—^n

■eresu

.‘r. varies

l

j23.9.73

Unit/
Location

Department

Operator

2. 28.9.73

ES

Injury

UrTt/Lo ca.ti on

I

! Chemical dust

LC-2

CRM

c<

Jeb

1. 13.9.73

!

o

nave

4

4

1!

p.

0

; ±.mergencieo

,,_______ i

13

p-

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i
;

0

0___ \

.............. ""'I
2
■ -1

fires/e

o______ 1

(V

} Tztai Inj ur ies
r*
...... -j Pct. Grave Ir.j-.
i
___________
i
1 pi

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Disabling

rn

(-

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•J

Q

p-

C
O

o

Tvyi vi .q?

CJ

1

Dust from
contaminated
glove entered
eye whilst
removing goggles

in left eye.

1

R-9

1.

AP-4

2.

Finishing Buildi

k

I

j 27.9.73

Line Supervisor

AP-4

Paramins

Contused wound
right finger.

Jammed in
office door.


1

1. Paramins
2. Elastomers



ii
I
!
\


i*

i
!

Description

1

K

1

r

?1 Welding sparks caused smouldering
■ of cable insulation.
?-2

•everse wage.

* Five in FinisLim; Ik;ikliug i

Sack which had been placed ever vent section of nn extruder* *
to smother a steam leak started to smoulder and caught fire.


PRODUCT LINE

Chemical Raw Materials

6

11

0
1

20
20

0

30
7


0
0

3
0

9
2

1973 TOTAL

2

49

-

19% TOTAL

6

-

69

.

Paramins
Solvents & Chemical Intermediate?
Engineering & Construction
Others

OCCUPATION
' '
----------- --- ----------------

i

.LAST YEAR

___iJ0JLATE^_..

1

Elastomers



THIS ‘/EAR
TO DATE

MONTH

j

.

7

THIS YEAR
LAST YEAR
..-JD-JUTE____ __

MONTH

, .

. .

B.M./tfeld/P.F.

0

6

16

Meeh. Fitter

o

1

3

Rigger

0

0

4

M.O..............................................

0

1

15

0 thers

.1

6

9

14

SS.^S S3

35

36

(
TOTAL MAINTENANCE .

1

1

TOTAL OPERATORS

'

1

j

i
1

PART OF BODY

THIS YEAR
TO DATE

' MONTH

Head
Eyer

LAST YEAR
IO DATE
,12
6

1

11
7

Body

• 0 .

8

8

Arms/Hands

1

14

35 .

0

9

8

;• 49

69

Legs/Feet
J
J. • •
—__
I__
TOTAL

0



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INFORMATION TO PE OBTAINED FROM S’JRVEys A^D MSErrcKh ^^jrKcr'ro

'''

Example 1 : Type of information obtained from preliminary surveys

This example lists the type of information than is particularly applicable
to monitoring at the National or regional level.
It nay be supplemented by data
obtained during more detailed -surveys •
PLACE OF WORK
Name and address

OFFICIAL CONTACT

'•

'

Name and title

DATE AND TFT] OF SURVEY
EMPLOYEES

Demographic data, e.g.,
ment of working hours

number, sex, age, employment status, arrange­

*

PROCESSES

Description, including raw materials and interned!ate and end products

POTENTTAI HEATTH RISKS
List by process, including population exposed a-id information on any
prior measurements of risks; eg.:

CHEMICAL AGENTS such as toxic aerosols and liquids
PHYSICAL AGENTS such as excessive temperature, noise,
radiation, inadequate illumination
PTOTOGTCAL AGENTS such as infected materials handled
ERGONOMIC ATT PS^CHOSOCIAI EACTORS such as machine design,
methods of payment, joint consultation, lines of communication
Other RISKS requiring specific evaluation (indicate and attach
relevant forms)

CONTROT MEAS7TRES AVATT APTE
Indicate, with assessment of condition and efficiency, eg., total
enclosures, ventilation, machine guards, personal protective devices

SANITARY FACITITtES

Drinking water, washing facilities, locker roor. s, toilets, eating and
recreation areas, methods of disposal of wastes, ii eluding solids, liquids
and aerosols
HEAT TH ATT) SAFETY PERSONNEL

Description, numbers employed ( full and part-time)
Health personnel - eg., physicians, hygienists, nurses, assistants,
first-aid attendants
Safety personnel, ego, safety supervisors, safety engineers
HEALTH AND SAFETY FACILITIES
Health facilities, egs, hospitals, health den- .rtments, dispensaries,
first aid stations, first aid kits, ambulances, records

Safety facilities, eg..,

safety equipment (general and- personal)

records.
2

: 2 :
HEAT .TH AND SAFETY PROGRAMMES
Health programmes, eg,, ore-employment, periodic and special medical
examinations; routine and special environments and monitoring
programmes; counselling and education; freciuency of visits by health
personnel to workplace; supervision of sanitarv facilities; types of
reports made

Safety programmes - egi, counselling and education; inspections
(routine and special) other than accident investigation; accident
investigations; emergency procedures'; tvpes of reports made

co*tci.ttsto?ts
Gene ral findi ngs, re c ommendati on s, foilow-up

Type of information obtained from medical surveys

Example 2.

