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Howard Frumkin, MD, MPH
Cambridge Hospital Cambridge, Mass

David Egilman, MD, MPH; Michael Kelly, MD, MPH
Greater Cincinnati Occupational Health Center

David Christiani, MD, MPH
Norfolk County Hospital South Braintree, Mass

Lewis Pepper, MD; James Cone, MD
San Francisco General Hospital

Nancy Sprince, MD, MPH
Massachusetts General Hospital Boston

Jay Himmelstein, MD, MPH
University of Massachusetts Medical Center Worcester

JAMA. 1985;254(10):1307-1308.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

As members of the Diagnostic Criteria Committee of the American Public Health Association's Occupational Health Section, we were pleased to see published the report on asbestos-related diseases of the Council on Scientific Affairs.¹ We were especially pleased at the disclaimer, which states that the report "is not intended as a standard of medical care" (p 2593), because a series of inaccuracies, omissions, and biases makes the report unsuitable for any such use. Specifically, we would like to address seven points.

1. The diagnosis of asbestosis. As practitioners of occupational medicine, we strongly maintain that asbestosis should be diagnosed in any patient with a significant exposure history and with characteristic findings on physical examination (rales), pulmonary function testing (restrictive lung disease), and chest roentgenography (interstitial disease). In fact, not all three findings are always necessary. In this regard, the report is unrealistic for two reasons. First, it
   

Footnotes
Edited by Drummond Rennie, MD, Senior Contributing Editor.

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