We have observed that the companion shadow of the upper rib may be misinterpreted as a small pnemothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their frndings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 compaion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any othe rivs due to its apical location and thinness. In six of 50 normal cases, the companion shadow on the first or second rib showed an inw rdly convex lower margin, mimicking pleural plaque. The compaion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity(47/50), thicker than normal pleura(3/4), persistent on serial filma with the same shape and specific location(4/4).
Asbestosis ; Friends* ; Humans ; Pleura ; Pneumothorax ; Radiography, Thoracic ; Ribs* ; Thinness

Pulmonary asbestosis is defined as bilateral diffuse interstitial fibrosis of the lungs caused by exposure to asbestos. Many occupations are at risk for asbestos exposure, particularly in the mining, milling, manufacturing, construction, shipbuilding, and automotive industries. Therefore, the prevalence of asbestosis should be fairly widespread. The diagnosis of asbestosis can be made on either clinical or pathological grounds. We recently encountered one case of asbestosis which was confirmed histologically. On HRCT, there was ground-glass opacity with irregular linear shadows, subpleural curvilinear lines and parenchymal bands. Neither plaque nor calcification were noted. The histologic findings observed on open-lung biopsy specimen were well in accord with those in HRCT. Many asbestos-coated bodies were present along with black dust.
Asbestosis/radiography* ; Asbestosis/pathology* ; Biopsy ; Case Report ; Human ; Male ; Middle Age ; Radiography, Thoracic ; Tomography, X-Ray Computed

Progressive massive fibrosis (PMF) involves extensive fibrosis of the lung and is usually bilateral in nature. This lesion occurs in patients showing silicosis and other pneumoconioses, including asbestosis, coal workers' pneumoconiosis, or mixed dust fibrosis. PMF tends to exacerbate fairly rapidly and may continue to grow even if the dust hazard is removed. It is frequently associated with functional impairment, including reduction in lung compliance, lung volumes, diffusing capacity, and presence of hypoxemia. However, pulmonary hemorrhage is rarely observed along with PMF. We present an autopsy case of a silicosis patient who died as a result of PMF complicated with massive hemoptysis.
Anoxia ; Asbestosis ; Autopsy ; Coal ; Dust ; Fibrosis ; Hemoptysis ; Hemorrhage ; Humans ; Lung ; Lung Compliance ; Pneumoconiosis ; Silicosis

Asbestos causes several asbestos related diseases (ARDs). Not only occupational asbestos exposure but also environmental asbestos exposure can cause ARDs. In Korea compensation for workers with ARDs has been provided by workers' compensation. Because the asbestos damage relief act (ADRA) was enacted in 2011, ARDs by environmental exposure can now be compensated. Korea is the sixth country in the world to compensate environmental asbestos victims. In the ADRA, the list of compensable diseases eligible for relief consists of lung cancer, malignant mesothelioma, and asbestosis. Because the back ground and criteria of each ARD for relief is different, physicians need to be familiar with all of them in order to deal with ARD patients. In this paper, the properties of asbestos, history of ARDs, and contents of the ADRA are discussed. Although the relationships between occupational asbestos exposure and ARDs have been well established, those for environmental exposure have not. More specifically, the relationship between lung cancer and environmental asbestos exposure is still not clear because of strong confounders. The first wave of asbestos problems arose from occupational exposure directly involving asbestos production, the second wave arose from usage of asbestos products, and the third wave would be related to asbestos ubiquitous in the environment. In Korea the second wave is just beginning to swell. Physicians must to prepare for these waves to crest in the near future.
Asbestos ; Asbestosis ; Compensation and Redress ; Environmental Exposure ; Humans ; Korea ; Lung Neoplasms ; Mesothelioma ; Occupational Exposure ; Workers' Compensation

Asbestos is a naturally occurring mineral in the Earth's crust, and it is not confined to the historic and current asbestos mining areas, but rather quite commonly encountered in certain geological environments across the world. The middle-west side of the Korean Peninsula (Chungnam province) has been composed of numerous talc and asbestos ore deposits derived from serpentine and dolomite. These areas have experienced epidemics of malignant mesothelioma and pleural plaques as a result of non-occupational "neighborhood" exposure and naturally occurring asbestos (NOA) exposure. However, asbestosis epidemics from environmental exposure were rare because asbestosis needs relatively high concentration of asbestos exposure. This review summarizes asbestosis epidemics which occurred in the residents who have lived past or current asbestos mining areas and natural in-place asbestos deposits (or asbestos-like mineral deposits) in the world, including Korean asbestosis endemics that occurred in Chungnam province, which has many historic asbestos mining. Also, this manuscript will describe effective public policies for managing NOA, minimizing potential hazards, and protecting public health from asbestos exposure.
Asbestos ; Asbestosis ; Calcium Carbonate ; Environmental Exposure ; Magnesium ; Mesothelioma ; Mining ; Public Health ; Public Policy ; Residence Characteristics ; Talc

The incidence of asbestos-related diseases (ARD) has increased in the last four decades. In view of the historical use of asbestos in Singapore since the country started banning it in phases in 1989 and the long latency of the disease, the incidence of ARD can be expected to increase further. As occupational exposure to asbestos still occurs, preventive measures to eliminate ARD continue to be required to protect the health of both workers and the public from asbestos exposure. The majority of occupational exposures to asbestos at present occur during the removal of old buildings. Preventive measures have been utilized by different government ministries and agencies in eliminating ARD in Singapore over the past 40 years. These measures have included the enforcement of legislation, substitution with safer materials, and engineering controls during asbestos removal as well as improvements in personal hygiene and the use of personal protective equipment. The existing Workman's Compensation System for ARD should be further refined, given that is currently stipulates that claims for asbestosis and malignant mesothelioma be made within 36 and 12 months after ceasing employment.
Asbestos ; Asbestosis ; Compensation and Redress ; Employment ; Humans ; Hygiene ; Incidence ; Mesothelioma ; Occupational Exposure ; Singapore ; Workers' Compensation

