Criteria for diagnosis of occupational asbestosis of the pulmonary parenchyma and pleura
Zavalić, M.; Bogadi-Sare, A.
Arhiv Za Higijenu Rada i Toksikologiju 46(4): 433-444
1995
ISSN/ISBN: 0004-1254 PMID: 8670014 Document Number: 448309
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 the 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 asbetosis of the lung is recognized only when parenchymal profusion is subcategory 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 Medical 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 (profession 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 246 (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 pleural plaques. According to the Criteria from the Conclusions of 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 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 asbestosis-related diseases and/or impaired ventilatory or diffusive function of the lungs are not decisive.