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Radiographic readings for asbestosis: Misuse of science—validation of the ILO classification
Author(s) -
Miller Albert
Publication year - 2007
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20401
Subject(s) - asbestosis , silicosis , medicine , pneumoconiosis , asbestos , workers' compensation , plaintiff , occupational disease , pulmonary fibrosis , lung fibrosis , radiography , occupational medicine , environmental health , occupational exposure , pathology , surgery , fibrosis , lung , compensation (psychology) , law , psychology , materials science , metallurgy , political science , psychoanalysis
Background Radiographic readings for pneumoconiosis (both asbestosis and silicosis), even those using the International Labour Office (ILO) Classification, have received widespread negative coverage in the media and strong judicial rebuke. Methods The medical literature over the past 90 years was reviewed for the relationships between radiographic severity (standardized as the ILO profusion score) and indices of exposure to silica or asbestos, tissue burden of silica particles or asbestos fibers, histologic fibrosis, various measurements of pulmonary function and mortality. Results Evidence from many different disciplines has demonstrated that the ILO profusion score correlates with occupational exposure, dust burden in the lung, histologic fibrosis and, more recently, with physiologic impairment and mortality. Conclusions The ILO Classification has therefore been validated as a scientific tool. Its fraudulent misuse by “hired‐gun” physicians, attorneys and elements of the compensation system to falsify claims of asbestosis and/or silicosis (often in the same claimant) must be condemned. Am. J. Ind. Med. 50:63–67, 2007. © 2006 Wiley‐Liss, Inc.