Reliability of early diagnosis of pleuropulmonary lesions in workers exposed to asbestos: the effect of position, radiographic quality and storage phosphor imaging on diagnostic accuracy.
Feist-JH; Hodgson-MJ; Fuhrman-CR; Owens-G; Gur-D
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 90-108, 1990 Sep; (Part I):463-478
An analysis was begun of a pilot group of workers with documented asbestos (1332214) exposure. Radiographically the majority of the workers had either minimal abnormal findings compatible with asbestosis or clearly normal chests. The analysis consisted of 100 consecutive workers with an occupational exposure to asbestos, mostly of 15 years or more. Pulmonary function studies were performed either using simple spirometry or whole body plethysmography with lung volumes and single breath carbon-monoxide diffusing capacity. The results confirmed that increased reliability of the radiographic diagnosis of asbestos related pulmonary and pleural lesions varied directly with diagnostic quality, sharpness, contrast and positioning, and that, particularly in early cases, PA films alone did not suffice. The authors state that in order to enhance recognition of actual disease and minimize false positive diagnoses, the standard examination for individuals suspected of asbestos related disease should consist of PA, left lateral and both 45 degree anterior oblique projections with very short radiographic exposure, high Kv technique, and proper positioning. Uncertainty concerning pleural and diaphragmatic lesions may be resolved by computer tomography.
Diagnostic-techniques; Clinical-diagnosis; Asbestos-workers; Asbestos-fibers; Dust-exposure; Occupational-exposure; Respiratory-system-disorders; Pulmonary-function-tests
DHHS (NIOSH) Publication No. 90-108
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA