Documents chest radiography 6 results

Background Diffuse pleural thickening and pleural plaques are the commonest radiological manifestations of asbestos exposure. Differentiation between subpleural fat and non-calcified pleural plaques is important clinically and medico-legally. This study aims to determine if apparent circumscribed pleural thickening on chest radiographs is related with obesity. Methods Surveillance chest x-rays of 693 former asbestos workers were read with the ILO classification. Subjects with costophrenic angle obliteration (n = 57) were analyzed separately. The remaining subjects were subdivided according to their body mass index (BMI): Group 1 < 26 kg/m2; Group 2 26-30 kg/m2; Group 3 > 30 kg/m2. Results Baseline characteristics, asbestos exposure, and profusion scores were evenly distributed. BMI of > 30 kg/m2 was associated with a higher prevalence of pleural thickening on CXR (Gp1 = 8.5%; Gp2 = 9.3%; Gp3 = 18.3%). This relationship was strongest in the subgroups with 25-50% of the lateral chest wall involved and pleural thickness of < 10 mm. Conclusions Obesity (BMI > 30 kg/m2) is related to apparent circumscribed pleural thickening on CXR, especially thin (< 1 cm) shadows covering 25-50% of the lateral chest wall.

A retrospective study of the possible association between retroperitoneal fibrosis and occupational asbestos (1332214) exposure was conducted, using hospital records for all cases of retroperitoneal fibrosis diagnosed in Tampere University Hospital, in Finland, for 1987 through 1995. There were 13 cases of idiopathic retroperitoneal fibrosis. Patients had surgery for ureteral obstruction, and ureterolysis was performed. Information on occupational history was obtained by questionnaire or interview for the ten living patients. All seven male patients showed exposure to asbestos in their occupational history, whereas generally only 5% of the total labor force in Finland has been so exposed. The asbestos exposure was confirmed by chest radiograph findings, which showed typical changes due to asbestos in four of the seven male patients exposed to asbestos, and an additional patient had a suggestive radiographic finding, unilateral plaque. The rate of bilateral plaques among the male patients was eight times more than that of the Finnish male population. The authors suggest that it may be possible for retroperitoneal fibrosis to be associated with asbestos exposure in the absence of radiographic pulmonary abnormalities. Three of the six female patients and one male patient had other risk factors for retroperitoneal fibrosis than asbestos exposure. The authors conclude that occupational exposure to asbestos may be an important etiological factor for retroperitoneal fibrosis. They encourage clinicians to take careful note of work histories when evaluating such patients, with special attention to asbestos exposure.

"We studied occupational physicians' (OPs) practices of referrals for imaging of workers occupationally exposed to lung/pleural carcinogens and the factors associated with them. This cross-sectional telephone survey of 379 OPs practicing in Southeastern France showed that 81% of them referred exposed patients for chest radiographs, 33.5% for computed tomography (CT), and 16.1% for neither. Making no referral was positively associated with believing cancer risks are lower in one's own geographic sector than elsewhere and negatively associated with keeping employee risk records up-to-date. Referrals for CT were positively associated with work at in-house occupational health services (OHS), and completing employee exposure histories often/always. Both the OHS type and factors that may shape OPs' awareness of cancer risks in their sector appear to influence imaging referral practices. Occupational physicians would benefit from guidelines clarifying benefits and risks associated with imaging in such patients. An effort to harmonize regulatory provisions and guidelines also appears necessary."