Publication2-presentation at ICOH 2009 conference,march22-27,Cape town, south africa

29th ICOH, International Congress on Occupational Health
March 2009,Cape Town, South Africa.
(Abstract submitted in July 2008, accepted in September 2008)
　　
Title: View-box seminar as a tool to improve Physicians’ Skill in reading
Chest radiographs related to Pneumoconioses

Ngatu roger Nlandu, MD1; Shun Suzuki1, Narufumi Suganuma, MD, PhD1; Yukinori Kusaka, MD, PhD2.
1. Department of Environmental Medicine, Kochi University Graduate Medical School.
Kohasu, Oko-cho. Nankoku 8505. Tel / Fax: +81 88 880 2407. Japan.
2. Department of Environmental Health, School of Medicine, Fukui University, Japan.

Abstract:
Objective
The ILO / WHO Global Programme on Elimination of Silicosis, adopted in 2003, aimed at establishing an international co-operation for elimination of Silicosis as occupational health problem by 2030. In 2006, cluster of environmental mesothelioma among inhabitants near an asbestos factory triggered social concern for asbestos in Japan and general practitioners as well as occupational physicians recognized the impact of asbestos. Numerous cases of misinterpretation of radiographs often occur, leading to biased diagnosis. This intervention trial was aimed at improving local physicians’ skill in Pneumoconioses CXR interpretation..
Method
Twenty-five physicians of Kochi, Japan, underwent two reading-tests using 12 test-radiographs, before and after a training session with standard films of ILO 2000 International classification of pneumoconioses chest radiographs, conducted by a NIOSH B-reader.
Result

Although variability has been observed among readers, the general trend was towards improvement. 80% (20/25) of readers had a good Sensitivity for the variable “small opacity” (≥ 0.70) in post-intervention reading-test, compared to 32% (8/25) before, and a very little increase readers with good specificity score (≥0.70) was observed, 20%(5/25) and 16%(4/25) respectively. However, for “plaque”, an increase of number of readers with higher score of Sensitivity and Specificity was observed for the intermediate sub-category (0.50 – 0.69). Mean values of Sensitivity and Specificity got increased, especially Sensitivity for “small opacity” (0.89 before and 0.93 after) and “plaque” (0.60 and 0.73 respectively), and Specificity for “profusion”(0.56 – 0.59). Mc Nemar’s Chi2 test was　significant for sensitivity for plaque (P=0.0013), marginally significant for Specificity for plaque (P=0.1701) and Sensitivity for small opacity (P=1573), not significant for Specificity for“small opacity” (P=0.4795).

Conclusion

This intervention corroborates with other previously published works, stressing the importance of use of ILO standard films for interpreting CXR related to pneumoconioses. Even non-experienced individuals, if well trained under controlled conditions,may read CXR related to those occupational diseases; but excluding standard films while performing CXR interpretation

can restrict reading performance.