석면에 의한 건강장해의 진단과 보상
Compensation and Diagnosis of Asbestos Related Disease
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초록
석면은 불에 타지 않는 특성이 있는 섬유상 물질로 건축자재 등 폭넓게 사용되고 있다. 건강에 문제를 일으키는 석면으로 는 백석면(크리소타일), 갈석면(아모사이트), 청석면(크로시 도라이트)이 있다. 석면에 의한 건강장해는 중피종과 폐암 외 에도 석면폐, 흉막판, 미만성 흉막 비후, 원형 무기폐 등이 있 다. 중피종은 흉막과 복막에 생기는 드문 질환이지만, 80%정 도가 석면에 의해서 생긴다. 우리나라에서 직업병으로 인정 되는 것은 폐암, 중피종과 석면폐이다. 석면에 의한 건강장해 는 10년에서 40년 정도의 긴 잠복기를 가지기 때문에 앞으로 주요한 공중보건의 문제가 될 것이다. 이들 건강장해를 진단 하기 위해서는 석면 노출에 대한 자세한 직업력이 매우중요 하고, 흉부 X-선 쵤영과 폐기능 검사, 흉수에 대한 세포검사, 병 리조직학적 검사와 특수염색을 하여 감별진단을 하고 있다.
Abstract
Asbestos is a fibrous silicate that was widely used because of its heat resistance properties. Asbestos exposure affects workers involved in mining or processing asbestos or those involved in the use of asbestos in the shipbuilding, construction, and textile- and insulation-manufacturing industries. There are three commonly available types of asbestos; chrysotile (white asbestos), amosite (brown asbestos), and crocidolite (blue asbestos). All three have been associated with cancerous and non-cancerous lung disease. Asbestos-related diseases includes benign pleural effusion, pleural plaques, diffuse pleural thickening (a non-malignant disease affecting the lung lining), rounded atelectasis, asbestosis (a scarring of the lung tissue caused by asbestos), mesothelioma and lung cancer. Mesothelioma is a malignant pleural or peritoneal tumor that rarely occurs in patients who have not been exposed to asbestos. The latency period of most asbestos-related disease is 10 years or longer, asbestos-related disease remains an important public health issue. The clinical diagnosis of asbestos related diseases should be based on a detailed interview of the patient and occupational data on asbestos exposure, signs and symptoms, radiological and lung physiological findings and selected cytological, histological and other laboratory studies. Radiological imaging plays a pivotal role in the diagnosis and management of asbestos-related disease.
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