BACKGROUND: We assessed the cancer risks of four different Finnish asbestos-exposed cohorts. We also explored if the cohorts with varying profiles of asbestos exposure exhibited varying relative risks of cancer. METHODS: The incident cancer cases for the asbestos-exposed worker cohorts were updated to the end of 2012 using the files of the Finnish Cancer Registry. The previously formed cohorts consisted of asbestos mine workers, asbestosis patients, asbestos sprayers, and workers who had taken part in a screening study based on asbestos exposure at work. RESULTS: The standardized incidence ratio (SIR) for mesothelioma varied from about threefold to > 100-fold in the different cohorts. In the screening cohort the SIR for mesothelioma was highest in 2003–2007, In other cohorts it was more constant in 5-year period inspection. The SIR for lung cancer was about twofold to tenfold in all except the screening cohort. Asbestos sprayers were at the highest risk of mesothelioma and lung cancer. CONCLUSION: The SIR for mesothelioma is high in all of the cohorts that represent different kinds of asbestos exposure. The smaller SIR for mesothelioma in the screening cohort with lowest level of asbestos exposure might suggest dose-responsiveness between asbestos exposure and mesothelioma. It does seem that the highest risk of lung cancer in these cohorts except in the youngest of the cohorts, the screening cohort, is over. The highest SIR for lung cancer of the asbestosis patient and sprayers cohort is explained by their heavy asbestos exposure.
Asbestos ; Asbestosis ; Cohort Studies* ; Follow-Up Studies ; Humans ; Incidence* ; Lung Neoplasms ; Mass Screening ; Mesothelioma ; Miners

Carcinogenicity of asbestos has been well established for decades and it has similar approval standards in most advanced countries based on a number of studies and international meetings. However, Korea has been lagging behind such international standards. In this study, we proposed the approval standards of an occupational cancer due to asbestos through intensive review on the Helsinki Criteria, post-Helsinki studies, job exposure matrix (JEM) based on the analysis of domestic reports and recognized occupational lung cancer cases in Korea. The main contents of proposed approval standards are as follows; (1) In recognizing an asbestos-induced lung cancer, diagnosis of asbestosis should be based on CT. In addition, initial findings of asbestosis on CT should be considered. (2) High Exposure industries and occupations to asbestos should be also taken into account in Korea (3) An expert's determination is warranted in case of a worker who has been concurrently exposed to other carcinogens, even if the asbestos exposure duration is less than 10 years. (4) Determination of a larynx cancer due to asbestos exposure has the same approval standards with an asbestos-induced lung cancer. However, for an ovarian cancer, an expert's judgment is necessary even if asbestosis, pleural plaque or pleural thickening and high concentration asbestos exposure are confirmed. (5) Cigarette smoking status or the extent should not affect determination of an occupational cancer caused by asbestos as smoking and asbestos have a synergistic effect in causing a lung cancer and they are involved in carcinogenesis in a complicated manner.
Asbestos* ; Asbestosis ; Carcinogenesis ; Carcinogens ; Diagnosis ; Judgment ; Korea* ; Laryngeal Neoplasms ; Lung Neoplasms ; Occupations ; Ovarian Neoplasms ; Smoke ; Smoking

Asbestosis is the most important change noted in the lung parenchyma after environmental and occupational exposure to asbestos fibers. It is characterized by diffuse interstitial pulmonary fibrosis. In Korea, the incidence of asbestosis will continue to increase for many years to come and the government enacted the Asbestos Damage Relief Law in 2011 to provide compensation to those suffering from asbestos-related diseases. Radiologic evaluation is necessary for diagnosis of asbestosis, and radiologists play a key role in this process. Therefore, it is important for radiologists to be aware of the various imaging features of asbestosis.
Asbestos ; Asbestosis* ; Compensation and Redress ; Diagnosis* ; Incidence ; Jurisprudence ; Korea* ; Lung ; Occupational Diseases ; Occupational Exposure ; Pulmonary Fibrosis ; Radiography

The classification for pneumoconiosis which was developed by International Labour Office(ILO) on the basis of Radiological findings of simple chest radiography has been widely used for the study and diagnosis of pneumoconiosis. But many problems have been revealed during the pneumoconiosis study using this classification. Those problems come from simple radiography itself or classification systems. Among those, inter-reader and intra-reader variability are the severest problems, even though many efforts have been devoted to lessen the variability. With introduction of computed tomography (conventional CT and HRCT), we are learning many new aspects about the occupational lung diseases, especially pneumoconiosis. So the studies for pneumoconiosis using tomography are reviewed, focusing on silicosis, coalworkers' pneumoconiosis, and asbestosis. But in our country, the studies of that kind are very scant. It is necessary to study and diagnose pneumoconiosis by CT, because that is the need of workers and the responsibility of physicians working in the field of occupational medicine. CT is superior to simple radiography in early detection, determination of severity, and follow-up of pneumoconiosis. But simple radiography is and should be the main method for the study and diagnosis of pneumoconiosis. Although, because of radiation hazard, cost, time, and geographical availability, the method can not and should not be used on the routine basis, we have to consider the use of CT, if possible and if necessary. Before using CT widely, we should develop the standardized criteria regarding to scanning methods and reading criteria. If not, the same problems as those of simple radiography will be occurred, and then there will be no progress in occupational medicine and workers' health.
Asbestosis ; Classification ; Diagnosis* ; Follow-Up Studies ; Learning ; Lung Diseases ; Occupational Medicine ; Pneumoconiosis* ; Radiography* ; Silicosis ; Thorax