PURPOSE: To describe the characteristic HRCT appearance and to evaluate the usefulness of HRCT in patients with welders' pneumoconiosis. MATERIALS AND METHODS: Chest radiographs and high-resolution computed tomography(HRCT) of 45 shipyard welders(male : female=41 : 4 ; age : 36-58 years, mean 47.8) with an occupational history of 4-25(mean 15.8) years were evaluated. Small rounded opacities in chest radiographs were read accordingto the ILO standard films(1980). HRCT were evaluated with micronodules, ground-glass attenuation, and other findings. Serial HRCT scans of seven welders taken 27 months apart were also evalauted. Two of these were still working in that job ; five had not worked as welders for 1-6(mean 4.4) years. RESULTS: HRCT of welders' pneumoconiosis showed poorly marginated centrilobular branching or dot opacities of low attenuation(n=36, 80.0%)with variable profusion and extent and ground-glass attenuation(n=8, 17.8%). HRCT abnormalities were seen in 39 welders(86.7%). It was able to depict micronodules(n=13) and/or ground-glass attenuation(n=3) in 15(68.2%) of 22welders with normal chest radiograph. Serial HRCT revealed no changes in parenchymal abnormalities(n=6) andslightly decreased profusion of micronodules(n=1). There was no HRCT abnormality suggesting gross parenchymal fibrosis. CONCLUSION: HRCT is more sensitive than chest radiography in detecting parenchymal changes in welders' pneumoconiosis, with characteristic poorly-marginated centrilobular branching opacities or dots and ground-glass attenuation. These HRCT appearances may be helpful in differentiating welders' pneumoconiosis from other diffuse lung diseases.
Pneumoconiosis* ; Radiography ; Radiography, Thoracic ; Thorax

Humans ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; standards ; X-Ray Film

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The Purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending over two or more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiography in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in FEV1, FEV1/FVC, PEER, FEF25, FEF50, and FEF75 and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.
Classification ; Dust ; Emphysema ; Humans ; Lung ; Pneumoconiosis* ; Prognosis ; Radiography ; Thorax

No abstract available.
Coal* ; Humans ; Pneumoconiosis* ; Radiography, Thoracic* ; Smoke* ; Smoking* ; Thorax*

Humans ; Pneumoconiosis ; diagnostic imaging ; Radiographic Image Enhancement ; Radiography ; methods

Humans ; Lung ; Pneumoconiosis/diagnostic imaging* ; Radiography ; Tomography, X-Ray Computed

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

Most of pneumoconiosis found in Korea can be categorized in coal worker's pneumoconiosis. However, in recent years, pneumoconiosis has been frequently found in the workers of manufacturing factories. Accordingly, this study was carried out to investigate relationship of dust exposure history and development and progress of pneumoconiosis. Chest radiographs, history of dust exposure, and other data of 144 workers, who were diagnosed as suspecter pneumoconiosis (0/l) or pneumoconiosis in special health examination center in Incheon from 1986 to 1996, were reviewed. The results were as follows ; 1. According to the type of main exposure, most common type of exposure was foundry dust(93workers, 64.6%), followed by welding fume(16workers, 11.1%), talc dust, lime dust and etc. 2. Among 144 workers, the history of dust exposure was investigated in 86 workers. Mean ages of 86 workers at the present study, initial exposure to the dusts, and at the time of initial diagnosis as having pneumoconiosis were 52.1, 29.1 and 46.5 years, respectively. The mean duration of exposure was 17.3 years. 3. Comparing the type of main exposure with dust exposure history, initially exposed age of welders, foundry workers, workers exposed to coal dust and other dusts were 24.6, 30.7, 28.0 and 28.5 years, respectively. Ages at the time of diagnosis as having pneumoconiosis of welders, foundry workers, coal dust and other dusts were 41.3, 49.3, 46.4 and 44.1 years, respectively. The duration of exposure to main dust of welders, foundry workers, workers exposed to coal dust and other dusts were 16.8, 18.2, 13.3 and 11.6 years, respectively. Therefore initially exposed age was significant difference between the welders and the foundry workers (p<.05). Age which was diagnosed pneumoconiosis was significant difference between the welders, workers exposed to other dusts and the foundry workers (p<.01). And exposure duration of main dust was significant difference between the workers exposed to other dusts and foundry workers (p<.01) 4. Initially diagnosed X-ray category of the workers were category 0/l (76workers, 52.8%), 1/0 (35workers, 24.3%) Therefore, workers' pneumoconiosis of manufacturing factories was mild, relatively. And there was no significant difference between initially diagnosed X-ray category of the workers and dust exposure history. 5. Among 97 workers, who could follow up more than 1 year, 60 workers(61.9%) were not changed, 24 workers (24.7%) were progressed, 13 workers (13.4%) were improved in their initially diagnosed X-ray category. Among 11 welders, initially diagnosed X-ray category of 5 welders(45.5%) were improved and of only 1 welder was progressed. But, among 19 workers exposed to other dusts, 10 (52.6%) workers were progressed and none of them were improved. 6. Among 53 workers, who were Initially diagnosed X-ray category was 0/l, 12 workers (22.6%) were progressed and 5 workers (9.4%) were improved in their initially diagnosed X-ray category. And among 40 workers, who were initially diagnosed X-ray category was 1, 12 workers(30.0%) were progressed and 7 workers(17.5%) were improved. Above results suggest that not a few workers of manufacturing factories have pneumoconiosis and their pneumoconiosis is progressed. Therefore, we have to prepare management plan and to study epidemiologic findings of pneumoconiosis with workers of manufacturing factories.
Anthracosis ; Coal ; Diagnosis ; Dust ; Follow-Up Studies ; Incheon* ; Korea ; Pneumoconiosis* ; Radiography, Thoracic ; Talc ; Welding