This example gives the type of information obtained during the medical.
monitoring of tnflivid.ua! workers. Where specific hazards are known
to exist, the information should be supplemented by a special diagnostic
test of the kind illustrated in Example 3 of this Annex.
PERSONAL DATA

,

Name, identification number, sex, date of birth, address, workplace
(plant and. department)
S OCT AT HISTORY

Education, marital status, fanrlv size, living conditions
OCCTIPATTONAT

HTStOPv

Present occupation. - duration) hours of work, shifts, degree of
responsibility, potential hazards and unusual job demands (as stated
by the worker), his/her opinion of job

Previous occupations - date of first exnloymert, tyres of employment,
potential risks and duration of each job
FANILV MEDIC'L HISTORY

Relevant diseases, eg, infections, tuberculosis, mental illness and
cardiovascular diseases
PAST MEDICAL HISTORY
Previous illnesses and operations, including ary ill-health or
disability related to exoloyment

PRESENT MEDICAL HISTORY

Present complaints or symptoms including endemic diseases
Personal habits - smoking, alcohol and drugs
CTINTCAL E7AMINATION AW 1S^HSS}WT OF OPACITIES
Weight, height and other anthropometric data
Examination of organ systems for defects and for assessment of
capacities, eg., vision -’acuity and visual fields
hearing - audi omotry
cardiovascular system - bloorl pressure, exorcise test,
and electro-cardi ography
blood - hae globin coll counts and platelets, lipids,
monitoring tests for toxic agents in blood
respiratory system - chest X ray, lung function tests,
monitoring tests for toxic agents in exhaled air.
• • -3

INTONATION TO BE OBTAINED FROM S^JRVEYS AW FEIPpaj,
Example 1 : Type of information obtained from prelimin; \ry surveys

This example lists the type of information tha_; is particularly applicable
to monitoring at the National, or Regional level.
It may be supplemented by data
obtained during more detailed surveys*
*

\

PLACE OP WORF

Name and address

OFFICIAL CONTACT

Name and title

}

DATE AND TJT^E OF SURVEY
NPI.OYEES
Demographic data., e.g.,
ment of working hours

number, sex, age, employment status, arrange­

PROCESSES
Description, including raw materials and interned!ate and end products

POTENTIAL HEATTH RISFS

'



List by process, including population exnosed j-ad information on any
prior measurements of risks; eg.:

. .

CHEMICAL AGENTS such as toxic aerosols and liquids
PHYSICAL AGENTS such as excessive temrerature, noise,
radiation, inadenuate illumination
BTOJ OGTCAI- AGENTS such as infected materials handled
ERGONOraC.AND ^CUOSOCIAT -FACTORS such as machine design,
methods of payment, joint consultation, lines of communication
Other RISKS reauiring specific evaluation (indicate and attach
relevant forms)

CONTROT MEASWES AVAILABLE
Indicate-, with assessment of condition and efficiency, eg., total
enclosures, ventilation, machine guards, personal rrotective devices

SANTTARV FACT!ITTOS -

Drinking water, washing facilities, locker rooms, toilets, eating and
recreation areas, methods of disposal of wastes, including solids, liauids
and aerosols
HEATTH AID SARETV PERSONNEL



• r . •

Description, numbers employed (ful l and nart-t’-me)
Health personnel - eg., physicians, hygienists, nurses, assistants,
first aid attendants'
Safety personnel, eg., safety supervisors, safety engineers
HEALTH ALT) SAFETY FACILITIES

Health facilities, eg., hospitals, health departments, dispensaries,
first aid stations, first aid kits, ambulances, re : ord s
Safety facilities, eg,,

safety equipment (general and personal)

records.
2

i 2
HEALTH ATT) SAFETY PROGRAMS
Health programmes, eg.,- ore-employment, periodic and special medical
examinations;., routine and special environments and monitoring
programmes; counselling and education; freauoncy of visits by health
personnel to workplace; supervision of sanitaw facilities; types of
reports made

Safety programmes - eg., counselling and education; inspections
(routine and special) other than accident investigation; accident
investigations; emergency procedures; tvoes of renorts made
CONCLUSIONS
General findings, recommendations, follow-up

Example ?.

Type of information obtained from medical surveys

This example gives the type of information, obtained during the medical
monitoring of individual workers. Where specific hazards are known
to exist, the information should be supplemented by a special diagnostic
test of the kind illustrated in Example 3 of this Annex.
PERSONAL DATA

*

Name, identification number, sex, date of birth, address, workplace
(plant and department)
SOCIAT HISTORY
Education, marital status, fanrlv size, living conditions

OCCTTPATTONAJ HISTORV

Present occupation - duration, hours of. work, shifts, degree of
responsibility, potential hazards ard unusual job demands (as stated
by the worker), his/her opinion of iob
Previous occupations - date of first exploymert, types of employment,
potential risks and duration of each job
FAMILY MEDIC/L HISTORY



Relevant diseases, eg, infections, tuberculosis, mental illness and
cardiovascular diseases

PAST MEDICAL PTSTORY

Previous illnesses and operations, including any ill-heal th or
disability related to exnloyment
PRESENT MEDICAL HISTORY

Present complaints or symptoms including endemic diseases
Personal habits - smoking, alcohol and drugs
CJINTCAL EXAMINATION AW ASCESS1|S OF OPACITIES
y

Weight, height and other anthropometric data
Examination of organ systems for defects and for assessment of
capacities, eg., vision -‘acuity and visual fields
hearing - audiometry
cardiovascular system - blood pressure, exercise tost,
and electro-cardiography
blood - haeglobin coll counts and platelets, linids,
monitoring tests for toxic agents in blood
resniratory system - chest X ray, lung function tests,
monitoring tests for toxic agents in exhaled air.
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