Sensitivity and Specificity of Occupational Health Doctors in Reading Pneumoconiosis Radiographs

Phanumas Krisorn¹, Naesinee Chaiear^1, , Ponglada Subhannachart², Narongpon Dumavibhat³ and Sutarat Tungsagunwattana²

¹Division of Occupational Medicine, Department of Community Medicine, Faculty of Medicine, Khon Kaen University

²Central Chest Institute of Thailand, Department of Medical Services, Ministry of Public Health

³Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University

Cite this paper:
Phanumas Krisorn, Naesinee Chaiear, Ponglada Subhannachart, Narongpon Dumavibhat and Sutarat Tungsagunwattana. Sensitivity and Specificity of Occupational Health Doctors in Reading Pneumoconiosis Radiographs. American Journal of Public Health Research. 2018; 6(2):106-110. doi: 10.12691/ajphr-6-2-13

Abstract

Objective: This study aimed to examine the sensitivity and specificity of occupational health doctors (OHDs)’ reading of early-stage pneumoconiosis radiographs. Materials and Methods: A screening test was applied, and 33 OHDs consented to participate in the study. There were atotal of 67 chest radiographs, which consisted of normal and early-stage pneumoconiosis film. The cut-point for disease was set at profusion0/1 and 1/0. Mean sensitivity and specificity for small opacity detection were analyzed. Results: The median sensitivity of ILO profusion of 0/1 or above was 88% (IQR 10.3), and the median sensitivity of film with a 1/0 cutoff pointwas slightly higher at90% (IQR 10.3).The average specificity for ILO profusion of 0/1 or above was 43.3% (SD21.1). Upon increasing the cut-point at profusion1/0, the average specificity increased to 47.0% (SD 20.9). Conclusion: This study showed that occupational health doctors were able to interpret chest radiographs of workers with early-stage pneumoconiosis. This indicates that the development of OHDs’ chest X-ray reading skillsis valuable in order to improve the national pneumoconiosis surveillance system.

Keywords:
silicosis ILO classification chest radiograph sensitivity occupational health doctor

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References:

[1]	Balmes, J.R. “Occupational Lung Diseases”. In: Ladou, J., Harrison, R.J. editors, Current occupational and environmental medicine. McGraw-Hill education, 2012, 378-380.
[2]	Speizer, F.E., “Environmental lung disease”, In, Braunwald, E., Fauci, A.S., Kasper, D.L., Hauser, S.L., Longo, D.L., Jameson, J.L. editors, Harrison's principles of internal medicine, McGraw-Hill education, 2001, 1, 470.
[3]	Siriruttanapruk, S., Ramakul, K., Sritulapruk, W., Chomsuan, R. Silicosis elimination program in Thailand, Bangkok, Bureau of Occupational and Environmental Diseases, 2005.
[4]	Disease Prevention Control Nakhon Ratchasima. Performance monitoring of the environment by activities and annual, Silicosis 2001-2005, [Online] Available: http://dpc5.ddc.moph.go.th/hot/situlation_ env_sili_table32.htm. [Accessed Apr, 9 2015].
[5]	The Bureau of Occupational and Environmental Diseases. Report in diseases and health hazards of occupational and environmental 2012, BOED, 2012.
[6]	Silanan, K., Chaiear, N., Reechaipichitkul, W., “Prevalence of silicosis in stone carving workers being exposed to inorganic dust at Sikhiu District Nakhon Ratchasima Province, Thailand; preliminary results”, J Med Assoc Thailand, 100 (5). 598-602. May. 2017.
[7]	International Labour Organization. Occupational health: Silicosis [Online]. Available: http://www.ilo.org/safework/areasofwork/occupational-health/ WCMS_108566/lang--en/index.htm. [Accessed Apr, 9 2015].
[8]	Bang, KM., Mazurek, JM., Attfield, MD. Silicosis mortality, prevention, and control – United States, 1968-2002. Morbidity and Mortality Weekly Report; 2005. [Online]. Available: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5416a2.htm#fig1. [Accessed Apr, 9 2015].
[9]	Occupational Safety and Health Administration. Respirable quartz: Geometric mean exposures by major industry division, MSHA and OSHA samples, 1979-2003. [Online]. 2008. Available: http://wwwn.cdc.gov/eworld/Data/Respirable_quartz_Geometric_mean_exposures_by_major_industry_ division_MSHA_and_OSHA_samples_1979-2003/303. [Accessed Apr, 28 2015].
[10]	The Ministry of Industry (Thailand). 2012 Report of Ministry of industry: guidelines for occupational health surveillance program by hazards. Bangkok: The Ministry, 2012.
[11]	Talini, D., Paggiaro, P.L., Falaschi, F., Battolla, L., Carrara, M., et al. “Chest radiography and high resolution computed tomography in the evaluation of workers exposed to silica dust: relation with functional findings.” Occup Environ Med, 52 (4). 262-267. Apr. 1995.
[12]	Center for Disease Control and Prevention. CDC - chest radiography: NIOSH successful international examinees [Online]. 2015. Available : http://www2a.cdc.gov/drds/cwhsp/examinees.asp?lastname=&sortkey=country&btnSubmitInternational=Submit. [Accessed Apr, 27, 2015].
[13]	Ngatu, N.R., Suzuki, S., Kusuka, Y., Shida, S., Akira, M., Suganuma, N. “Effect of a two-hour training on physicians’ skill in interpreting pneumoconiosis chest radiographs.” J Occup Health, 52 (5). 294-301. Aug. 2010.
[14]	Zhou, H., Kusuka, Y., Tamura, T., Suganuma, N., Subhannachart, P., Sirirattanapruk, S., et al. “The 60-film set with 8-index for examining physician’s proficiency in reading pneumoconiosis chest X-ray.” Ind Health, 50 (2). 84-94. Feb. 2012.
[15]	Morgan, R.H. “Proficiency examination of physicians for classifying pneumoconiosis chest films.” AJR Am J Roentgenol, 132 (5). 803-808. May. 1979.
[16]	Hnizdo, E., Murray, J., Sluis-Cremer, G.K., Thomas, R.G. “Correlation between radiological and pathological diagnosis of silicosis: an autopsy population based study.” Am J Ind Med, 24 (4). 427-445. Oct. 1993.