An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria

Anselm Ejike Chukwuani; Abimbola Osanaiye; Obinna Franklin Eneje; David Oselumenosen Omiyi

doi:doi:10.11648/j.cajph.20170304.13

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An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria

Anselm Ejike Chukwuani, Abimbola Osanaiye, Obinna Franklin Eneje, David Oselumenosen Omiyi

Published in Central African Journal of Public Health (Volume 3, Issue 4)

Received: 10 June 2017 Accepted: 30 June 2017 Published: 24 August 2017

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Abstract

Routine pre-employment chest radiography is one of the examinations performed to assess the medical fitness of prospective employees in many establishments around the world. It is also used to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis. Despite these focused goals, there are concerns over poor positive result yield, associated unnecessary exposure to ionizing radiation and wastage of economic resources linked to pre-employment chest x-ray. This study aimed to audit the reports of pre-employment chest radiographs, documented associated radiological findings and subsequently examined the clinical relevance or otherwise of this practice in the locality under study. The records of 725 patients, who had underwent pre-employment chest x-rays between January 2014 and December 2016 in three foremost teaching hospitals in South-western Nigeria, were retrospectively reviewed. All findings were documented including abnormalities ‘flagged’ as clinically-significant by the radiologists’ reports irrespective of the severity or the effect of the abnormality on the employment outcome of the individual. The results show that majority of the patients referred for pre-employment chest x-ray presented with normal radiological findings (n = 687, 94.8%). The significant abnormal findings (n = 38, 5.2%) were chronic cardiovascular disorder (n = 15, 2.0%), followed by chronic lung disease (n = 18, 2.5%) and finally skeletal abnormality (n = 5, 0.7%). Individuals 25 years and below presented with no abnormal findings while abnormal findings are found in subjects in the age range of 26-30 years and above. This audit has shown that chest radiography has little or no clinical relevance in routine pre-employment medical screening of physically healthy and asymptomatic prospective employees. Therefore, chest radiography should be restricted to individuals with clinical findings suggestive of cardio-thoracic disorders during pre-employment medical screening.

Published in	Central African Journal of Public Health (Volume 3, Issue 4)
DOI	10.11648/j.cajph.20170304.13
Page(s)	51-54
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Human Resources, Medical Fitness, Chest Radiography, Pulmonary Tuberculosis

References

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[2]	Samuel J, Gibikote S, and Henry K. The routine pre-employment screening chest radiograph: Should it be routine? Indian J Radiol Imaging. 2016 Jul-Sep; 26(3): 402-404.
[3]	Ogbeide O and Adeyekun A, An audit of 3859 preadmission chest radiographs of apparently healthy students in a Nigerian Tertiary Institution. Niger Med J. 2011 Oct-Dec; 52(4): 260-262.
[4]	Serra C, Rodriguez MC, Delclos GL, Plana M, Gómez López LI, Benavides FG. Criteria and methods used for the assessment of fitness for work: a systematic review. Occup Environ Med 2007; 64: 304-12.
[5]	Carter T. The application of the methods of evidence based practice to occupational health. Occup Med (Chic Ill) 2000; 50: 231-6.
[6]	Franco G. Evidence-based decision making in occupational health. Occup Med (Chic Ill) 2005; 55: 1-2.
[7]	Kumar V, Abdul K, Richard N. Robbins Basic Pathology (8^th ed.) Saunders Elsevier. 2007 pp. 516-522.
[8]	Kouamé N, Ngoan-Domoua AM, Konan AN. Systematic chest radiography during pre-employment check-up. African Journal of Respiratory Medicine. 2012; 7: 15-8.
[9]	Tigges S, Roberts DL, Vydareny KH, Schulman DA. Routine chest radiography in a primary care setting. Radiology. 2004; 233: 575-8.
[10]	Cockroft A. Chapman S. Insal C. Soper P. Kennard Y, Hollis C. Tuberculin reactivity in new employees in London Health District 1998; 43: 834.
[11]	Ogbole GI, Agunloye AM, Adeyinka AO. Are routine chest radiographic examinations of students in Nigerian Universities still relevant? An imaging perspective, Journal of Medicine and Medical Sciences. 2014: 3(12) 780-783.
[12]	Lee TK, Low CH. Routine roentgenography on 4,036 health screening patients in a private hospital out-patient clinic. Singapore Med J. 1986; 27: 18-25.
[13]	Chaturvedi N, Cockcroft A (1992). Tuberculosis screening in health service employees: who needs chest X-rays? Occup Med (Lond). 42: 179-82.
[14]	Eisenberg RL, Pollock NR (2010). Low yield of chest radiography in a large tuberculosis screening program. Radiology. 256: 998-1004.
[15]	Adeyekun AA, Egbagbe EE, Oni OA (2010). Contact tracing/preemployment screening for pulmonary tuberculosis: should positive Mantoux test necessitates routine chest X-ray? Ann Afr. Med. 3: 159-63.

