title: [Are chest radiographs justified in pre-employment examinations? Presentation of legal position and medical evidence based on 1760 cases].
abstract: BACKGROUND
  The legal and medical basis for chest radiographs as part of pre-employment examinations (PEE) at a University Hospital is evaluated. The radiographs are primarily performed to exclude infectious lung disease.
  
  
  METHODS
  A total of 1760 consecutive chest radiographs performed as a routine part of PEEs were reviewed retrospectively. Pathologic findings were categorized as "nonrelevant" or "relevant."
  
  
  RESULTS
  No positive finding with respect to tuberculosis or any other infectious disease was found; 94.8% of the chest radiographs were completely normal. Only five findings were regarded as "relevant" for the individual. No employment-relevant diagnosis occurred.
  
  
  CONCLUSIONS
  The performance of chest radiography as part of a PEE is most often not justified. The practice is expensive, can violate national and European law, and lacks medical justification.
authors.affiliation: Institut für Diagnostische und Interventionelle Radiologie und Neuroradiologie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen. susanne.ladd@uni-duisberg-essen.de
authors.forename: S C
authors.initials: SC
authors.lastname: Ladd
authors.forename: U
authors.initials: U
authors.lastname: Krause
authors.forename: M E
authors.initials: ME
authors.lastname: Ladd
mesh_terms: D003141:Communicable Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology; D019317:Evidence-Based Medicine / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D005858:Germany; D006801:Humans; D015994:Incidence; D007586:Job Application; D008403:Mass Screening / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data*; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*