General Guideline Principles for History Taking and
Physical Examination of Occupational Interstitial Lung Disease
for workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Hip and Groin Disorders.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

History Taking and Physical Examination of Occupational Interstitial Lung Disease

The history of occupational exposure, the symptoms, and the findings of diagnostic screening tests serve as the basis for both diagnosis and treatment strategies.

History of Present Illness

The foundation for diagnosis and treatment programmes is laid forth by the history of occupational exposure, the symptoms, and the findings of diagnostic screening tests.

• Pulmonary exposures, both occupational and otherwise.

• Occupation: current/past and types of work activities (such as mining, manufacturing, drilling, construction, demolition, and so on). For instances, see the table below.

• The length of time spent at each employment, even those held years or decades ago.

Exposures to:

• Dusts, including inorganic mineral dusts and organic dusts made of fungal, bacterium, plant, and animal proteins (silica, asbestosis, coal).

• Metals (tin, cobalt, beryllium (ancient light bulbs, aerospace)).

• Gases, vapours, flammable fumes, and aerosols.

• Non-occupational exposures to these chemicals should be listed together with a description of the exposure, how long it lasted, and how intense it was.

• Exposure intensity: ideally with measurements of the environment (data on industrial hygiene) or at the very least a qualitative description of the expos

• Incorporate inquiries about the person’s obligations and exposure (e.g. did you work in the office, etc.).

Symptoms:

• Symptoms and when they first appeared

• Including complaints of:

• Throat tightness

• Shortness of breath

• Difficulty with inspiration or expiration

• Harsh sounds

• Cough

• Sputum production

Duration, onset and frequency of symptoms.

• Symptom development including:

• In relation to the workplace, the symptoms’ deterioration and improvement

• Changes in work environment

• Symptoms may alter depending on the number of days worked and unworked.

• Progression of symptoms

• Pulmonary imaging and testing.

• Previous treatments.

• Relation to work: This also contains a statement of the likelihood.

• That the illness or injury was brought on at work.

• Ability to carry out regular tasks and job responsibilities.

Past History

• Past medical history, including but not limited to previous lung exposures and treatments (such as being susceptible to pneumonia and bronchitis).

• The symptoms of rheumatologic, neurologic, endocrine, neoplastic, and other systemic disorders are included in the review of systems, although they are not the only ones.

• Detailed history of smoking (including marijuana, vaping, etc.).

• A thorough medical history that includes the usage of nitrofurantoin, chemotherapy, and amiodarone.

• Vocational and recreational pursuits.

• Prior imaging studies.

• Past surgical history.

• Allergy history.

Physical Examination

The following aspects of an occupational pulmonary physical examination should be present:

• Vital indicators, such as calculated respiration rate and oxygen saturation.

• Generally speaking, functional abilities include being able to move easily, walk, change positions, dress, and undress while evaluating dyspnea symptoms and indicators.

• Evaluation of the respiratory state, including rate, depth, usage of accessory muscles, and nasal flare-ups.

• Examination for pulmonary illness stigmata and probable causes, such as

• Mucous membrane abnormalities

• Nasal polyps/swelling/discharge

• Clubbing (certain idiopathic pulmonary fibrosis, asbestosis, and

• Hypersensitivity pneumonitides)

• Anterior-posterior diameter

• Scoliosis

• Kyphosis

Palpation for:

• Chest wall abnormalities

• Adenopathy and neck masses

• Percussion for resonance to identify:

• Aeration

• Diaphragm level

• Suggestion for fluid interface or consolidation

Auscultation for:

• Inspiration to expiration ratio

• Adventitious breath sounds include crackles, wheeze (typically a secondary HP symptom and a primary eosinophilic pneumonia symptom), rales, and rhonchi).

• Pleural rubs, in addition to the timing, place, and persistence of lung findings

• Cardiac examination paying close attention to heart failure and cor pulmonale results

• Examining the skin for illness symptoms, such as erythema nodosum (sarcoidosis).

What our office can do if you have workers compensation History Taking and Physical Examination of Occupational Interstitial Lung Disease

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.