Can Chest X-rays Help Prevent Mesothelioma?

A mesothelioma doctor believes that lives might be saved if people exposed to asbestos in the workplace received annual chest X-rays.

Asbestos is the cause of malignant mesothelioma, an aggressive cancer that affects the membranes around the lungs, heart or abdomen. Asbestos is still used in some industrial applications and is present in the insulation, floor tiles and shingles of tens of thousands of older homes and buildings. People who work or live around asbestos are at significantly higher risk of eventually developing mesothelioma.

There is, as yet, no way of predicting which asbestos exposed individuals will develop mesothelioma, but, as with many cancers, early detection improves the odds of survival. Because mesothelioma usually does not cause many symptoms until in its later stages, Surgery Department Chairman Roy Smythe, MD,  of Texas A & M University Health Sciences Center College of Medicine recommends an annual chest X-ray for people who worked around asbestos in that area’s Alcoa plant. “I’ve seen hundreds of patients with [mesothelioma] in my career and I’ve seen less than five with Stage I,” Smythe told a local newspaper.

But getting regular chest X-rays may not be easy for every asbestos-exposed person. Although some employers do pay for annual X-rays as a way to detect signs of mesothelioma and other asbestos diseases in the absence of symptoms, it is not a requirement of the Occupational Safety and Health Administration’s mesothelioma surveillance guidelines.

OSHA requires employers to institute a medical surveillance program for “all employees who are or will be exposed to asbestos at or above the permissible exposure limit (0.1 fiber per cubic centimeter of air).”  That program must include annual exams during which case histories are taken, surveys are completed, and pulmonary function tests administered. The use of X-rays or other laboratory tests are left up to the discretion of the physician. OSHA requires that this surveillance be free to the patient.

The National Institute of Occupational Safety and Health (NIOSH) estimates that 1.3 million people have worked in jobs that may have exposed them to asbestos. To reduce workers’ mesothelioma risk, federal regulations require that these workers be provided with special training, warnings, and protective gear and that their exposure time be limited.

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