title: Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT.
abstract: BACKGROUND
  To determine the prevalence of asbestos-related changes on chest X-ray (CXR) and low-dose multidetector-row CT (MDCT) of the thorax in a cohort of formerly asbestos-exposed power industry workers and to assess the importance of common risk factors associated with specific radiological changes.
  
  
  METHODS
  To assess the influence of selected risk factors (age, time since first exposure, exposure duration, cumulative exposure and pack years) on typical asbestos-related radiographic changes, we employed multiple logistic regression and receiver operating characteristic (ROC) analysis.
  
  
  RESULTS
  On CXR, pleural changes and asbestosis were strongly associated with age, years since first exposure and exposure duration. The MDCT results showed an association between asbestosis and age and between plaques and exposure duration, years since first exposure and cumulative exposure. Parenchymal changes on CXR and MDCT, and diffuse pleural thickening on CXR were both associated with smoking. Using a cut-off of 55 years for age, 17 years for exposure duration and 28 years for latency, benign radiological changes in the cohort with CXR could be predicted with a sensitivity of 82.0% for all of the three variables and a specificity of 47.4%, 39.0% and 40.6%, respectively.
  
  
  CONCLUSIONS
  Participants aged 55 years and older and those with an asbestos exposure of at least 17 years or 28 years since first exposure should be seen as having an increased risk of abnormal radiological findings. For implementing a more focused approach the routine use of low-dose MDCT rather than CXR at least for initial examinations would be justified.
authors.affiliation: Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Eisenhawer
authors.affiliation: Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Felten
authors.affiliation: Department of Medical Statistics, RWTH Aachen University, Aachen, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Tamm
authors.affiliation: Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands ; GROW, School for Oncology & Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands ; Department of Diagnostic Radiology, RWTH Aachen University, Aachen, Germany.
authors.forename: Marco
authors.initials: M
authors.lastname: Das
authors.affiliation: Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kraus
keywords: Asbestos; Chest X-ray; Early detection; MDCT; Power industry