title: Use of imaging in the follow-up of workers exposed to lung carcinogens: practices in occupational medicine and its determinants.
abstract: We studied occupational physicians' (OPs) practices of referrals for imaging of workers occupationally exposed to lung/pleural carcinogens and the factors associated with them. This cross-sectional telephone survey of 379 OPs practicing in Southeastern France showed that 81% of them referred exposed patients for chest radiographs, 33.5% for computed tomography (CT), and 16.1% for neither. Making no referral was positively associated with believing cancer risks are lower in one's own geographic sector than elsewhere and negatively associated with keeping employee risk records up-to-date. Referrals for CT were positively associated with work at in-house occupational health services (OHS), and completing employee exposure histories often/always. Both the OHS type and factors that may shape OPs' awareness of cancer risks in their sector appear to influence imaging referral practices. Occupational physicians would benefit from guidelines clarifying benefits and risks associated with imaging in such patients. An effort to harmonize regulatory provisions and guidelines also appears necessary.
authors.affiliation: ORS PACA, Observatoire Regional de la Santé Provence Alpes Côte d'Azur, Southeastern Regional Health Observatory Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Verger
authors.forename: Sandrine
authors.initials: S
authors.lastname: Cabut
authors.forename: Alain
authors.initials: A
authors.lastname: Viau
authors.forename: Marc
authors.initials: M
authors.lastname: Souville
authors.forename: Claire
authors.initials: C
authors.lastname: Pardon
authors.forename: Danielle
authors.initials: D
authors.lastname: Charrier
authors.forename: Benoît
authors.initials: B
authors.lastname: De Labrusse
authors.forename: Marie-Pascale
authors.initials: MP
authors.lastname: Lehucher-Michel
authors.forename: Sandrine
authors.initials: S
authors.lastname: Arnaud
mesh_terms: D000395:Air Pollutants, Occupational / Q000633:toxicity; D002274:Carcinogens, Environmental / Q000633:toxicity*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis*; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014057:Tomography, X-Ray Computed
chemical_list: D000395:Air Pollutants, Occupational; D002274:Carcinogens, Environmental