Asbestos-related Diseases In Mineworkers: A Clinicopathological Study
The accurate diagnosis of asbestos-related diseases is important because of past and current asbestos exposures. This study evaluated the reliability of clinical diagnoses of asbestos-related diseases in former mineworkers using autopsies as the reference standard.
Sensitivity, specificity, positive predictive value and negative predictive value were calculated.
The 149 cases identified had clinical examinations 0.3–7.4 years before death. More asbestos-related diseases were diagnosed at autopsy rather than clinically: 77
The low sensitivity values are indicative of the high proportion of false-negative diagnoses. It is unlikely that these were the result of disease manifestation between the last clinical assessment and autopsy. Where clinical features suggest asbestos-related diseases but the chest radiograph is negative, more sophisticated imaging techniques or immunohistochemistry for asbestos-related cancers should be used. Autopsies are useful for the detection of previously undiagnosed and misdiagnosed asbestos-related diseases, and for monitoring clinical practice and delivery of compensation.