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[ARDCO队列监测期间的职业病补偿]

[Compensation of occupational diseases during monitoring of the ARDCO cohort].

作者信息

Gislard A, Gramond C, Clin B, Paris C, Delva F, Brochard P, Laurent F, Benoist J, Andujar P, Chouaïd C, Thaon I, Boudet L, Pairon J C

机构信息

UNIROUEN, UNICAEN, ABTE, Normandie université, 76000 Rouen, France; Centre de consultations de pathologie professionnelle et environnemental, CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen cedex, France.

Inserm U1219, équipe EPICENE, université de Bordeaux, Aquitaine, Bordeaux cedex, France.

出版信息

Rev Mal Respir. 2024 Sep;41(7):472-487. doi: 10.1016/j.rmr.2024.06.010. Epub 2024 Jul 25.

Abstract

INTRODUCTION

Questions concerning under-reporting of occupational diseases (OD) linked to asbestos exposure are regularly voiced in France. Monitoring of the French multicenter Asbestos-Related Disease Cohort (ARDCO), which ensures post-occupational medical surveillance of subjects having been exposed to asbestos, provides information on (1) the medico-legal steps taken following screening by computed tomography (CT) for benign thoracic diseases, and (2) recognition of OD as a causal factor in malignant diseases.

METHODS

OD recognition - and possible compensation - was analyzed in July 2021 among 13,289 volunteers in the cohort recruited between 2003 and 2005.

RESULTS

Fifteen percent of the subjects in the cohort were found to have at least one recognized asbestos-related OD (78.2% benign pleural disease, 10.3% asbestosis, 14.2% lung cancer, and 6.0% mesothelioma). Only 58% of pleural plaques reported by the radiologist who performed the CT resulted in their recognition as ODs. On a parallel track, 88.7% of the mesotheliomas identified based on French National health insurance data and 46.9% of lung cancers were recognized as ODs.

CONCLUSIONS

This study confirms the feasibility of a system designed to facilitate recognition, leading to possible compensation, of asbestos-related occupational diseases. The system could be improved by better training of the medical actors involved.

摘要

引言

在法国,与接触石棉相关的职业病(OD)报告不足的问题经常被提及。对法国多中心石棉相关疾病队列(ARDCO)的监测可确保对接触过石棉的人员进行职业后医学监测,该监测提供了以下方面的信息:(1)在通过计算机断层扫描(CT)筛查良性胸部疾病后采取的法医学措施;(2)将职业病认定为恶性疾病的病因。

方法

2021年7月,对2003年至2005年招募的队列中的13289名志愿者进行了职业病认定及可能的赔偿分析。

结果

该队列中15%的受试者被发现至少有一种已认定的与石棉相关的职业病(78.2%为良性胸膜疾病,10.3%为石棉肺,14.2%为肺癌,6.0%为间皮瘤)。进行CT检查的放射科医生报告的胸膜斑中,只有58%被认定为职业病。与此同时,根据法国国家医疗保险数据确定的间皮瘤中,88.7%被认定为职业病,肺癌中46.9%被认定为职业病。

结论

本研究证实了一个旨在促进石棉相关职业病认定并可能给予赔偿的系统的可行性。通过对相关医疗人员进行更好的培训,可以改进该系统。

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