Professional paper
Criteria for acknowledgement of occupational asbestosis of the lung parenchyma and pleura
Marija Zavalić
; Institut za medicinska istraživanja i medicinu rada, Zagreb, Hrvatska
Ana Bogadi-Šare
; Institut za medicinska istraživanja i medicinu rada, Zagreb, Hrvatska
Abstract
The criteria for acknowledgement of occupational parenchymal asbestosis were set out in the List of Occupational Diseases of 1983, under paragraph 26. In spite of this, some occupational health specialists and invalidity committees acknowledge Ihe disease only when it meets the criteria recommended in the Conclusions of a Workshop on Asbestosis, held in former Yugoslavia, although such criteria were never legally implemented. According to these criteria asbestosis of the lung is recognized only when parenchymal profusion is subcategory 2/1 and higher, or at least subcategory 1/1 with visible pleural plaques and/or bilateral calcifications.
In the Department of Occupational Health of the Institute for Medicai Research and Occupational Health in Zagreb chest X-rays were taken and examined in 350 workers occupationally exposed to asbestos. In 51 (15%) of the workers lung fibrosis was excluded (profusion of the parenchyma was subcategory 0/-) and in 53 (15%) fibrosis of the parenchyma could not be excluded or confirmed on the basis of the X-rays. In the remaining 245 (70%) the X-rays demonstrated "clearly visible fibrosis" and, depending on the parenchymal profusion, the finding was classified as subcategory 0/1 - 2/1 and higher, i.e. in 9% of the workers subcategory 1/1 was accompanied by visible bilateral pleuial plaques. According to the Criteria from the Conclusions ol a Workshop, on the basis of parenchymal profusion, asbestosis of the lungs would have to be acknowledged in 4% of those examined, while in 9% of the workers with parenchymal profusion of subcategory 1/1 or 1/2 asbestosis could be acknowledged only if visible bilateral plaques or pleural calcifications were present. On the other hand, according to the List of Occupational Diseases, only 15% of the examined workers offered no ground for acknowledging occupational parenchymal asbestosis. In another 15% of the workers additional confirmation would be necessary, based on computerized tomography or histopathological examination, by which parenchymal asbestosis could be confirmed or excluded.
Asbestosis of the lungs is a disease sui generis which should, with a positive work history, always be recognized as an occupational disease, after other etiology of the parenchymal fibrosis has been excluded. The extent of parenchymal profusion, other asbestos-related diseases and/or impaired ventilatory or diffusive function of the lungs are not decisive.
Keywords
asbestos exposure; parenchymal fibrosis; pleural plaques
Hrčak ID:
145236
URI
Publication date:
16.4.1996.
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