Cases of alleged asbestos-related disease: a radiologic re-evaluation

Article Abstract:

Surveillance of personnel who have known or suspected asbestos fiber exposure is an ongoing process. The principal diagnostic tool available for this purpose is the chest X-ray. The presence of irregular or linear opacities in the bases of the lungs and/or the presence of bilateral pleural thickening on the chest wall or diaphragm are considered to be diagnostic features consistent with asbestos and asbestiform mineral exposure. In 1986, approximately 750 retired and employed tireworkers at a specific site were interviewed about pulmonary symptoms, smoking habits, occupational history. They were also given a medical examination which included chest X-rays and spirometry (to measure the air capacity of the lungs). Approximately 440 of those examined filed claims for asbestos-related injury, based on the findings of the questionnaire responses and evaluation of the chest films. This proportion of persons would have suggested a 60 percent prevalence of asbestos-related injury, indicative of an epidemic of extraordinary proportions. Three independent radiologists reevaluated the chest X-rays without knowledge of the purpose of the study or previous diagnoses, and without consulting with each other. Individually, they determined that 3.7 percent, 3.0 percent and 2.7 percent of the tireworkers had asbestos-related injury. Sixteen cases were suspected but, after further review, only 11 cases (2.5 percent) were finally diagnosed as having injuries consistent with exposure to asbestiform minerals. One reason why so many chest X-rays were initially categorized as indicative of asbestos injury is that most of the tireworkers were over 50 years of age and may have developed pulmonary changes, due to other causes, that could produce similar X-ray images. (Consumer Summary produced by Reliance Medical Information, Inc.)

Officials and employees, Causes of, Occupational diseases, Lungs, Lung, Asbestos industry, Asbestos, Asbestosis, Pneumoconiosis, Black lung disease

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Compliance with colorectal cancer screening in a high-risk occupational group

Article Abstract:

People who make patterns and models have been shown to have an increased risk for colon and rectal cancer. The suspected cancer-causing agent is wood dust, but this has not been proven. The union for these workers in the Detroit area has established a colorectal screening program for its members, aimed at early detection and following the American Cancer Society recommendations that patients over age 50 undergo a sigmoidoscopy for two consecutive years and if the results are normal, then every three years thereafter. A group of men who had complied with the screening were compared with a second group who did not take advantage of the program. The workers most likely to participate in the program were older, woodworkers, nonsmokers, married, had a history of colon polyps and did not have relatives in the same industry or union. The main reason men did not participate in the screening program appeared to be the feeling that the test was unnecessary, anxiety and other emotional concerns regarding the procedure and possibly learning they had cancer, and time and motivation problems. Of the 980 members of the union, 159 (16 percent) took part in the full five-year screening program; 62 percent had at least one screening in five years. The authors conclude that for a program like this to succeed, health education must have an important role. The workers need to have their concerns about the procedure addressed and also need to know how important early detection of colorectal cancer is and that it significantly improves chances of longer survival.

Research, Usage, Colorectal cancer, Social policy, Diseases, Detroit, Michigan, Medical screening, Health screening, Preventive medicine, Woodworkers, Medicine, Preventive, American Cancer Society, Detroit

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