686B.2 Definitions. As used in this chapter, unless the context otherwise requires:1. 'AMA guides' means the American medical association’s guides to the evaluation of permanent impairment in effect at the time of the performance of any examination or test onthe exposed person required under this chapter. 2. 'Asbestos' means the same as defined in section 686A.2.3. 'Asbestos action' means the same as defined in section 686A.2.4. 'Asbestosis' means bilateral diffuse interstitial fibrosis of the lungs caused by inhalation of asbestos fibers. 5. 'Board-certified in internal medicine' means certified by the American board of internal medicine or the American osteopathic board of internal medicine at the time of theperformance of an examination and rendition of a report required by this chapter. 6. 'Board-certified in occupational medicine' means certified in the specialty of occupational medicine by the American board of preventive medicine or the specialty ofoccupational/environmental medicine by the American osteopathic board of preventivemedicine at the time of the performance of an examination and rendition of a report requiredby this chapter. 7. ty ofoccupational/environmental medicine by the American osteopathic board of preventivemedicine at the time of the performance of an examination and rendition of a report requiredby this chapter. 7. 'Board-certified in pathology' means holding primary certification in anatomic pathology or clinical pathology from the American board of pathology or the Americanosteopathic board of pathology at the time of the performance of an examination andrendition of a report required by this chapter, and practicing principally in the field ofpathology including regular evaluation of pathology materials obtained from surgical orpostmortem specimens. 8. 'Board-certified in pulmonary medicine' means certified in the specialty of pulmonary medicine by the American board of internal medicine or the American osteopathic board ofinternal medicine at the time of the performance of an examination and rendition of a reportrequired by this chapter. 9. 'Certified B-reader' means an individual who has qualified as a national institute for occupational safety and health final or B-reader of X rays under 42 C.F.R. a reportrequired by this chapter. 9. 'Certified B-reader' means an individual who has qualified as a national institute for occupational safety and health final or B-reader of X rays under 42 C.F.R. §37.51(b), whosecertification was current at the time of any readings required under this chapter, and whoseB-reads comply with the national institute for occupational safety and health B-reader’s codeof ethics, issues in classification of chest radiographs, and classification of chest radiographsin contested proceedings. 10. 'Exposed person' means a person whose exposure to asbestos or silica or to asbestos-containing products or silica-containing products is the basis for an asbestos actionor silica action. 11. 'FEV1' means forced expiratory volume in the first second, which is the maximal volume of air expelled in one second during the performance of simple spirometric tests. 12. 'FEV1/FVC' means the ratio between the actual values for FEV1 over FVC.13. 'FVC' means forced vital capacity, which is the maximal volume of air expired with maximum effort from a position of full inspiration. 14. ns the ratio between the actual values for FEV1 over FVC.13. 'FVC' means forced vital capacity, which is the maximal volume of air expired with maximum effort from a position of full inspiration. 14. 'ILO system' and 'ILO scale' mean the radiological ratings and system for the classification of chest X rays of the international labour office provided in guidelines for theuse of ILO international classification of radiographs of pneumoconioses in effect on the dayany X rays of the exposed person were reviewed by a certified B-reader. 15. 'Nonmalignant condition' means any condition that can be caused by asbestos or silica other than a diagnosed cancer. 16. 'Official statements of the American thoracic society' means lung function testing standards set forth in statements from the American thoracic society, includingstandardizations of spirometry, standardizations of lung volume testing, standardizations ofdiffusion capacity testing or single-breath determination of carbon monoxide uptake in thelung, and interpretive strategies for lung function tests, which are in effect on the day of thepulmonary function testing of the exposed person. 17. ath determination of carbon monoxide uptake in thelung, and interpretive strategies for lung function tests, which are in effect on the day of thepulmonary function testing of the exposed person. 17. 