[Prophylactic examinations of former workers of asbestos processing plants: the Amiantus project]

Prophylactic examinations of the former workers of asbestos plants are performed by virtue of the Law of 19 June 1997 on a prohibition against the use of asbestos-containing products. Periodical examinations allow to detect pathological changes in the pre-symptomatic or early-symptomatic period, which permits to apply an appropriate treatment and slows down considerably the progress of morbid processes. The main objectives of the surveillance and coordination are as follows: (1) to assure good quality of prophylactic examinations through the uniform methods of medical examinations and the detection of pathology resulting from the exposure to asbestos dust, based on international criteria for diagnosing asbestos-related diseases (the Helsinki criteria, 1997); (2) to monitor the respiratory health effects among persons occupationally exposed to asbestos dust; and (3) to keep the database on persons examined and subjected to periodical prophylactic examinations throughout the country. The program of prophylactic examinations of persons occupationally exposed to asbestos dust includes mass screening. For the purpose of this program, a unified strategy of mass screening, including documentation (questionnaires on clinical, radiological and spirometric examinations) and instructions for persons responsible for performing these examinations has been worked out. Each center involved in the implementation of the program has been provided with binding criteria elaborated on the basis of the world standards (the Helsinki criteria, 1977) of clinical, radiological, spirometric and histological examinations aimed at detecting asbestos-related diseases: asbestosis, fibrous mesothelioma and lung cancer. The data obtained will serve as a basis for assessing the morbidity and incidence of asbestos-related diseases among persons occupationally exposed to asbestos dust in asbestos processing plants.