Most of pneumoconiosis found in Korea can be categorized in coal worker's pneumoconiosis. However, in recent years, pneumoconiosis has been frequently found in the workers of manufacturing factories. Accordingly, this study was carried out to investigate relationship of dust exposure history and development and progress of pneumoconiosis. Chest radiographs, history of dust exposure, and other data of 144 workers, who were diagnosed as suspecter pneumoconiosis (0/l) or pneumoconiosis in special health examination center in Incheon from 1986 to 1996, were reviewed. The results were as follows ; 1. According to the type of main exposure, most common type of exposure was foundry dust(93workers, 64.6%), followed by welding fume(16workers, 11.1%), talc dust, lime dust and etc. 2. Among 144 workers, the history of dust exposure was investigated in 86 workers. Mean ages of 86 workers at the present study, initial exposure to the dusts, and at the time of initial diagnosis as having pneumoconiosis were 52.1, 29.1 and 46.5 years, respectively. The mean duration of exposure was 17.3 years. 3. Comparing the type of main exposure with dust exposure history, initially exposed age of welders, foundry workers, workers exposed to coal dust and other dusts were 24.6, 30.7, 28.0 and 28.5 years, respectively. Ages at the time of diagnosis as having pneumoconiosis of welders, foundry workers, coal dust and other dusts were 41.3, 49.3, 46.4 and 44.1 years, respectively. The duration of exposure to main dust of welders, foundry workers, workers exposed to coal dust and other dusts were 16.8, 18.2, 13.3 and 11.6 years, respectively. Therefore initially exposed age was significant difference between the welders and the foundry workers (p<.05). Age which was diagnosed pneumoconiosis was significant difference between the welders, workers exposed to other dusts and the foundry workers (p<.01). And exposure duration of main dust was significant difference between the workers exposed to other dusts and foundry workers (p<.01) 4. Initially diagnosed X-ray category of the workers were category 0/l (76workers, 52.8%), 1/0 (35workers, 24.3%) Therefore, workers' pneumoconiosis of manufacturing factories was mild, relatively. And there was no significant difference between initially diagnosed X-ray category of the workers and dust exposure history. 5. Among 97 workers, who could follow up more than 1 year, 60 workers(61.9%) were not changed, 24 workers (24.7%) were progressed, 13 workers (13.4%) were improved in their initially diagnosed X-ray category. Among 11 welders, initially diagnosed X-ray category of 5 welders(45.5%) were improved and of only 1 welder was progressed. But, among 19 workers exposed to other dusts, 10 (52.6%) workers were progressed and none of them were improved. 6. Among 53 workers, who were Initially diagnosed X-ray category was 0/l, 12 workers (22.6%) were progressed and 5 workers (9.4%) were improved in their initially diagnosed X-ray category. And among 40 workers, who were initially diagnosed X-ray category was 1, 12 workers(30.0%) were progressed and 7 workers(17.5%) were improved. Above results suggest that not a few workers of manufacturing factories have pneumoconiosis and their pneumoconiosis is progressed. Therefore, we have to prepare management plan and to study epidemiologic findings of pneumoconiosis with workers of manufacturing factories.
Anthracosis ; Coal ; Diagnosis ; Dust ; Follow-Up Studies ; Incheon* ; Korea ; Pneumoconiosis* ; Radiography, Thoracic ; Talc ; Welding

Aged ; Aged, 80 and over ; Humans ; Male ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; Tin ; toxicity