Chest
Occupational and Environmental Lung DiseaseVariability in the Classification of Radiographs Using the 1980 International Labor Organization Classification for Pneumoconioses
Section snippets
Background
Sheet metal work includes a variety of tasks entailing fabrication or installation of metal products. Respiratory hazards identified with sheet metal work include exposure to asbestos, welding fumes, and man-made vitreous fibers, primarily fiberglass. Three investigations have specifically studied asbestos-related disease among sheet metal workers employed in construction.18, 19, 20, 21 The most recent of these studies was sponsored by the Sheet Metal Occupational Health Institute Trust.
Results
Materials and Methods
A set of 119 radiographs was created and read by three Canadian and three US readers. The three Canadian readers and three US readers who had interpreted the largest number of radiographs for the program were asked to participate; initially, all six agreed to do so. One of the US readers was ultimately unable to fulfill this commitment, and an additional reader from the US program was asked to contribute at a later date. Each of the participating US readers had read > 350 radiographs for the
Concordance
Of the 119 radiographs in the study set, 114 had complete data from all readers for pleural changes, and 110 had complete data for profusion. Table 1 presents the distribution of pleural changes and profusion ratings for each of the six readers. The percent of radiographs positive for pleural changes ranged from 19 to 80%, with reader 1 having the highest proportion of abnormal radiographs and readers 4 and 5 reading the fewest pleural changes. For profusion, the proportion of radiographs with
Discussion
This study showed that five of six readers had good fair to good agreement for recording pleural findings and for profusion as a dichotomous variable (≥ 1/0 vs ≤ 0/1), while a sixth reader had poor agreement. We found that concordance, expressed as percent agreement with the group median, was higher for normal radiographs than for ones that showed disease, and illustrates the use the kappa statistic to test this finding. We also present each reader's sensitivity and specificity (each reader
References (31)
- et al.
Railroad workers with pleural plaques
Am J Ind Med
(1988) - et al.
Asbestos-related disease in plumbers and pipefitters employed in building construction
J Occup Med
(1985) - et al.
Asbestos-induced pleural fibrosis and impaired lung function
Am Rev Respir Dis
(1990) - et al.
Occupational exposure to asbestos: population at risk and projected mortality-1980-2003
Am J Ind Med
(1982) - et al.
Projection of asbestos related diseases in the United States, 1985–2009 I
Cancer. Br J Ind Med
(1988) Asbestos-related diseases of the lungs and pleura: current clinical issues
Am Rev Respir Dis
(1982)Guidelines for the use of ILO international classification of radiographs for pneumoconioses
Occup Safety Health Series
(1980)Proficiency examination for classification of pneumoconiosis chest films
AJR Am J Roentgenol
(1979)- et al.
Classification of radiographs for pneumoconiosis: the Canadian pneumoconiosis reading panel
Am J Ind Med
(1993) - et al.
The problem of consistent radiological diagnosis in coal miners' pneumoconiosis
Br J Ind Med
(1949)
The classification of chest radiographs for coal workers pneumoconiosis: a study of the performance of two readers over a period of 6 years
Br J Ind Med
Observations on the results of multiple readings of chest films in coal miners' pneumoconiosis
Radiology
An investigation of inter-reader variability among xray readers employed in the underground coal miner surveillance program
Ann Amer Conf Gov Ind Hyg
International classification trial of AIA set of 100 radiographs of asbestos workers
Br J Ind Med
A study of a sample of chest radiographs from the Health and Safety Executive's survey of asbestos workers
Report No. TM/83/4, Institute of Occupational Medicine, Edinburgh, Great Britain
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Funded in part by the Sheet Metal Occupational Health Institute Trust, a trust jointly funded by the Sheet Metal Workers International Union and the Sheet Metal and Air Conditioning National Association.