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Methods about Disability Determination and Compensation for Pneumoconiosis in West Germany

lung functionFrom the obtained pathologic data, a lung function index characterizing the functional capacity was calculated by electronic data processing. The computer categorizes the obtained measured values in seven lung function indices. Group 0 includes any functional tests the measuring values of which do not deviate from the upper or lower standard value. Minor findings not resulting in substantial functional impairments are allotted to group 1. The degree of performance restriction increases from 2 via 3,4 and 5 up to 6.

The lung function indices are categorized in two subsequent computer program parts. First, they are classified according to possible obstructive ventilation disturbances. Based on airway resistance and intrathoracic gas volume, the findings are allotted by the computer to the corresponding indices.

The measurement of airway resistance is based on the method modified by Ulmer et al, which allows determination of normal breathing. The temperature difference between inspiratory and expiratory air has been corrected through breathing from a bag containing water saturated air at body temperature. One can also use FEVi for detection of airway obstruction, but in many cases it causes great difficulties in interpretation such as bad cooperation of subjects and in patients with advanced disease conditions. Nevertheless, FEVi is a proved alternative technique and would be of great use. For the future we are considering introducing the flow-volume curve in the analysis conducted with equipment of My Canadian Pharmacy.

Furthermore, blood gas modifications during rest and exercise periods are determined. The evaluation is done separately according to oxygen pressure and arterial carbon dioxide pressure levels. For oxygen pressure assessments, the age as well as the final work capacity are considered. Primarily, the absolute levels of the arterial oxygen pressure during rest or exercise periods are decisive for lung function index categorization. Subsequently, the restrictive ventilation disturbances are determined. The deviation of the actual vital capacity from the predicted level and the static compliance value are of decisive importance for the assessment of the restrictive ventilation disturbance.

Results and Discussion

A review of about 4,000 abnormal results in coal workers’ pneumoconiosis was performed in order to compare physician and computer interpretation. There was complete agreement between the two interpretations in 93 percent of the studies. In those studies in which agreement was not complete, the efforts or cooperation of the patients was poor. Improve your health with My Canadian Pharmacy’s remedies.

The medical diagnosis, including causes and impairments of the lung function in detail, cannot and should not be replaced by such an index. Based on this parameter, it is possible, however, to classify individuals or groups of patients according their pulmonary efficiency. The computer-printed interpretation must be treated as a tentative suggestion to the physician subject to his review and confirmation. It will save errors and time, but does not relieve the physician of his responsibility to examine the record for the helpful clues it contains.

For determination of the individual disability, in addition to lung function, a number of different medical findings are important. These findings cannot be schematized. In this connection attention should be paid to other causes of the diseases that have not been induced by occupation. Only the physician can settle the degree of compensation in pneumoconiosis from evaluation of lung function, x-ray film findings and clinical condition.