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APA Style

Anselm Ejike Chukwuani, Abimbola Osanaiye, Obinna Franklin Eneje, David Oselumenosen Omiyi. (2017). An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Central African Journal of Public Health, 3(4), 51-54. https://doi.org/10.11648/j.cajph.20170304.13

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ACS Style

Anselm Ejike Chukwuani; Abimbola Osanaiye; Obinna Franklin Eneje; David Oselumenosen Omiyi. An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Cent. Afr. J. Public Health 2017, 3(4), 51-54. doi: 10.11648/j.cajph.20170304.13

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AMA Style

Anselm Ejike Chukwuani, Abimbola Osanaiye, Obinna Franklin Eneje, David Oselumenosen Omiyi. An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Cent Afr J Public Health. 2017;3(4):51-54. doi: 10.11648/j.cajph.20170304.13

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@article{10.11648/j.cajph.20170304.13,
  author = {Anselm Ejike Chukwuani and Abimbola Osanaiye and Obinna Franklin Eneje and David Oselumenosen Omiyi},
  title = {An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria},
  journal = {Central African Journal of Public Health},
  volume = {3},
  number = {4},
  pages = {51-54},
  doi = {10.11648/j.cajph.20170304.13},
  url = {https://doi.org/10.11648/j.cajph.20170304.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20170304.13},
  abstract = {Routine pre-employment chest radiography is one of the examinations performed to assess the medical fitness of prospective employees in many establishments around the world. It is also used to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis. Despite these focused goals, there are concerns over poor positive result yield, associated unnecessary exposure to ionizing radiation and wastage of economic resources linked to pre-employment chest x-ray. This study aimed to audit the reports of pre-employment chest radiographs, documented associated radiological findings and subsequently examined the clinical relevance or otherwise of this practice in the locality under study. The records of 725 patients, who had underwent pre-employment chest x-rays between January 2014 and December 2016 in three foremost teaching hospitals in South-western Nigeria, were retrospectively reviewed. All findings were documented including abnormalities ‘flagged’ as clinically-significant by the radiologists’ reports irrespective of the severity or the effect of the abnormality on the employment outcome of the individual. The results show that majority of the patients referred for pre-employment chest x-ray presented with normal radiological findings (n = 687, 94.8%). The significant abnormal findings (n = 38, 5.2%) were chronic cardiovascular disorder (n = 15, 2.0%), followed by chronic lung disease (n = 18, 2.5%) and finally skeletal abnormality (n = 5, 0.7%). Individuals 25 years and below presented with no abnormal findings while abnormal findings are found in subjects in the age range of 26-30 years and above. This audit has shown that chest radiography has little or no clinical relevance in routine pre-employment medical screening of physically healthy and asymptomatic prospective employees. Therefore, chest radiography should be restricted to individuals with clinical findings suggestive of cardio-thoracic disorders during pre-employment medical screening.},
 year = {2017}
}

