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Pleural Malignancy (ICD-9 Code 163)Malignant neoplasm of pleura (ICD-9 code 163) is a disease category that might be expected to include pleural mmesothelioma, a tumor type that is strongly associated with asbestos exposure. Although malignant mesotheliomprimary malignant neoplasm of the pleura, in practice this ICD-9 code 163 is by no means entirely specific or sensidentifying malignant mesothelioma deaths [Davis et al. 1992].Amphibole fiber types, especially crocidolite, appear to be the most potent inducers of malignant mesothelioma. Hexposure can also cause this disease [Ross and McDonald 1995]. Therefore, all occupational groups exposed to adeveloping asbestos-related pleural malignancy. Apart from crocidolite miners and millers, occupations with high workers, insulation workers, and workers employed in construction trades. Approximately 85 percent of individumesothelioma have a history of asbestos exposure [Rom 1992]. Malignant mesothelioma is also caused by nonoccupational environmental exposure to asbestos and related fibers. mesothelioma has been documented among family members of asbestos workers [Anderson et al. 1979] and amonpopulation living in a region of Turkey where nonoccupational exposures to xeolite (erionite) fibers are prevalent Lockey 1994]. ReferencesAnderson HA, Lilis R, Daum SM, Selikoff IJ [1979]. Asbestosis among household contacts of asbestos factory workers. Ann NY AcaDavis LK, Martin TR, Kligler B [1992]. Use of death certificates for mesothelioma surveillance. Pub Health Rep 107:481-483.Rom WN [1992]. Asbestos-related disease. In: Rom WN, ed. Environmental and occupational medicine. 2nd ed. Boston, MA: Little, pp. 269-291.Ross D, McDonald JC [1995]. Occupational and geographical factors in the epidemiology of malignant mesothelioma. Monaldi Arch Wakeman MJ, Lockey JE [1994]. Other pneumoconioses. In: Rosenstock L, Cullen MR, eds. Textbook of clinical occupational and enPhiladelphia, PA: W.B. Saunders Company, pp. 287-296.
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Pneumonia (ICD-9 Codes 480-486) Infectious pneumonia (ICD-9 codes 480-486) and influenza together represent the sixth leading cause of death in with a mortality rate of 12.9 per 100,000 [NCHS 1997]. Nearly all deaths in this leading cause of death are attribpneumonia, a feared complication of many acute illnesses and the most frequent cause of death due to infectious dcommon pathogen causing community-acquired pneumonia is Streptococcus pneumoniae, a bacterium for which a

available [Niederman 1987]. Other organisms commonly causing pneumonia include Legionella, mycoplasma, Chviruses [Fein et al. 1987]. Respiratory viruses cause pneumonia either as primary viral infection or as a result of sinfection. Chronic obstructive lung disease, a condition that is highly prevalent among the elderly, is associated wpneumonia [Koivula et al. 1994]. Risk factors for secondary bacterial pneumonia include advanced age and chronheart and kidneys, as well as of the lungs [Rose et al. 1987]. The problem of occupationally-associated pneumonia is substantial. Clusters of pneumonia caused by recently rechave been reported in occupational settings (e.g., Legionnaires’ disease in industrial workers and Chlamydia pneu

military personnel) [Esposito 1992]. Some studies of welders have demonstrated that there is an increased risk of pneumonia [McMillan and Pethybridge 1983]. It has long been recognized that clinically useful clues for diagnosipneumonias can be obtained from patient histories of occupational contact with animals [Gerberding 1996].References

Esposito AL [1992]. Pulmonary infections acquired in the workplace. A review of occupation-associated pneumonia. Clin Chest Med Fein AM, Feinsilver SH, Niederman MS, Fiel S, Pai PB [1987]. When the pneumonia doesn’t get better? Clin Chest Med 8:529-541.Gerberding JL [1996]. Infectious organisms. In: Harber P, Schenker MB, Balmes JR, eds. Occupational and environmental respiratorMosby, pp. 561-570.Koivula I, Sten M, Makela PH [1994]. Risk factors for pneumonia in the elderly. Am J Med 96(4):313-320.McMillan GHG, Pethybridge RJ [1983]. The health of welders in naval dockyards: proportional mortality study of welders and two coMed 33:75-84.NCHS (National Center for Health Statistics) [1997]. Health United States 1996-97 and injury chartbook. DHHS Pub. No. (PHS) 97-1Niederman MS [1987]. Strategies for the prevention of pneumonia. Clin Chest Med 8:543-556.Rose RM, Pinkston P, O’Donnell C, Jensen WA [1987]. Viral infection of the lower respiratory tract. Clin Chest Med 8:405-418.