BACKGROUND & AIMS:
Screening for asbestos-induced diseases in Finland was carried out in 1990-1992 as a part of the Asbestos Program of the Finnish Institute of Occupational Health. The aim of the present study was to find the workers who had developed an asbestos-induced disease in certain occupations. Examination of active or retired workers included a personal interview on work history and asbestos exposure, and a chest X-ray. The target group for the screening comprised workers under 70 years of age who had worked at least for 10 years in construction, 1 year in a shipyard or in the manufacture of asbestos products. A preliminary questionnaire was sent to 54,409 workers, 18,943 of whom finally participated in the screening examination. The mean age of the workers was 53 years; 95% were employed in construction, 2% in shipyards, and 3% in the asbestos industry. The criteria for a positive screening result were (1) a radiographic finding clearly indicating lung fibrosis (at least ILO category 1/1), (2) a radiographic finding indicating mild lung fibrosis (ILO category 1/0) with unilateral or bilateral pleural plaques, (3) marked abnormalities of the visceral pleura (marked adhesions with or without pleural thickening), or (4) bilateral pleural plaques. The positive cases totalled 4,133 (22%) and were sent for further investigation. In addition to the screening, information on the presence of asbestos in the work environment, prevention of asbestos exposure, as well as on the health effects of asbestos exposure and smoking were given to the participating workers. The screening acted as a preliminary survey to prompt further national follow-up of asbestos-induced diseases among the workers who have been exposed to asbestos. This article presents the material, methods, and overall results of the screening.
背景与目标:
1990-1992年,作为芬兰职业健康研究所石棉计划的一部分,对芬兰的石棉诱发疾病进行了筛查。本研究的目的是寻找在某些职业中患有石棉诱发疾病的工人。对现役或退休工人的检查包括对工作经历和石棉暴露的个人访谈,以及胸部X光检查。筛查的目标人群包括70岁以下的工人,这些工人至少在建筑业工作了10年,在造船厂工作了1年,或者在制造石棉产品中工作了至少1年。初步调查表已发送给54,409名工人,其中18,943名工人最终参加了筛查。工人的平均年龄为53岁;建筑业雇用了95%,造船厂雇用了2%,石棉行业雇用了3%。阳性筛查结果的标准是(1)影像学检查明确表明肺纤维化(至少是ILO 1/1类),(2)影像学检查表明患有轻度肺纤维化(ILO 1/0类)伴有单侧或双侧胸膜斑块,(3)内脏胸膜明显异常(明显的粘连伴或不伴有胸膜增厚),或(4)双侧胸膜斑。阳性病例总计4,133(22%),并已送去进一步调查。除筛查外,还向参加活动的工人提供了有关工作环境中石棉的存在,石棉暴露的预防以及石棉暴露和吸烟对健康的影响的信息。筛查是一项初步调查,目的是促使在接触石棉的工人中进一步对石棉诱发的疾病进行全国性的随访。本文介绍了筛选的材料,方法和总体结果。