Recommendations for diagnosis and management of ILD are supported by quality evidence. These guidelines may be useful to help guide providers who are tasked with diagnosing and/or treating patients with occupationally related ILD.
There is preliminary evidence that the opinion letters of Navy physicians influenced case decisions. Because of the selection bias in how the cases came to the study population, a prospective cohort study is warranted to establish whether this conclusion and the other results noted are valid.
The U.S. Navy Asbestos Medical Surveillance Program is a comprehensive effort to decrease exposure to asbestos, a known health hazard. This study was part of a programmatic review of the Asbestos Medical Surveillance Program database, which included 233,353 radiographic examinations from 1990 to 1999. The initial review focused on incidental findings recorded by B-readers for 23,460 radiographs. Abnormalities reported included bullae (0.68%), cancer (0.56%), cardiac size/ shape abnormalities (1.36%), emphysema (0.74%), subpleural fat (2.62%), fractured ribs (1.24%), hilar adenopathy (0.13%), ill-defined diaphragm (0.46%), ill-defined heart border (0.29%), Kerley lines (0.06%), pleural thickening (2.35%), and tuberculosis (0.27%). The rates by age cohort for pleural abnormalities decreased significantly (30-39 years, chi2 for trend = 23.49, df = 1; 40-49 years, chi2 for trend = 176.21; 50-59 years, chi2 for trend = 401.87), but findings were not significantly different for those > or =60 years of age. This suggests that sequential age cohorts in the program are developing fewer pleural abnormalities; pleural abnormalities have historically been associated with asbestos exposure.
A 10-year cross-sectional analysis was conducted for 233,353 radiographic examinations performed as part of the Navy Asbestos Medical Surveillance Program. Demographic and temporal trends in abnormal radiographs were assessed during this analysis. Abnormal radiograph prevalence increased significantly with age, and abnormal radiographs were nearly 30 times more likely to occur among participants 60 to 69 years of age, compared with participants < 20 years of age (odds ratio, 27.57; 95% confidence interval, 14.75-51.53). Men were 5 times more likely than women to have an abnormal radiograph (odds ratio, 5.84; 95% confidence interval, 5.02-6.80); after controlling for differences in age, this gender association remained significant only for participants > 30 years of age. The proportion of abnormal radiographs decreased significantly over the study period [chi2 (df = 1) test for trend, chi2 = 198.7, p < 0.0001], although the cohort mean age increased. Despite aging of the Asbestos Medical Surveillance Program population, the overall prevalence of radiographic abnormalities is declining; future studies should examine the reasons for this observation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.