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Practical recommendations for the clinical assessment of workers, as referred to in Article 18(2), second subparagraph 1. Current knowledge indicates that exposure to free asbestos fibres can give rise to at least the following diseases:

— asbestosis,

— mesothelioma,

— lung carcinoma,

— gastro-intestinal carcinoma,

— carcinoma of the larynx,

— carcinoma of the ovary,

— non-malignant pleural diseases.

2. The doctor and/or authority responsible for the medical surveillance of workers exposed to asbestos must be familiar with the exposure conditions or circumstances of each worker.

3. Health examination of workers should be carried out in accordance with the principles and practices of occupational medicine. It should include at least the following measures:

— keeping records of a worker’s medical and occupational history,

— a personal interview,

— a general clinical examination, with particular reference to the chest,

— lung function tests (respiratory flow volumes and rates).

The doctor and/or authority responsible for health surveillance should decide on further examinations, such as sputum cytology tests or a chest X-ray or a tomodensitometry, in the light of the latest occupational health knowledge available.