title: [Prophylactic examinations of workers formerly employed in asbestos processing plants: outcome of the Amiantus project in 2000-2004].
abstract: BACKGROUND
  Prophylactic examinations of workers formerly employed in asbestos processing plants were performed by virtue of the Act, dated 19 June 1997, putting a ban on the production of asbestos-containing products. To enforce the provisions of the Act, the Ministry of Health has initiated the Amiantus project implemented by 13 Occupational Medicine Centers throughout the country and coordinated by the Nofer Institute of Occupational Medicine (IMP) in Lódź.
  
  
  METHODS
  All the Centers perform diagnostic procedures according to the same criteria (clinical, radiological, spirometric and histological), based on the 1997 Helsinki criteria, to diagnose asbestos-related diseases. A specific "Examination Form", developed for the needs of the Amiantus project, is completed by an occupational physician during examinations and sent to the IMP, where health effects in the whole population covered by the project are monitored. Periodical medical examinations are performed at least every three years and they include: general examination, chest x-ray, resting spirometric examination and supplementary examinations (e.g., resting gasometric examination) or other diagnostic examinations if necessary (e.g., computed tomography).
  
  
  RESULTS
  Owing to the project implementation, it was possible to collect in the database information on 5466 persons who underwent 8763 prophylactic examinations in 2000-2004. Of the total population examined during a five-year period, occupational disease was certified in 728 (13%) persons. Asbestosis was diagnosed in 790 persons, lung cancer in 19 persons and pleural mesothelioma in 12 persons. Pleural changes in x-ray imaging were found in 1662 (30%) persons and opacities in pulmonary parenchyma in 2088 (38%) persons. Having compared these results with those from previous examinations, the total health condition deterioration was observed in 882 (16%) persons, including worsening of the lung x-ray imaging in 512 (9%) persons. An analysis showed the highest incidence of asbestos-related pathologies in workers of asbestos-cement plants. The collected data also confirmed an upward trend in the incidence of asbestosis and changes in the lung x-ray imaging related to age, duration of employment and latency.
  
  
  CONCLUSIONS
  The implementation of the Amiantus project has contributed to an increased detection of pathologies related with exposure to asbestos fibers. A growing proportion of radiograms, which indicate worsening of health condition provides evidence that morbid processes in the respiratory system are progressing in persons who in the past were occupationally exposed to asbestos dust.
authors.affiliation: Z Zakłdadu Epidemiologii Srodowiskowej Instytutu Medycyny Pracy im prof J Nofera w Lodzi. zuzanna@imp.lodz.pl
authors.forename: Zuzanna
authors.initials: Z
authors.lastname: Szubert
authors.forename: Bozenna
authors.initials: B
authors.lastname: Stankiewicz-Choroszucha
authors.forename: Magdalena
authors.initials: M
authors.lastname: Wrońska-Sobolewska
authors.forename: Henryka
authors.initials: H
authors.lastname: Siewierska
authors.forename: Maria
authors.initials: M
authors.lastname: Kosińska
authors.forename: Wiktoria
authors.initials: W
authors.lastname: Borys
authors.forename: Jacek
authors.initials: J
authors.lastname: Jakubowski
authors.forename: Regina
authors.initials: R
authors.lastname: Wróbel
authors.forename: Urszula
authors.initials: U
authors.lastname: Gazda
authors.forename: Bozena
authors.initials: B
authors.lastname: Kedzierska
authors.forename: Marek
authors.initials: M
authors.lastname: Andrzejewski
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Sova
authors.forename: Halina
authors.initials: H
authors.lastname: Pawłowska-Koziełł
authors.forename: Ewa
authors.initials: E
authors.lastname: Komorowska
authors.forename: Beata
authors.initials: B
authors.lastname: Ksiazkiewicz
authors.forename: Wojciech
authors.initials: W
authors.lastname: Sobala
authors.forename: Neonila
authors.initials: N
authors.lastname: Szeszenia-Dabrowska
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000395:Air Pollutants, Occupational / Q000032:analysis*; D001195:Asbestosis / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D016208:Databases, Factual; D004784:Environmental Monitoring / Q000379:methods / Q000706:statistics & numerical data*; D062665:Epidemiological Monitoring; D005260:Female; D006284:Health Plan Implementation; D006291:Health Policy; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D009313:National Health Programs / Q000458:organization & administration; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011044:Poland / Q000453:epidemiology; D011159:Population Surveillance; D015397:Program Evaluation; D011634:Public Health
chemical_list: D000395:Air Pollutants, Occupational