Individual AOEC Guidance Documents
Date: Spring 2000
Topic: Asbestos Screening
AOEC has temporarily removed the Medical Management of Lead Exposed Adults guidance while it is being updated
The Association of Occupational and Environmental Clinics is concerned that medically inadequate screening tests are being conducted to identify cases of asbestos-related disease for legal action. These tests do not conform to the necessary standards for screening programs conducted for patient care and protection. Screening is only conducted as a preliminary step in determining the presence of asbestos-related disease. AOEC therefore supports the following statement:
Screening on the basis of chest x-ray and work history alone identifies possible cases but does not by itself provide sufficient information to make a firm diagnosis, to assess impairment or to guide patient management.
An appropriate screening program for asbestos-related lung disease includes properly chosen and interpreted chest films, reviewed within one week of screening; a complete exposure history; symptom review; standardized spirometry; and physical examination.
Programs should also include smoking cessation interventions, evaluation for other malignancies and evaluation for immunization against pneumococcal pneumonia.
Timely physician disclosure of results to the patient, appropriate medical follow-up and patient education are essential.
Omission of these important preventive aspects in the clinical assessment of asbestos-related lung disease falls short of the standard of care and ethical practice in occupational health.
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