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International Classification of HRCT for Occupational and Environmental Respiratory Diseases

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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.
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