Many international experts collaborated in creating this groundbreaking work, a principal-coding system, and in developing reference films and imaging parameters for the International Classification of HRCT for Occupational and Environmental Respiratory Diseases. The book is an authoritative guide to the recognition of dust diseases of the lung, using radiological imaging techniques, with special emphasis on high-resolution computerized tomography (CT). The classification is a powerful, essential tool for recording patient data on CT in a globally standardized semiquantitative way. The system is also applicable to surveillance and screening for occupational and environmental respiratory diseases. The book is a valuable resource not only for radiologists but for all who work in occupational medicine and public health.
Environmental and occupational exposure to mineral dusts (i.e., pneumoconiosis)
has long been known to be an important cause of lung disease. Since the latter half
of the twentieth century, the number of pneumoconiosis cases recognized by physicians
has increased significantly, related to both an increased likelihood of exposure
to toxic materials in industry and more detailed surveillance of workers.
Our ability to diagnose and subsequently avoid, control, and regulate these
harmful exposures has been based on understanding their relationship to clinical
symptoms and pathologic lung abnormalities. Fundamental to this understanding
has been the widely used system for classification of chest radiographic abnormalities
in pneumoconiosis introduced by the International Labour Office (ILO).
Based on this system, the type and degree of lung abnormality could be readily
assessed in a population of exposed subjects, and correlations made with exposure
severity or duration, morbidity, and mortality. However, the limitations of the ILO
system have long been recognized. Chest radiographs are insensitive to the diagnosis
of early abnormalities produced by pneumoconioses, and they lack specificity
as well; a number of findings considered abnormal on chest radiographs using
ILO criteria are in fact nonspecific and may not be related to pneumoconiosis
at all.
The development of high-resolution computed tomography (HRCT) over the
last 20 years has revolutionized the diagnosis of all types of lung disease, including
pneumoconiosis. The anatomic detail provided by HRCT, in combination with
detailed correlations of HRCT lung abnormalities and histologic findings, has
provided a powerful tool for assessment of these diseases. However, a comprehensive
system for the classification and quantification of the lung abnormalities
typically seen in patients with pneumoconiosis has been lacking. Without question,
a HRCT system for the classification and quantification of pneumoconiosis,
similar to the ILO system, would be valuable in our attempts to accurately diagnose
and effectively prevent these diseases.
