[Detection of pleural plaques on chest X-ray film by chest physicians]

With increasing awareness about health damage due to asbestos exposure, the number of people presenting with non-occupational exposure has increased remarkably. Consequently, chest physicians in general hospitals must read the chest X-ray films of patients with asbestos exposure. Can non-specialized chest physicians, who may have little experience of occupational medicine, diagnose pleural plaques accurately? The study subjects were 44 consecutive patients who were admitted to our hospital, under the Japanese medical health check system for workers employed in dangerous work. Their chest X-ray films were checked by 4 chest physicians, who were independently informed that the patients had a high suspicion of asbestos exposure. The detection rate of chest Xray for pleural plaques was compared with computed tomography (CT) results as the gold standard. The sensitivity was 0.818 and the specificity was 0.393. The sensitivity of the presence of pleural plaques was lower in anterior and posterior sites, and on the pleura adjacent to the mediastinum, pericardium and vertebral (0.429, 0.348, 0.217), while specificity was lower on lateral sites (0.610). Chest physicians in general hospitals must be trained in the manifestation of asbestos-related diseases.