Asbestos screenings

Our plain-English summary of Asbestos screenings, by D. Egilman (American Journal of Industrial Medicine, 2002).

The study

• Author: D. Egilman
• Journal: American Journal of Industrial Medicine
• Published: 2002;42(2):163
• Type of article: Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This one-page letter to the editor is not a research study and gives no methods or count of workers reviewed. The author, an expert witness mainly for plaintiff lawyers, wrote that over the past 2 years many workers whose records and X-rays the author reviewed could not (due to inadequate latency or exposure) and did not show evidence of asbestos-related disease. The author attributed most such cases to lawyer-sponsored screenings, many consisting only of a chest X-ray with a B-reading, with no history, pulmonary function tests or smoking counseling. In one series, the reader knew the compensation cut-off and was paid $70 for a 1/0 reading, $35 for 0/1 or lower. Some X-rays went to as many as six radiologists until one reported a slightly positive reading. The author argued that the disparity in Johns-Manville bankruptcy payments ($10,000 for mesothelioma, up to $2000 for a non-impaired pleural case) had no medical cost justification. The author concluded that, to the extent litigation screenings involving physicians contribute to the problem, physicians and their organizations have a responsibility to speak out and intervene.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: letter to the editor (opinion based on the author's own observations as an expert witness; no formal study)
• Who was studied: workers whose medical records and X-rays the author reviewed while serving as an expert witness, mostly at the request of plaintiff lawyers; no number of workers, location or exact dates given
• Exposure: no fiber type or dose specified; the letter concerns lawyer-sponsored asbestos litigation screenings, many using only a chest X-ray with a B-reading
• Main results:
  • Over the past 2 years, the author noted that many of the workers reviewed could not (due to inadequate latency or exposure) and did not show any evidence of asbestos-related disease; no count was given
  • Many screenings included no history, pulmonary function tests, or smoking or continuing exposure-related counseling
  • In one series of ongoing screenings, the reader was paid $70 for a 1/0 reading and $35 for 0/1 or lower
  • In some screenings, a worker's X-ray had been sent to as many as six radiologists until the last one reported a slightly positive reading
  • The author stated that cancer victims often have medical bills in the $150,000 to $250,000 range, while patients with only questionable minimal asbestos-related X-ray changes have few expected medical costs
  • The author stated there is no medical cost justification for the disparity in Johns-Manville bankruptcy payments, in which a mesothelioma victim receives $10,000 and a non-impaired pleural case can receive as much as $2000
• The authors' conclusion: The author concluded that shopping X-rays around is not sound or proper medical practice and may harm some screened individuals, and that, to the extent litigation screenings requiring physician participation contribute to the problem, physicians and their organizations have a responsibility to speak out and intervene

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Related studies

• Inequities in reporting asbestos-related lung cancer: influence of smoking stigma and physician's specialty, workload and role perception — P. Verger, S. Arnaud, et al. (2008)
• Cohort mortality study of women compensated for asbestosis in Italy — D. Germani, S. Belli, et al. (1999)
• Compensation, radiographic changes, and survival in applicants for asbestosis compensation — W.O. Cookson, A.W. Musk, et al. (1985)
• Mesothelioma incidence surveillance systems and claims for workers' compensation. Epidemiological evidence and prospects for an integrated framework — A. Marinaccio, A. Scarselli, et al. (2012)
• Surveillance of mesothelioma and workers' compensation in British Columbia, Canada — T.L. Kirkham, M.W. Koehoorn, et al. (2011)
• Patterns of care for malignant pleural mesothelioma patients compensated by the Dust Diseases Board in New South Wales, Australia — S.C. Kao, S. Clarke, et al. (2013)

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