UNEXPECTED OPPORTUNITIES - INCIDENTAL FINDINGS DETECTED DURING IMPAIRMENT EVALUATIONS FOR COAL-WORKERS PNEUMOCONIOSIS

Coal workers' pneumoconiosis impairment evaluations for 374 miners, pr edominately from eastern Kentucky, were conducted by our department be tween January 1, 1989, and June 30, 1992. During a review of the cases , potentially significant findings not directly related to any detecte d pneumoconiosis were recorded. Sixty-five (17.4%) of the men had bloo d pressure greater than or equal to 150 mm Hg systolic or greater than or equal to 90 mm Hg diastolic during one measurement. Of 89 workers who had a previous diagnosis of hypertension and were being treated, 4 0 (44.9%) had an elevated blood pressure measurement. Twelve cases of incidental, previously undetected chest radiogaph findings warranted f ollowup; 9 of these were isolated pulmonary nodules. In addition, thre e patients were immediately referred for evaluation and treatment of c onditions newly diagnosed during the examination-one for unstable angi na pectoris, one for congestive heart failure, and one for recent cere brovascular accident. These cases illustrate that physicians doing imp airment evaluations, even if they are not the patient's treating physi cian, have the opportunity and responsibility to intervene and reduce morbidity and mortality.