Clinical – Pulmonary

With a thorough understanding of the anatomy, physiology, and pathology of the respiratory system, the OEM physician is able to assess the causes and occupational impact of respiratory disorders and pulmonary impairment.

1. Prevent, identify, diagnose, treat and/or refer occupational/environmental lung disorders, including:
   • Occupational asthma and bronchoreactivity (e.g., toluene diisocyanate sensitization, exposure to inhaled allergens, byssinosis, reactive airways dysfunction syndrome [RADS]).
   • Pneumoconioses (e.g., silicosis, coal workers’ pneumoconiosis, asbestosis, hard-metal disease, benign radio-opaque pneumoconiosis, chronic beryllium disease).
   • Irritant inhalations (e.g., acids, alkalis, oxides of nitrogen, phosgene, phosphine).
   • Chronic obstructive pulmonary disease (COPD).
   • Hypersensitivity pneumonitis.
2. Manage work restrictions for both occupational and non-occupational lung diseases.
3. Perform and interpret a spirogram according to American Thoracic Society/European Respiratory Society standards.
4. For the work-up of occupational or environmental related pulmonary conditions, order and interpret the appropriate diagnostic tests, including:
   • Peak-flow testing and post-shift spirometry in the assessment of exposure-related bronchoreactivity
   • Post-bronchodilator pulmonary function testing in the assessment of bronchoreactivity.
   • Methacholine and specific challenge testing in the assessment of exposure-related bronchoreactivity.
   • Exercise disability tests in the assessment of pulmonary impairment.
   • Pulmonary function testing.
   • Imaging studies (e.g., chest radiographs, magnetic resonance imaging, computed tomography, plain tomography).
   • Allergy testing.
5. Interpret x-ray results reported by an International Labor Organization (ILO) B-Reader.
6. Perform respirator certification examinations tailored to the anticipated workplace exposures, to the exertional demands of the job, and to the type of respiratory protection used.