'Pathological evidence of asbestosis' means a statement by a physician who is board-certified in pathology that more than one representative section of lung tissue Sat Dec 23 12:26:20 2023 Iowa Code 2024, Section 686B.2 (9, 0) §686B.2, ASBESTOS AND SILICA CLAIMS PRIORITIES 2 uninvolved with any other disease process demonstrates a pattern of peribronchiolar orparenchymal scarring in the presence of characteristic asbestos bodies graded 1(B) or higherunder the criteria published in asbestos-associated diseases, 106 Archive of Pathology andLaboratory Medicine 11, appendix 3 (October 8, 1982), or grade one or higher in pathologyof asbestosis, 134 Archive of Pathology and Laboratory Medicine 462-80 (March 2010)(tables 2 and 3), as amended at the time of the exam, and there is no other more likelyexplanation for the presence of the fibrosis. 18. 'Pathological evidence of silicosis' means a statement by a physician who is board-certified in pathology that more than one representative ore likelyexplanation for the presence of the fibrosis. 18. 'Pathological evidence of silicosis' means a statement by a physician who is board-certified in pathology that more than one representative section of lung tissueuninvolved with any other disease process demonstrates complicated silicosis withcharacteristic confluent silicotic nodules or lesions equal to or greater than one centimeterand birefringent crystals or other demonstration of crystal structures consistent with silica,well-organized concentric whorls of collagen surrounded by inflammatory cells, in the lungparenchyma and no other more likely explanation for the presence of the fibrosis exists,or acute silicosis with characteristic pulmonary edema, interstitial inflammation, and theaccumulation within the alveoli of proteinaceous fluid rich in surfactant. 19. 'Plaintiff' means the person bringing an asbestos action or silica action, including a personal representative if the asbestos action or silica action is brought by an estate, or aconservator or next friend if the asbestos action or silica action is brought on behalf of aminor or legally incapacitated individual. 20. sbestos action or silica action is brought by an estate, or aconservator or next friend if the asbestos action or silica action is brought on behalf of aminor or legally incapacitated individual. 20. 'Predicted lower limit of normal' means the test value that is the calculated standard convention lying at the fifth percentile, below the upper ninety-five percent of the referencepopulation, based on age, height, and gender, according to the recommendations by theAmerican thoracic society and as referenced in the applicable AMA guides, primarilynational health and nutrition examination survey predicted values, or as amended. 21. 'Pulmonary function test' means spirometry, lung volume testing, and diffusion capacity testing, including appropriate measurements, quality control data, and graphs,performed in accordance with the methods of calibration and techniques provided in theapplicable AMA guides and all standards provided in the official statements of the Americanthoracic society in effect on the day pulmonary function testing of the exposed person wasconducted. 22. 'Qualified physician' means a physician who is board-certified in internal medicine, board-certified in pathology, effect on the day pulmonary function testing of the exposed person wasconducted. 22. 'Qualified physician' means a physician who is board-certified in internal medicine, board-certified in pathology, board-certified in pulmonary medicine, or board-certified inoccupational medicine, as may be appropriate to the actual diagnostic specialty in question,and for whom all of the following are true: a. The physician conducted a physical examination of the exposed person and has taken a detailed occupational, exposure, medical, smoking, and social history from the exposedperson, or if the exposed person is deceased, has reviewed the pathology material and hastaken a detailed history from the person most knowledgeable about the information formingthe basis of the asbestos action or silica action. b. The physician treated or is treating the exposed person, and has or had a doctor-patient relationship with the exposed person at the time of the physical examination, or in the caseof a physician who is board-certified in pathology, examined tissue samples or pathologicalslides of the exposed person at the request of the treating physician. c. hysical examination, or in the caseof a physician who is board-certified in pathology, examined tissue samples or pathologicalslides of the exposed person at the request of the treating physician. c. The physician spends no more than twenty-five percent of the physician’s professional practice time providing consulting or expert services in actual or potential civil actions, andwhose medical group, professional corporation, clinic, or other affiliated group earns notmore than twenty-five percent of its revenue providing such services. d. The physician was licensed to practice on the date any examination or pulmonary function testing was conducted, and actively practices or practiced in the state where