Screening for asbestos-induced diseases in Finland

Abstract

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 I/O) 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. © 1996 Wiley‐Liss, Inc.

Impairment of lung function in asbestos-exposed workers in relation to high-resolution computed tomography

“…Previously 2857 persons with asbestos-related occupational nonmalignant pulmonary or pleural diseases among 18 900 asbestos-exposed persons were diagnosed (15,16) according to international guidelines (6,17). Of these, ethnically Finnish smoking men from the Helsinki area and willing to participate in additional studies and, in addition, nonsmokers with asbestosis were included (N=602) (18,19); however, women (N=10) and two persons with insufficient data were excluded.…”

Prospective population-based study on the survival of patients with lung cancer

“…However, survival was better in the present survey, suggesting that radiographical screening is not effective. Asbestos-induced diseases were screened in some groups of workers in the construction field, shipyards and in the manufacture of asbestos products in Finland during the years 1990-1992 [27]. However, only six out of 602 lung cancer patients in this series were recognized by this screening.…”

Radiographic abnormalities among Finnish construction, shipyard and asbestos industry workers

“…The mean age of those with positive findings was 59 years, and for those who were negative it was 51 years. The prevalence of radiological findings increased with age as reported earlier (5,18). Of all the 18 983 persons screened, 66% were still working.…”

“…Koskinen@occuphealth.fi] ize the follow-up, to stop further exposure to asbestos, to influence smoking habits, and to establish a register of heavily exposed and diseased workers, as well as to evaluate the possibilities of preventing asbestos-related cancer (3,5). In several studies of plumbers, pipefitters, boilermakers, carpenters, and other workers employed in building construction, parenchymal findings [International Labour Office (LO) 110 or higher] have ranged from 6.8% to 19.4% and pleural abnormalities from 16.8% to 29.4% (6-1 1).…”