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TY  - JOUR
T1  - An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria
AU  - Anselm Ejike Chukwuani
AU  - Abimbola Osanaiye
AU  - Obinna Franklin Eneje
AU  - David Oselumenosen Omiyi
Y1  - 2017/08/24
PY  - 2017
N1  - https://doi.org/10.11648/j.cajph.20170304.13
DO  - 10.11648/j.cajph.20170304.13
T2  - Central African Journal of Public Health
JF  - Central African Journal of Public Health
JO  - Central African Journal of Public Health
SP  - 51
EP  - 54
PB  - Science Publishing Group
SN  - 2575-5781
UR  - https://doi.org/10.11648/j.cajph.20170304.13
AB  - Routine pre-employment chest radiography is one of the examinations performed to assess the medical fitness of prospective employees in many establishments around the world. It is also used to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis. Despite these focused goals, there are concerns over poor positive result yield, associated unnecessary exposure to ionizing radiation and wastage of economic resources linked to pre-employment chest x-ray. This study aimed to audit the reports of pre-employment chest radiographs, documented associated radiological findings and subsequently examined the clinical relevance or otherwise of this practice in the locality under study. The records of 725 patients, who had underwent pre-employment chest x-rays between January 2014 and December 2016 in three foremost teaching hospitals in South-western Nigeria, were retrospectively reviewed. All findings were documented including abnormalities ‘flagged’ as clinically-significant by the radiologists’ reports irrespective of the severity or the effect of the abnormality on the employment outcome of the individual. The results show that majority of the patients referred for pre-employment chest x-ray presented with normal radiological findings (n = 687, 94.8%). The significant abnormal findings (n = 38, 5.2%) were chronic cardiovascular disorder (n = 15, 2.0%), followed by chronic lung disease (n = 18, 2.5%) and finally skeletal abnormality (n = 5, 0.7%). Individuals 25 years and below presented with no abnormal findings while abnormal findings are found in subjects in the age range of 26-30 years and above. This audit has shown that chest radiography has little or no clinical relevance in routine pre-employment medical screening of physically healthy and asymptomatic prospective employees. Therefore, chest radiography should be restricted to individuals with clinical findings suggestive of cardio-thoracic disorders during pre-employment medical screening.
VL  - 3
IS  - 4
ER  -

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Author Information

Anselm Ejike Chukwuani

Department of Radiology, Reddington Hospital, Lagos, Nigeria
Abimbola Osanaiye

Department of Radiology, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria
Obinna Franklin Eneje

Department of Radiology, Garki General Hospital, Abuja, Nigeria
David Oselumenosen Omiyi

Department of Radiation Biology, Radiotherapy, Radiodiagnosis and Radiography, College of Medicine, University of Lagos, Lagos, Nigeria

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APA Style

Anselm Ejike Chukwuani, Abimbola Osanaiye, Obinna Franklin Eneje, David Oselumenosen Omiyi. (2017). An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Central African Journal of Public Health, 3(4), 51-54. https://doi.org/10.11648/j.cajph.20170304.13

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ACS Style

Anselm Ejike Chukwuani; Abimbola Osanaiye; Obinna Franklin Eneje; David Oselumenosen Omiyi. An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Cent. Afr. J. Public Health 2017, 3(4), 51-54. doi: 10.11648/j.cajph.20170304.13

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AMA Style

Anselm Ejike Chukwuani, Abimbola Osanaiye, Obinna Franklin Eneje, David Oselumenosen Omiyi. An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria. Cent Afr J Public Health. 2017;3(4):51-54. doi: 10.11648/j.cajph.20170304.13

