An audit of 3859 preadmission chest radiographs of apparently healthy students in a Nigerian Tertiary Institution

Abstract

Background:Chest radiographs are routinely requested as part of the medical screening process prior to admission to institutions. Literature on the yield of such an exercise is sparse especially in the Nigerian setting. This study was therefore carried out to assess the usefulness of routine chest radiography for students at the time of admission.Materials and Methods:This was a prospective study of 3859 chest X-rays taken at the department of radiology, University of Benin Teaching Hospital for one admission screening for the 2008/2009 academic year. The age and sex of the subjects were also recorded. The heart, lung fields and bony thorax were examined for any abnormality.Results:Out of the 3859 pre-admission chest radiographs studied, there were 1951 males or 50.56% and 1908 females or 49.44% subjects. The mean age for males was 21.15±3.Conclusion:This study has shown that pre-admission routine chest radiography in asymptomatic patients remains a relevant screening tool for medical fitness during admissions into institutions. However because of dangers of exposure to ionizing radiation, we advise that a detailed medical history and physical examination be done to restrict its use to only those subjects with signs and symptoms suggestive of disease.

An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria

“…The most common pulmonary lesion detected in this study is pulmonary tuberculosis (TB). Tuberculosis continues to be a pressing public health problem in developing nations [3]. Lee et al [12] showed tuberculosis and cardiomegaly as the commonest findings in their study.…”

“…In the light of proper indication, its use and importance cannot be overemphasized [5]. On the other hand, its use for routine health examinations; preadmission, preoperative, preemployment and lung cancer screening has long been a source of intense controversy [1][2][3][4][5][6].…”

“…In many establishments around the world, routine preemployment chest radiograph is performed to assess the medical fitness of prospective employees [1,2]. Nigeria, where pre-employment chest radiograph is routinely done in many large private as well as government owned facilities, is not an exception in this trend [3]. The second rationale for pre-employment chest x-ray is to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis [4,5].…”

“…The second rationale for pre-employment chest x-ray is to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis [4,5]. Despite these focused goals, there has been a lot of discussion regarding the usefulness or otherwise of routine chest radiographs as part of screening of prospective employees, with some studies concluding in favour and others against such practice [1,3,[4][5][6]. Critics have cited the often clinically-insignificant findings flagged by this screening as one of the drawbacks of this practice [3].…”

“…Despite these focused goals, there has been a lot of discussion regarding the usefulness or otherwise of routine chest radiographs as part of screening of prospective employees, with some studies concluding in favour and others against such practice [1,3,[4][5][6]. Critics have cited the often clinically-insignificant findings flagged by this screening as one of the drawbacks of this practice [3]. The required follow-up or clearance for these findings can delay employment, result in the rejection of an otherwise healthy candidate, divert resources and cause unnecessary expenses [1,4].…”