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Table 2 Approval standards

From: Review of carcinogenicity of asbestos and proposal of approval standards of an occupational cancer caused by asbestos in Korea

Disease Requirements for recognition
Asbestosis (including complications of asbestosis) A disease occurring in a worker exposed to asbestos, corresponding to either or according to the pneumoconiosis management classification (management 1 ~ 4) under the Pneumoconiosis Act. In addition, the occupational disease is judged after determination of the pneumoconiosis management classification by the prefectural labor minister, in principle.
· Management 4 asbestosis (pneumoconiosis due to asbestosis)
Complications of Management 2, Management 3, or Management 4 asbestosis1
Malignant mesothelioma (1) Malignant mesothelioma in the pleura, peritoneum, pericardium or tunica vaginalis testis of a worker exposed to asbestos; it is recognized as an occupational disease in case the chest X-ray images (type 1~4) show asbestosis findings as specified in the Pneumoconiosis Act or the work period with asbestos exposure corresponds to either or .
However, cases with less than 10 years since the first occupational asbestos exposure are excluded.
Type 1 or higher asbestosis findings in chest X-ray images
Engaged in work involving asbestos exposure for at least 1 year
※ As it is challenging to diagnose malignant mesothelioma, it is important to confirm malignant mesothelioma with pathology results but in case pathology results are not available, the case should be judged by comprehensively considering clinical test results, imaging findings, clinical course and differentiation with other diseases.
Lung cancer 'Primary lung cancer' in an worker exposed to asbestos; it is recognized as an occupational disease if corresponding to any of to . However, cases with less than 10 years since the first occupational asbestos exposure are excluded.
· Presence of asbestosis findings2
Pleural plaque findings + engaged in work involving asbestos exposure for at least 10 years3
Broad range of pleural plaque findings4 + engaged in work involving asbestos exposure for at least 1 year
Findings of asbestos bodies or asbestos fibers5 + engaged in work involving asbestos exposure for at least 1 year
Complication of diffuse pleural thickening
Engaged in 3 specific types of work6 + engaged in work involving asbestos exposure for at least 5 years7
Positive asbestos pleural fluid As pleural fluid may be present with various causes (including tuberculous pleurisy and rheumatoid pleurisy) other than asbestos, diagnosis of positive asbestos pleural fluid should rule out the cause of pleural fluid other than asbestos. Since it may make its diagnosis highly challenging, recognition of an occupational disease is judged in discussion between the Labor Standards Inspection Office Director and the Ministry of Health, Labour and Welfare Main Office.
Diffuse pleural change Diffuse pleural thickening present in a worker exposed to asbestos; the thickness should meet the following standards and be accompanied by apparent respiratory dysfunction. It is recognized as an occupational disease if the work period involving asbestos exposure is at least 3 months (meeting all of ~ as follows).
Engaged in work involving asbestos exposure for at least 3 years
Apparent respiratory dysfunction: Vital capacity (%VC) of < 60 %
Pleural thickening beyond a certain extent: On chest CT images
Unilateral thickening: Involving at least 1/2 of the chest wall
Bilateral thickening: Involving at least 1/4 of the chest wall
  1. 1Complications refer to the followings. Pulmonary tuberculosis, Tuberculous pleurisy, Secondary bronchitis, Secondary bronchiectasis, Secondary pneumothorax
  2. 2Type 1 or higher asbestosis on chest X-ray images as specified in the Pneumoconiosis Act
  3. 3In case of asbestos product manufacturing, the work period since 1996 is calculated as 1/2 of the actual work period
  4. 4Broad range of pleural plaque refers to the case that apparent opacities are recognized that can be judged as a pleural plaque on chest X-ray images, the opacities are confirmed as a pleural plaque on chest CT images, and the pleural plaque accounts for 1/4 of the chest wall on chest CT images
  5. 5One of the followings are required for findings of asbestos bodies or asbestos fibers
  6. Asbestos bodies of at least 5,000 per 1 g of dry lung tissue
  7. Asbestos bodies of at least 5 in 1 ml of bronchial alveolar lavage fluid
  8. Asbestos fibers (>5μm) of at least 2 million per 1 g of dry lung tissue
  9. Asbestos fibers (>1μm) of at least 5 million per 1 g of dry lung tissue
  10. Presence of asbestos bodies or asbestos fibers on a lung tissue section
  11. 6 "3 specific types of work" refers to asbestos spun product manufacturing, asbestos cement product manufacturing, and asbestos fit-up work
  12. 7 "Work period" refers the period of working in 1 of the above 3 types of work or their total period. However, for the work period after 1996, the period is calculated as 1/2 of the actual work period