theexposed person resides or resided at the time of the examination or pulmonary functiontesting, or the state where the asbestos action or silica action was filed. e. The physician received or is receiving payment for the treatment of the exposed person from the exposed person, a member of the exposed person’s family, or the exposed person’shealth care plan and not from the exposed person’s attorney. Sat Dec 23 12:26:20 2023 Iowa Code 2024, Section 686B.2 (9, 0) f. person, a member of the exposed person’s family, or the exposed person’shealth care plan and not from the exposed person’s attorney. Sat Dec 23 12:26:20 2023 Iowa Code 2024, Section 686B.2 (9, 0) f. The physician prepared or directly supervised the preparation and final review of any medical report under this chapter. g. The physician has not relied on any examinations, tests, radiographs, reports, or opinions of any physician, clinic, laboratory, or testing company that performed anexamination, test, radiograph, or screening of the exposed person in violation of any law,regulation, licensing requirement, or medical code of practice of the state in which theexamination, test, or screening was conducted, or that was conducted without establishinga physician-patient relationship with the exposed person or medical personnel involved inthe examination, test, or screening process, or that required the exposed person to agree toretain the service of an attorney. 23. 'Radiological evidence of asbestosis' means a quality 1 chest X ray under the ILO system, or a quality 2 chest X ray in a death case when no pathology or quality 1 chest X rayis available, showing bilateral small, irregular f asbestosis' means a quality 1 chest X ray under the ILO system, or a quality 2 chest X ray in a death case when no pathology or quality 1 chest X rayis available, showing bilateral small, irregular opacities (s, t, or u) occurring primarily in thelower lung zones graded by a certified B-reader as at least 1/1 on the ILO scale. 24. 'Radiological evidence of diffuse bilateral pleural thickening' means a quality 1 chest X ray under the ILO system, or a quality 2 chest X ray in a death case when no pathology orquality 1 chest X ray is available, showing diffuse bilateral pleural thickening of at least b2on the ILO scale and blunting of at least one costophrenic angle as classified by a certifiedB-reader. 25. 'Radiological evidence of silicosis' means a quality 1 chest X ray under the ILO system, or a quality 2 chest X ray in a death case when no pathology or quality 1 chest X ray isavailable, showing bilateral predominantly nodular or rounded opacities (p, q, or r) occurringprimarily in the upper lung fields graded by a certified B-reader as at least 1/1 on the ILOscale or A, B, or C sized opacities representing complicated silicosis or acute silicosis withcharacteristic pulmonary n the upper lung fields graded by a certified B-reader as at least 1/1 on the ILOscale or A, B, or C sized opacities representing complicated silicosis or acute silicosis withcharacteristic pulmonary edema, interstitial inflammation, and the accumulation within thealveoli of proteinaceous fluid rich in surfactant. 26. 'Silica' means a respirable crystalline form of silicon dioxide, including quartz, cristobalite, and tridymite. 27. 'Silica action' means a claim for damages or other civil or equitable relief presented in a civil action arising out of, based on, or related to the health effects of exposure to silica,including loss of consortium, wrongful death, mental or emotional injury, risk or fear ofdisease or other injury, costs of medical monitoring or surveillance, and any other derivativeclaim made by or on behalf of a person exposed to silica or a representative, spouse, parent,child, or other relative of that person. 28. 'Silicosis' means simple silicosis, acute silicosis, accelerated silicosis, or chronic silicosis caused by the inhalation of respirable silica. 29. 'Supporting test results' means copies of the B-reading; pulmonary function tests, including printouts of ccelerated silicosis, or chronic silicosis caused by the inhalation of respirable silica. 29. 'Supporting test results' means copies of the B-reading; pulmonary function tests, including printouts of the flow volume loops, volume time curves, diffusing capacity of thelung for carbon monoxide graphs, lung volume tests and graphs, quality control data andother pertinent data for all trials and all other elements required to demonstrate compliancewith the equipment, quality, interpretation, and reporting standards set forth in this chapter;B-reader reports; reports of X ray examinations; diagnostic imaging of the chest; pathologyreports; and all other tests reviewed by the diagnosing physician or a qualified physician inreaching the physician’s conclusions. 2017 Acts, ch 11, §11 Sat Dec 23 12:26:20 2023 Iowa Code 2024, Section 686B.2 (9, 0)
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