Asbestos disease screening by non-specialists

We performed a medical audit of an asbestos disease screening program offered to New York City sheet metal workers by a corporate medical service. The screening program purported to evaluate the health status of workers exposed to asbestos in the past and present during construction and renovation of commercial buildings. Using current Occupational Safety and Health Administration (OSHA) regulations as a benchmark, medical records for more than 800 workers who took the examination between 1982-83 were reviewed; x-ray interpretations of the staff radiologist were compared with the interpretations of specialists in occupational lung diseases. The audit found inadequate record-keeping procedures, a lack of a comprehensive occupational history, poor notification and absence of any form of health education. Further, there was an extreme lack of concordance between the staff radiologist and the specialist readers in the interpretation of x-rays (kappa = .14 for pleural disease and .26 for asbestosis). To an increasing extent, occupational clinical services are being provided by corporate medical groups; such groups may not be familiar with occupational health problems

Asbestos · Asbestosis · Audit · Business · Concordance · Disease · Environmental health · Family medicine · Medical emergency · Medical record · Medical surveillance · Occupational disease · Occupational exposure · Occupational lung disease · Occupational medicine · Occupational safety and health · Pathology · Medicine · Occupational and environmental lung diseases · Occupational Health and Safety Research · Radiation Dose and Imaging · Surgery

• Asbestos examinations for construction workers

  M D Whorton•American Journal of Public Health•1986

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• Statistical Methods for Rates and Proportions

  Open Access•Joseph L Fleiss, Bruce Levin et al.•Statistical methods for rates and…•2003

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• Activities of an employer independent Occupational Medicine Clinic, Cook County Hospital, 1979-1981

  Peter Orris, Mary Jayne Kennedy et al.•American Journal of Public Health•1982

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