Screening
Occupational exposure
Workplace regulations promulgated by the Occupational Safety and Health Administration (OSHA) require that workers exposed to asbestos at or above 0.1 fibers/cm³ have an annual exam that consists of a medical and occupational history, a physical exam focused on the respiratory system and spirometry. Chest x-ray is required at baseline every 5 years within the first 10 years from the onset of asbestos exposure and for those ages ≤35 years. After 10 years of latency, it is required every 2 years for those ages >35 years through 45 years and every year for those >45 years.
OSHA: asbestos standard for general industry Opens in new window
In the UK, the Health and Safety Executive (HSE) has published guidance for physicians undertaking medical monitoring of workers who do licensed or unlicensed asbestos work.
There is an increased risk of lung cancer among both cigarette smokers and never smokers with asbestos exposure.[27][28][29][30][31] Low dose chest computed tomography is advisable for:[32]
Those ages ≥50 years with a history of ≥5 years of asbestos exposure in combination with either a history of smoking at least 10 pack-years with no limit on time since quitting, or
A history of asbestos-related parenchymal fibrosis.
General population
Screening of former workers with asbestos exposure or residents of areas where there is either natural or industrially derived asbestos contamination should be advised to minimize any future exposure, to emphasize the importance of smoking cessation, to identify people who are at increased risk of asbestos-associated cancers and to identify individuals who can take legal action for compensation.[1] There are no medications known to be useful after early identification to prevent progression. Medical and occupational history, spirometry and chest x-ray are used for screenings. Lung volumes, diffusing capacity, oblique radiographs, and high-resolution computed tomography are all more sensitive and, although used in a clinical setting for individual patients, typically have not been used in mass population-based screenings.
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