ABSTRACT
There are millions of workers whose exposure to asbestos dust prior to the implementation of asbestos regulation and improved control measures places them at risk of asbestos-related disease today. In addition, workers are still being exposed to significant amounts of asbestos, when asbestos materials in place are disturbed during renovation, repair, or demolition. Given the continued presence of asbestos-containing materials in industrial, commercial, and residential settings throughout the U.S., a sizeable population remains at risk of asbestos-related disease. This article reviews the health effects associated with exposure to asbestos and delineates the steps necessary for the comprehensive screening and clinical assessment for asbestos-related disease, in order to assist physicians in identifying and preventing illness associated with exposure to asbestos among their patients.
Subject(s)
Asbestos/adverse effects , Asbestosis/diagnosis , Asbestosis/prevention & control , Asbestosis/therapy , Construction Materials/adverse effects , Diagnostic Imaging , Dust/adverse effects , Humans , Mass Screening , Mineral Fibers/adverse effects , Occupational Exposure , Physical Examination , Respiratory Function Tests , Risk Factors , United StatesABSTRACT
PURPOSE: To assess needs for breast cancer screening education by comparing medical students' training and knowledge of breast cancer screening upon their entry to and exit from medical school. METHOD: Seventy-seven medical students at one medical school completed questionnaires as first-year students (in 1992) and again as fourth-year students (in 1996) that assessed their breast cancer screening knowledge. The fourth-year questionnaire included additional questions about the students' clinical training in breast cancer screening skills and their perceptions of needs for further training. RESULTS: Although the students performed significantly better on the knowledge-based questions in their fourth year than they did in their first year, considerable room for improvement remained. The students reported learning the most from surgery rotations and more from standardized patients than from faculty. Women medical students performed significantly more clinical breast examinations than did men students. CONCLUSIONS: Most of the medical students reported needing additional training in clinical breast examination. More curricular time devoted to education about breast cancer screening is needed.
Subject(s)
Breast Neoplasms/diagnosis , Clinical Competence , Education, Medical, Undergraduate/methods , Students, Medical , Educational Status , Female , Health Knowledge, Attitudes, Practice , Humans , Male , New York , Sex Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To describe the outcomes of breast biopsy recommendations for women screened through a mobile mammography van. METHODS: Data on all women screened through the Mobile Mammography Program in Suffolk County, Long Island, NY, from 1990 to 1994 were analyzed to determine biopsy recommendation rates, biopsy rates, positive biopsy rates, and cancer detection rates. Follow-up information was obtained from the women's physicians. RESULTS: The breast cancer detection rate for women screened through the Mobile Mammography Program averaged 0.33% over a five-year period. The biopsy recommendation rate based on abnormal mammograms remained stable, at about 1% to 2%, over a five-year period, as did the rate of positive biopsies among women having biopsies (36.8% to 44.4%). For women ages 50 and older, the cancer rate in 1994 was 0.36%, while for women younger than age 50, the cancer rate was 0.25% (0.32% for all ages). CONCLUSIONS: These findings show that a breast cancer screening program using a mobile van can have comparable cancer detection rates to national figures and a fairly stable biopsy recommendation rate from which follow-up resource needs can be estimated.
