Gislard A, Schorle E, Letourneux M, Ameille J, Brochard P, Clin B, Conso F, Laurent F, Luc A, Paris C, Pairon J-C
Service de pathologie professionnelle, CHU de Rouen, 76031 Rouen cedex, France.
Rev Epidemiol Sante Publique. 2013 Feb;61(1):11-20. doi: 10.1016/j.respe.2012.06.402. Epub 2013 Jan 14.
Underreporting of occupational diseases related to asbestos exposure remains a matter of concern in France. The aim of this study was to evaluate the number of claims for compensation for asbestos-related non-malignant pulmonary or pleural occupational disease in subjects having undergone a chest CT-scan in a multiregional screening programme.
Among the 5444 voluntary retired asbestos-exposed subjects recruited in four regions between 2003 and 2005 who had undergone a chest CT-scan, the number of claims for compensation for an asbestos-related pulmonary or pleural benign disease was analysed in 2006 and 2010.
Following CT-scan screening, 17.2% of participants were acknowledged as presenting with an asbestos-related non-malignant occupational disease, essentially pleural plaques, by the French National Health Insurance fund. Underreporting decreased as duration of follow-up after CT-scan increased. Nevertheless, 4 years after CT-scan, underreporting was still as high as 36% for subjects identified as presenting with pleural plaques. Mean duration between the date of CT-scan and the date of recognition as occupational disease was 7.4 months, shorter in cases where screening was coordinated by specialized centres.
A plan of action for an easier claiming process for compensation of asbestos-related diseases is desired. This could probably be obtained through improved sensitization of physicians engaged in the follow-up of asbestos-exposed subjects, and by standardization of the interpretation and reporting of asbestos-related abnormalities observed on chest CT-scans.
在法国,与石棉暴露相关的职业病报告不足仍是一个令人担忧的问题。本研究的目的是评估在一项多区域筛查计划中接受胸部CT扫描的受试者中,与石棉相关的非恶性肺部或胸膜职业病的赔偿申请数量。
在2003年至2005年期间于四个地区招募的5444名自愿退休的石棉暴露受试者中,这些人都接受了胸部CT扫描,分析了2006年和2010年与石棉相关的肺部或胸膜良性疾病的赔偿申请数量。
在CT扫描筛查后,法国国家健康保险基金确认17.2%的参与者患有与石棉相关的非恶性职业病,主要是胸膜斑。随着CT扫描后随访时间的延长,报告不足的情况有所减少。然而,在CT扫描4年后,被确定患有胸膜斑的受试者的报告不足率仍高达36%。从CT扫描日期到被确认为职业病的平均时间为7.4个月,由专业中心协调筛查的病例时间较短。
需要制定一项行动计划,以简化石棉相关疾病赔偿的申请流程。这可能通过提高参与石棉暴露受试者随访的医生的认识,以及对胸部CT扫描中观察到的石棉相关异常的解释和报告进行标准化来实现。