#0063 Progress in educational program for diagnosis of occupational respiratory disease in Japan -Activity of Asian Intensive Reader of Pneumoconioses (AIR Pneumo)-
AIR-Pneumo Program can Improve Diagnosis and Surveillance of Occupational Lung Diseases
Occupational exposure to mineral dust like silica, coal and asbestos can cause a group of lung diseases known as ‘pneumonoconiosis’. These are characterized by damage to the lung tissue with fibrosis and result in difficulty in breathing with prolonged cough. The worldwide incidence of pneumonoconiosis has escalated by 66% over the last two decades with more than half of the cases from East Asia. Yet, several Asian countries do not have a surveillance system to monitor exposure and many enterprises do not seem to adhere to regulations and standards laid down by health authorities.
In an attempt to eliminate pneumonoconiosis, the International Labour Organization (ILO) and World Health Organization (WHO) jointly promote screening using ILO Classification of Radiograph of Pneumoconioses (ILO/ICRP). Collaboratively, the Occupational Lung Disease Study Group from Japan has established the Activity of Asian Intensive Reader of Pneumoconioses (AIR Pneumo) program to train physicians in improving proficiency towards diagnosing pneumonoconiosis from chest radiographs (CXRs). Diagnosis is mainly based on the presence of abnormal opacities such as small and large opacities and pleural (thin layer of tissue on the lung) abnormalities due to different densities of lung structures.
In the current study published in Journal of Occupational Health, my aim was to evaluate whether CXRs can accurately reflect the presence of pneumonoconiosis and to compare the diagnostic proficiency of AIR Pneumo trained physicians.
For this, chest computed tomography (CT) scans from 97 construction workers who were assessed by board certified physicians were treated as a reference. Various abnormalities were detected such as 9.3% irregular opacities, 1.0% ground glass opacities, 18.6% emphysema, 1.0% of honeycombing, and 1.0% lung cancer, along with 45.4% of pleural plaques and 6.2% of pleural calcification. AIR Pneumo trained physicians were able to detect abnormalities with high specificity, indicating that CXRs can be a useful educational tool. Moreover, CT images along with CXRs helped improved diagnostic accuracy.
Overall my findings suggest the need to improve the surveillance and monitoring of occupational lung diseases and that this can be achieved through the AIR Pneumo program. As laborers diagnosed with lung diseases are often dismissed by employers, regular screening can help better the management of occupational lung diseases and assessment of the risk of exposure. The program can help minimize the impact of occupational lung diseases not only in Asian countries but also worldwide.
Link to the original journal article:
https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12156
Title of the paper:
Progress in educational program for diagnosis of occupational respiratory disease in Japan -Activity of Asian Intensive Reader of Pneumoconioses (AIR Pneumo)-
Authors:
Yasuo Morimoto
