#0102 Retrospective investigation on diagnostic process for benign asbestos pleural effusion (BAPE) using checklist
A Six-Item Checklist is Suitable for Diagnosing Benign Asbestos Pleural Effusion
Benign asbestos pleural effusion (BAPE) is a medical term referring to asbestos-related lesions found within the pleural space, which is a body cavity located between the lungs and the chest wall. These lesions are nonmalignant (i.e., not cancerous), but the condition is sufficiently disabling that people with BAPE have been eligible for Japan’s industrial accident compensation scheme since 2003.
However, there is not yet any consensus regarding diagnostic criteria for BAPE, and researchers suspect that this lack of established criteria has led to many people with BAPE going undiagnosed and missing out on compensation payments. We therefore set out to compile a checklist of essential clinical features that should be present to justify a diagnosis of BAPE. Our results appear in an article recently published in the Journal of Occupational Health.
For our research, we retrospectively examined the clinical features of 105 men initially diagnosed with suspected BAPE through four hospitals in Japan. All of these men underwent thoracocentesis, which is a procedure in which clinicians remove air or fluids from the pleural cavity for diagnostic analyses.
After reviewing the available data, we agreed on a set of six diagnostic criteria: (1) occupational asbestos exposure; (2) thoracocentesis findings indicative of pleural damage; (3) the absence of thoracocentesis findings indicative of cancer; (4) the absence of thoracocentesis findings indicative of rheumatic, bacterial, or tuberculous pleural inflammation; (5) X-ray findings that rule out cancer; and (6) histopathology findings that also rule out cancer.
By applying these six criteria to the 105 suspected cases of BAPE, we determined that 87 cases were genuine. We rejected the other 18 cases on grounds such as the patient not having a history of asbestos exposure, having thoracocentesis findings suggestive of tuberculous pleural inflammation, or having clinical findings indicative of cancer.
In conclusion, we have succeeded in developing a brief diagnostic checklist that can be applied to cases of suspected BAPE. This checklist will help clinicians determine whether their patients are eligible for the Japanese government’s compensation scheme.
Link to the original journal article:
https://onlinelibrary.wiley.com/doi/10.1002/1348-9585.12182
Title of the paper:
Retrospective investigation on diagnostic process for benign asbestos pleural effusion (BAPE) using checklist
Authors:
Takumi Kishimoto, Nobukazu Fujimoto, Keiichi Mizuhashi, Satoko Kozawa, and Motohiko Miura