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@article{10.11648/j.cajph.20170304.13,
  author = {Anselm Ejike Chukwuani and Abimbola Osanaiye and Obinna Franklin Eneje and David Oselumenosen Omiyi},
  title = {An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria},
  journal = {Central African Journal of Public Health},
  volume = {3},
  number = {4},
  pages = {51-54},
  doi = {10.11648/j.cajph.20170304.13},
  url = {https://doi.org/10.11648/j.cajph.20170304.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cajph.20170304.13},
  abstract = {Routine pre-employment chest radiography is one of the examinations performed to assess the medical fitness of prospective employees in many establishments around the world. It is also used to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis. Despite these focused goals, there are concerns over poor positive result yield, associated unnecessary exposure to ionizing radiation and wastage of economic resources linked to pre-employment chest x-ray. This study aimed to audit the reports of pre-employment chest radiographs, documented associated radiological findings and subsequently examined the clinical relevance or otherwise of this practice in the locality under study. The records of 725 patients, who had underwent pre-employment chest x-rays between January 2014 and December 2016 in three foremost teaching hospitals in South-western Nigeria, were retrospectively reviewed. All findings were documented including abnormalities ‘flagged’ as clinically-significant by the radiologists’ reports irrespective of the severity or the effect of the abnormality on the employment outcome of the individual. The results show that majority of the patients referred for pre-employment chest x-ray presented with normal radiological findings (n = 687, 94.8%). The significant abnormal findings (n = 38, 5.2%) were chronic cardiovascular disorder (n = 15, 2.0%), followed by chronic lung disease (n = 18, 2.5%) and finally skeletal abnormality (n = 5, 0.7%). Individuals 25 years and below presented with no abnormal findings while abnormal findings are found in subjects in the age range of 26-30 years and above. This audit has shown that chest radiography has little or no clinical relevance in routine pre-employment medical screening of physically healthy and asymptomatic prospective employees. Therefore, chest radiography should be restricted to individuals with clinical findings suggestive of cardio-thoracic disorders during pre-employment medical screening.},
 year = {2017}
}

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TY  - JOUR
T1  - An Audit of Routine Chest X-ray Done During Pre-employment Medical Screening in South-Western Nigeria
AU  - Anselm Ejike Chukwuani
AU  - Abimbola Osanaiye
AU  - Obinna Franklin Eneje
AU  - David Oselumenosen Omiyi
Y1  - 2017/08/24
PY  - 2017
N1  - https://doi.org/10.11648/j.cajph.20170304.13
DO  - 10.11648/j.cajph.20170304.13
T2  - Central African Journal of Public Health
JF  - Central African Journal of Public Health
JO  - Central African Journal of Public Health
SP  - 51
EP  - 54
PB  - Science Publishing Group
SN  - 2575-5781
UR  - https://doi.org/10.11648/j.cajph.20170304.13
AB  - Routine pre-employment chest radiography is one of the examinations performed to assess the medical fitness of prospective employees in many establishments around the world. It is also used to ensure that prospective employees can perform their jobs safely without placing co-workers and others at potential health risk by ruling out the existence of chronic infectious pulmonary diseases like tuberculosis. Despite these focused goals, there are concerns over poor positive result yield, associated unnecessary exposure to ionizing radiation and wastage of economic resources linked to pre-employment chest x-ray. This study aimed to audit the reports of pre-employment chest radiographs, documented associated radiological findings and subsequently examined the clinical relevance or otherwise of this practice in the locality under study. The records of 725 patients, who had underwent pre-employment chest x-rays between January 2014 and December 2016 in three foremost teaching hospitals in South-western Nigeria, were retrospectively reviewed. All findings were documented including abnormalities ‘flagged’ as clinically-significant by the radiologists’ reports irrespective of the severity or the effect of the abnormality on the employment outcome of the individual. The results show that majority of the patients referred for pre-employment chest x-ray presented with normal radiological findings (n = 687, 94.8%). The significant abnormal findings (n = 38, 5.2%) were chronic cardiovascular disorder (n = 15, 2.0%), followed by chronic lung disease (n = 18, 2.5%) and finally skeletal abnormality (n = 5, 0.7%). Individuals 25 years and below presented with no abnormal findings while abnormal findings are found in subjects in the age range of 26-30 years and above. This audit has shown that chest radiography has little or no clinical relevance in routine pre-employment medical screening of physically healthy and asymptomatic prospective employees. Therefore, chest radiography should be restricted to individuals with clinical findings suggestive of cardio-thoracic disorders during pre-employment medical screening.
VL  - 3
IS  - 4
ER  -

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