Korean J Occup Environ Med.  2006 Jun;18(2):112-122.

Usefulness of High Resolution Computed Tomography (HRCT) in the Diagnosis of Asbestos-Related Lung Diseases

Affiliations
  • 1Department of Occupational Medicine, Dong-A University Hospital, Korea.
  • 2Department of Preventive Medicine, College of Medicine, Dong-A University, Korea. yshong@daunet.donga.ac.kr
  • 3Medical Research Center for Cancer Molecular Therapy, Dong-A University, Korea.
  • 4Department of Occupational Medicine, College of Medicine, Dong-A University, Korea.
  • 5Center of Occupational and Environmental Medicine, Incheon Sarang Hospital, Korea.
  • 6Department of Occupational Medicine, Hallym University Sacred Heart Hospital, Korea.
  • 7Department of Occupational and Environmental Medicine, College of Medicine, Soonchunhyang University, Korea.

Abstract


OBJECTIVES
This study was carried out to improve the medical surveillance program of workers exposed to asbestos by examining the usefulness of High Resolution Computed Tomography (HRCT) in the diagnosis of asbestos-related lung disease.
METHODS
The study subjects comprised 162 workers in a ship-repairing yard, 68 of whom had been directly exposed to asbestos and 94 indirectly exposed. The 'Occupational Safety & Health Administration (OSHA) asbestos standard, medical surveillance program' and HRCT were conducted to analyze the aspects of the asbestos-related lung disease. The OSHA asbestos standard, medical surveillance program consists of simple chest x-ray, spirometry and medical questionnaire.
RESULTS
Seventeen (10.5%) of the 162 subjects, 10 (14.7%) directly exposed and 7 (7.4%) indirectly exposed, revealed asbestos-related lung disease on HRCT. The sensitivity and specificity of simple chest x-ray for asbestos-related lung disease were 70.6% and 98.6%, and the positive and negative predictive values were 85.7% and 96.6% respectively, as compared with HRCT. HRCT was an effective diagnostic tool especially to detect early asbestos-related lung disease. The study results indicated a relative significant association between the results of spirometry and HRCT. The variables significantly associated with asbestos-related lung disease on HRCT were work duration, smoking history (pack-years), past history of respiratory disease, cough and dyspnea.
CONCLUSIONS
In the diagnosis of asbestos-related lung disease, HRCT should be considered not only for workers with positive findings on simple chest x-ray, but also workers with specific findings on spirometry, occupational history, smoking history, and past history of respiratory disease, or with respiratory symptoms such as cough and dyspnea.

Keyword

Asbestos; High Resolution Computed Tomography (HRCT); Medical surveillance

MeSH Terms

Asbestos
Cough
Diagnosis*
Dyspnea
Lung Diseases*
Lung*
Questionnaires
Sensitivity and Specificity
Smoke
Smoking
Spirometry
Thorax
United States Occupational Safety and Health Administration
Asbestos
Smoke
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