Monitoring of health surveillance of workers who remove materials containing asbestos and quality assessment of radiographs

Background. Chest radiography performed with ILO criteria remains an excellent test for health surveillance due to its low cost, easy accessibility and low dose of ionizing radiation: in Italy, however, the technical quality of chest radiographs for pneumoconiosis is often unsatisfactory. Objectives. In accordance with the Regional Prevention Plan of the Marche Region (Line 6.3) a monitoring of the health surveillance in companies involved in the removal of products containing asbestos was carried out, verifying the application of the ILO guidelines and the quality of the radiographs of the chest of workers. Methods. A trained reader (A reader) and two expert readers (B Readers) evaluated the application of the ILO Guidelines in a sample of 188 chest radiographs that classified according to the technical quality, the presence of parenchymal anomalies and pleural anomalies. Results. The results highlight the failure to apply the ILO guidelines and the poor compliance with the technical quality standards of the radiograms performed during the health surveillance of exposed workers, in accordance with previous reports. Conclusions. The authors reaffirm the need to tackle the problem of the quality of radiographic examinations by promoting the application of the ILO Guidelines and the criteria of good practice (including the criteria of radiological protection), to direct the monitoring of health surveillance on these aspects, to strengthen the network of radiologists and occupational physicians with specific training and certification of B-reader.