- Diagnostic Meaning of High Resolution Computed Tomography Compared with Chest Radiography for Screening of Welder's lung.
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J H Kang, J H Chun, H W Gu, K S Ko, B C Yu, H S Sohn, J T Lee
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Korean J Prev Med. 1996;29(4):853-862.
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 Abstract
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- Pneumoconiosis is one of the major problem in the field of occupational health at Korea. Therefore, the efficient diagnosis of pneumoconiosis is a hot issue on the occupational health program. The author executed this study to estimate the diagnostic value of high resolution computed tomography(HRCT) compared with chest radiography for screening of welder's lung. HRCT was introduced very recently for the diagnosis of pneumoconiosis, however, the diagnostic value for screening of welder's lung-principally nonfibrogenic and reversible-has not been evaluated. The subjects were fifty cases of welder's lung or suspected cases who had been collected between 1989 and 1994 from one shipyard and continuously followed-up on the basis of in-plant periodic health check program. We applied both chest radiography and HRCT on the same subjects from May 1 to 30, 1996. The images were evaluated by two careered radiologists independently. The findings of chest radiography were classified into four category by ILO classification, and the findings of HRCT according to the criteria of Bergin et al. The concordance between two radiologists expressed with Kendall's tau-b was 0.72 by chest radiography and 0.44 by HRCT- that is, interobserver variation of HRCT was bigger than that of chest radiography. The concordance between the two different methods was highly variable as 0.44 by radiologist A and 0.06 by radiologist B- that is, interobserver variation was very big. However, HRCT looked more detectable for the minor parenchymal change. These findings suggested that it is not appropriate to use HRCT routinely for screening of welder's lung due to lack of diagnostic criteria, and feasibility, acceptability and economic aspects. Nevertheless, HRCT might be recommendable in the case of equivocal parenchymal features on the chest radiography, unexplained respiratory symptoms, and/or lung function abnormalities suggestive of interstitial fibrosis.
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Summary
- Chest Radiological Changes after Cessation and Decrease of Exposure to Welding Fume in Shipyard Welders.
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H S Sohn, J T Lee, H R Shin, C U Lee, K T Pae, H J Park, Y W Kim
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Korean J Prev Med. 1989;22(3):328-336.
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Abstract
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- 27 shipyard welders were diagnosed as pneumoconiosis and suspected pneumoconiosis(1976 - 1988) by chest radiographs and were observed over three years. 27 welders were divided into three groups by the state of exposure to welding fume i.e. cessation, decrease or continuity of exposure. And we observed the changing pattern of the chest radiographs of 27 welders with the passage of time. The results were as follows; 1. Group I (ceased exposure to welding fume) were 10 cases: suspected pneumoconiosis, 7 cases: pneumoconiosis). Chest radiographs of all cases were improved. The shape and size of small opacities was improved in 6 cases(85.7%) and did not changed in 1 case(14.3%) out of 7 pneumoconiosis welders. 2. Group II (decreased exposure to welding fume) were 5 cases(2 cases: suspected pneumoconiosis, 3 cases: pneumoconiosis). Chest radiographs were progressed in 2 cases(40%), did not changed in 1 case(20%), were improved in 2 cases(40%) out of 5 cases. The shaped and size of small opacities was progressed in 1 case(33.3%) and was improved in 2 cases(66.7%) out of 3 pneumoconiosis welders. 3. Group III (continued exposure to welding fume) were 12 cases(1 case: suspected pneumoconiosis, 11 cases: pneumoconiosis). Chest radiographs were progressed in 9 cases(75%), did not changed in 3 cases(25%) out of 12 cases. The shape and size opacities was progressed in 1 case(9.1%) and did not changed in 10 cases(90.9%) out of 11 pneumoconiosis welders. 4. The average duration for development into suspected pneumoconiosis was 6.6 years and for progression of each one category after that was 2.2 years(p<0.01). The radiological appearance of pneumoconiosis had disappeared or decreased after cessation of exposure to the welding fume. So that, early detection and control e.g., change of department of pneumoconiosis of welders by screening program will be important for medical surveillance of welders.
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