An asbestos-exposed worker who smokes cigarettes has a high risk of developing cancer of the lung. One thousand ninety-five former workers at a plant manufacturing asbestos (amosite) insulation products were exposed to high levels of asbestos dust concentrations in the atmosphere. The workers have been identified and located. A semi-annual medical surveillance program has been developed with National Cancer Institute support. Examination of the worker includes the following: history (questionnaire), physical examination, sputum cytopathology, chest roentgenogram, pulmonary function studies, and other tests. Emphasis has been placed on understanding the role of sputum cytopathology in a cancer control program in former asbestos workers.

It is concluded that sputum cytopathology is an excellent, simple, noninvasive, painless, and inexpensive means for early detection of malignant and premalignant lesions of the lung, and that no special techniques are necessary for the identification of ferruginous bodies.

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