Routine chest radiograph in pre-employment medical examination for healthcare workers: Time for a review of the protocol

Adeko, Oluseun O.; Ariba, Adekunle Joseph; Olatunji, AO; Toyobo, Oluyemisi O

doi:10.4103/npmj.npmj_55_17

Cited by 6 publications

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“…abnormalities [4], and quite apart from those of Moifo et al who found 2.5% of pathologies in a study evaluating the role of routine chest radiography in students during university enrollment in an area endemic for tuberculosis [5].…”

Section: Discussionmentioning

confidence: 78%

“…Most of the workers in our studied population were men, this was due to the fact that most of the personnel of the companies occupy posts dedicated to men, such as storekeepers, drivers, assistant drivers and mechanics, posts dedicated to few women, hence the low representation of women in this study. With an average age of 39 years, we think that this represents perfectly the majority of people of working age, able to exercise the different trades found in the companies concerned by these periodic medical visits, the majority of these staff was between 30 and 47 years old, about 78%, Adeko et al [4] in a study of routine chest X-ray during pre-employment medical visits to health workers found an average age of 26.6 years and from 20 to 49 years was predominant, this difference is due to the fact that in this study the people concerned are still looking for work whereas in our study, they are confirmed workers in different companies.…”

Section: Discussionmentioning

confidence: 91%

“…Its usual justification outside any occupational exposure is the search for undifferentiated tuberculosis [3]. Adekol et al in a study on routine chest X-ray in pre-employment medical examination for healthcare workers found a single abnormality that was cardiomegaly in 4.8%, so 66% was over 41 years old therefore significantly associated with age, he therefore concluded that this practice was not necessary and should be reserved for older workers [4]. Moifo et al…”

Section: Introductionmentioning

confidence: 99%

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Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Guena¹,

Tchouezoue²,

Alapha³

et al. 2019

AMI

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Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus 2 -Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clini-How to cite this paper: Guena, M.N., 44Advances in Molecular Imaging cal signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Guena¹,

Tchouezoue²,

Alapha³

et al. 2019

AMI

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“…Por otro lado, existen investigaciones que no están a favor de la utilización de las radiografías de tórax de manera rutinaria como parte de los exámenes médicos con fines laborales. Así tenemos que, Adeko et al, evaluó 416 radiografías de tórax pre ocupacionales en un centro hospitalario de Nigeria y encontró hallazgos anormales en la radiografía de tórax en el 4,8 %; sugiriendo que el uso de la radiografía de tórax sea limitado a personas mayores de cuarenta años [12] . Samuel et al, revisó 4 113 radiografías de tórax de personas que solicitaron evaluación previa al empleo en la India, encontrando 202 anomalías (4,9 %) y necesitando evaluación adicional el 0,17 % recomendaron que las radiografías de tórax previas al empleo deben restringirse a postulantes con antecedentes relevantes y con hallazgos clínicos sugestivos de enfermedad pulmonar [13] .…”

Section: Discussionunclassified

Factores asociados a hallazgos anormales en radiografías digitales de tórax en trabajadores asintomáticos en Lima, Perú

Maguiña

Murguía²,

Verona

et al. 2021

Acta Med Peru

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Introducción: La radiografía posteroanterior (PA) de tórax es utilizada rutinariamente como examen complementario en la evaluación de trabajadores. Sin embargo, existe la controversia sobre su indicación y utilidad en todos los trabajadores. El presente estudio tuvo como objetivo describir los factores asociados a hallazgos anormales en radiografías digitales de tórax en trabajadores sin síntomas respiratorios. Materiales y métodos: Realizamos un estudio observacional transversal analítico, utilizando registros de placas radiografías digitales de tórax PA de 24069 trabajadores asintomáticos respiratorios, evaluados en un establecimiento de salud acreditado para la realización de exámenes médicos ocupacionales en el Perú, entre los años 2016 - 2019. Resultados: De los 24069 trabajadores asintomáticos, 1166 (4,84% IC 95% [4,58 – 5,12]) presentaron radiografía anormal. Los principales hallazgos se encontraron en el parénquima pulmonar y de estas, las imágenes secuelares de tuberculosis fueron las más frecuentes. Se observó que los trabajadores mayores de 50 años (RP(a) = 6,34), los que presentaron bajo peso (RP(a) = 2.71) y los que tuvieron antecedentes patológicos pulmonares (RP(a) = 6,19) presentaron mayor probabilidad de presentar anormalidades en la radiografía pulmonar. Conclusiones: Debido a la baja frecuencia de radiografías digitales anormales de tórax, creemos que no resulta de utilidad como detección precoz de patología respiratoria en la población estudiada y que debería considerarse en trabajadores mayores de 50 años, con antecedente de enfermedad respiratoria y/o con bajo peso. Es importante realizar mayor cantidad de estudios que confirmen nuestros resultados.

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ACR Appropriateness Criteria® Routine Chest Imaging

Bang,

Chung,

Walker

et al. 2023

Journal of the American College of Radiology

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Routine chest radiograph in pre-employment medical examination for healthcare workers: Time for a review of the protocol

Abstract: Routine CXR as part of PEME for prospective employees into this healthcare institution is no longer necessary. It is suggested that its routine use should be limited to older job seekers.

Cited by 6 publications

References 0 publications

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Factores asociados a hallazgos anormales en radiografías digitales de tórax en trabajadores asintomáticos en Lima, Perú

ACR Appropriateness Criteria® Routine Chest Imaging

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