Screening

If you are currently working with asbestos in a production process or if your job requires you to do maintenance work on asbestos-containing products more than 30 days out of the year, then the new asbestos standards require your employer to provide medical surveillance of your health on an annual basis. If you were exposed to asbestos in the past, then you may want to consider arranging for a medical test.

A medical screening program for asbestos exposed workers should include:

• A work history. This should list in detail all jobs a person has ever had and all the hazardous conditions about those jobs.
  

• A medical history. This should review all of the symptoms that a person remembers having. It should also ask about smoking and illnesses that run in the family.

• A physical exam. The doctor should look closely at the mouth and throat, since asbestos exposed workers have an increased risk of developing cancer there; the lungs, where abnormal sounds may indicate the development of scarring; and the abdomen, to feel for signs of tumors of the digestive tract or its lining. A rectal examination can often detect tumors in the lower intestine. A hemacult test is another method to screen for colon and/or rectal cancer. This test looks for blood in a stool sample and can help detect cancer or other intestinal problems. If a hemacult is positive, additional tests are recommended to find the reason.

• X-rays.A full-size front chest x-ray (posterior/anterior) should be taken. Often side view (laterals) or view at an angle (oblique) are also recommended. The x-ray should be examined for evidence of occupational lung disease by specially trained x-ray readers called B-Readers. X-rays can reveal evidence of scarring of the lung tissue and thickening of the lining of the lungs which are characteristic of asbestosis. Cancers of the lung and lining of the lung may also be detected by an x-ray. X-rays are usually recommended to be repeated annually only if a person is at high risk of developing an asbestos-related disease or if other signs and symptoms of disease are present. Not every medical doctor is qualified to interpret x-ray findings for asbestos-related disease. Be sure the physician interpreting your x-ray is certified to do so (a certified person is termed a "B" reader) and that your own personal physician has access to x-ray films and copies of the reports.

• Lung Function Tests. These are simply breathing tests. As explained above, asbestos dust causes scars to form in the lung tissue, stiffening the lung and making it difficult for the lung to expand when one breathes in. Lung (or pulmonary) function tests can demonstrate these changes, especially if the tests are repeated periodically on standardized equipment. Usually, simple spirometry tests are given first to find out if the volume of the lung has been reduced by scarring or if the flow of air is blocked through the large airways or hindered by the loss of elasticity in the small airways. A specialized lung function test measuring the diffusion capacity of the lung may also be given. It measures the extent to which scar tissue has become a barrier to the passage of oxygen from the lung spaces into the blood stream. The purpose of spirometry tests are to measure the volume of air your lungs can contain and how well the lungs can move that air out -- an indication of the elasticity of the lower lung. Your results are compared to the results of a standard reference group and reported in terms of the percent predicted for your age, height, weight, and sex.