Original scientific paper
Diagnostic criteria of asbestosis
T. Beritić
; Institut za medicinska istraživanja i medicinu rada, Zagreb, Hrvatska
S. Kovač
; Institut za medicinska istraživanja i medicinu rada, Zagreb, Hrvatska
L. Kurajica
; Zavod za zaštitu na radu, Split, Hrvatska
I. Sokol
; Dom zdravlja, Kardeljevo, Hrvatska
Abstract
The ever-increasing 1ilncidence of asbestosis, the diversity of clinical effects and the great interobserver (and not infrequent intraobserver) variations in the assessment of radiological features of the disease have imposed many problems when diagnosing asbestosis in ruts early stages. Several current attempts for establishing acceptable diagnostic criteria are reported and the authors' own points of view, leading to a new proposal, are presented. The proposed scheme divides the diagnostic elements into two groups: obligatory and ancillary criteria. Obligatory criteria are indispensable and are based on the morphological substrate obtained by radiography and/or biopsy and/or autopsy. Ancillary criteria (dyspnoea, clubbing of fingers, positive asbestos bodies, pulmonary functional impairment) may be highly contributing and much supporting, yet not decisive unless simultaneously coupled with the obligatory ones. Radiological criteria are based on those changes of the lungs and pleura as classified by the International ILO 1980 Classification. However, the new requirements are proposed to be included in addition to »face on« X-ray films; oblique views and/or computerized axial tomograms as alternative techniques if the »face on« films are negative. Ancillary criteria, though non-specific, are not only a valid confirmation of diagnosis but should also be considered solid and reasonable ground for continuous monitoring and mandatory follow-up examinations. Diagnostic criteria have a desicive rule for the removal of workers from further exposure and have important legal implications. If accepted they may be considered official, and may thus become features of the law and incorporated into the Workers Compensation Act. Several illustrative case reports are presented, showing the misunderstandings arising from ignorance and negligence when applying diagnostic criteria
Keywords
Hrčak ID:
153600
URI
Publication date:
21.8.1987.
Visits: 1.196 *