The association between tobacco burden and "dirty chest" is unlikely to follow a linear dose-response pattern.
Laney-A; Tramma-S; Petsonk-EL; Attfield-MD
Br J Radiol 2012 Apr; 85(1012):470-471
We read with interest the recent report by Kirchner et al  in BJR, which describes the results of the International Labour Office (ILO) classifications of routine digital chest radiographs as well as readings of contrast-enhanced chest CT images among a convenience-based sample of 85 tobacco smokers who were clinically referred for chest imaging, primarily for known or suspected cancer. Chest radiographs for the study were obtained using a storage phosphor digital system, and hard copies were printed from the digital image files via a laser printer. Transparencies were then displayed and classified by two board-certified radiologists. It was not described whether or not the classifications were made independently, and if so, how the readings were summarised. The data were presented as a correlation between pack-years and the ILO classification scores, which was found to be significant. Only slightly more than half of the data points were visible in this figure, leaving the reader to infer that some of the points presented represented more than one value. However, the actual distribution of the data cannot be inferred with the presentation of the results in this format. Additionally, there was no mention of how recognised confounding factors, such as age or occupational exposures, were accounted for in the correlation.
Tobacco; Tobacco-smoke; Smoking; Smoke-inhalation; Chest-X-rays; Cancer; Radiography; Surveillance
A Scott Laney, Surveillance Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Mail Stop HG900.2, Morgantown, WV 26505-2888
British Journal of Radiology