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Asbestos-Related Diseases-Reply

John E. Craighead, MD; David W. Cugell, MD; Elliott Kagan, MD; Michael B. Shimkin, MD; Robert H. Wheater, MS
JAMA. 1985;254(10):1308-1309. doi:10.1001/jama.1985.03360100055007.
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In Reply—  The specific issues posed by members of the Diagnostic Criteria Committee of the American Public Health Association Occupational Health Section focus on several current controversies concerned with the asbestos-associated diseases. At the outset, we emphasize that our report was prepared for physicians addressing the problems of individual patients. Thus, we did not consider broad public health issues in detail.

  1. The finding of a characteristic x-ray picture, even when accompanied by rales and associated with functional evidence of restrictive lung disease, does not permit a definitive clinical diagnosis of asbestosis. Asbestosis occurs after prolonged exposure to high concentrations of dust in the ambient air. Rarely is there sufficient information available to the physician to permit an assessment of the duration and severity of exposure to asbestos. Thus, the physician usually must depend on the patient for such information. All too often, a history of workplace exposure is based


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