Occupation Doc seeks to prove causation for his own illness from work exposure

[Guest guest]

This is interesting. An occupational doctor is trying to prove causation

that he acquired illness from an exposure at work to a patient with pneumonia.

He had not been exposed to anyone else with pneumonia.

A message posted by his doctor on the UNC List-serv

" Dear Colleaagues/All,

I have got a question about a patient of mine who is a GP as well. Further

to my previous message I now understand how this forum works so I'm hereby

adding more information to make it easier to understand the problem and

hopefully help me out.

The problem at the moment is a patient of mine, a GP himself, who was

coughed in the face by a patient with pneumonia and then my patient was

admitted to

hospital with pneumonia.

As there was no one in his private life with pneumonia or any other

infection (not even a cold) he thinks he picked it up from this patient. I

agree with

him and so does his chest physician.

The trouble is that unfortunately the lung physicians here do not do any

cultures as they are of the opinion that it won't culture the culprit and so it

is a waste of time and money. They also say that more and more lung

physicians start to abandon cultures for this very reason. And that the only

reliable

way to culture would be to do a bronchoscopy lavage.

I must say as a simple GP that I thought sputum culturing was standard

procedure but apparently not anymore.

The occ health dr now says there is no evidence that my patient picked it up

at work.

According to the company website where my patient works the following should

have happened:

The medical adviser will be asked to make an assessment of how much of the

injury/illness is 'wholly' (more than 90%) or 'mainly' (between 50% and 90%)

attributable to the nature of the duty.

If the medical adviser considers the injury or illness is less than 50%

attributable then the claim will fall and no award will be made.

One occ health dr has already replied and said:

In conclusion I would agree with your inference, that denying a causal

connection for this pneumonia in a physician, would require strong evidence,

rather than the other way around.

What my patient and I are trying to do is gather some info and opinions by

other doctors to see what they think and to see if there is anything we can

use to convince the occ health dr that:

1. He was asked the wrong question and

2. That it is very likely that my patient picked his pneumonia up at work.

I would be grateful for your ideas/input.

Kind regards

XXXXXX

The nuclear power plant workers at Rocky Flats have massive amounts of

cancer known to be indicative of radiation exposure. But NIOSH did dose

response

theories that say it is inconclusive if the workers were exposed to enough to

cause their illnesses. Thus these workers are being denied their workers

compensation benefits. So how would a physician with pneumonia blown in his

face even think he has a chance to prove causation when in need of financial

benefits from his employer?

Ironically for the poor physician with pneumonia, it is his own peers that

have heavily promoted this industry friendly concept used extensively to deny

financial liability for illness. The org his doctor seeks assistance from,

is the exact same org that has lobbied into NIOSH's psyche, the dose response

concept before causation can be established.

Although logic would tell us that a person got pneumonia after another

person with pneumonia coughed in their face, before receiving restitution from

the

employer, the sick occupational doctor would have to prove:

1. His pneumonia is caused by a certain antigen

2. The patient he saw had the same antigen

3. The dose he was exposed to when blown in his face, was enough to cause

illness. As no studies have

been done on this and linear quantitative risk analysis is joke when

determining dose response for

individual humans, it is impossible to prove. (But I feel certain, NIOSH

would be willing to spend millions

to study it anyway)

4. He had no underlying conditions that would have made him susceptible to

pneumonia. Otherwise, this

could be considered a contributing cause, thereby lessening the

financial obligation of the employer.

_Rocky Flats workers die waiting for help - News - MSNBC.com_

(http://www.msnbc.msn.com/id/19024886/)

_http://www.thedenverchannel.com/news/13490403/detail.html_

(http://www.thedenverchannel.com/news/13490403/detail.html)

Sharon Kramer

************************************** See what's free at http://www.aol.com.

[Guest guest]

Their (NIOSH's) response doesn't make sense for the simple reason that

radiation exposures (at least this is what I have heard again and again) are

stochastic. There are no thresholds like they (NIOSH) imply with gamma

radiation.

Its like Russian Roulette. That is a very good analogy for many reasons

because particles of gamma radiation target cellular DNA, just like many

mycotoxins do. They cause a similar kind of genetic cell damage, which the

body tries to repair, but the body can and does get overloaded because the

repair cells get used up. (You are born with a finite number, these are the

'stem cells' we read about)

[Guest guest]

Oops, I'm sorry.. I was talking about the other story.. the radiation

workers.. I got confused sorry everybody..