An asbestos screening is a medical evaluation and educational session for sheet metal workers who may have been exposed to asbestos. Find out when our Asbestos Screening Program will be visiting a location in your area.
The following SMOHIT health screenings are scheduled as of today’s date. All sheet metal workers who were initiated to journey-level status prior to January 1, 1994 and are on minimum dues (if retired) are eligible.
Here’s what you need to know about HDLs, LDLs, and all those confusing numbers.
Back to Basics Despite the negative connotation attached to it, cholesterol is essential to your life. It’s the primary element of the membrane that surrounds every cell in your body—without cholesterol, your body won’t synthesize vitamin D, bile acids, or steroid hormones. Cholesterol is found in all animal tissues—cheese, butter, rib-eye steaks, chicken tenders, you name it. It isn’t found, however, in any plant tissues, which is why vegetable oil is labeled “cholesterol-free.”
To reach every cell in your body, cholesterol travels in the bloodstream. It’s a waxy, fat-like substance formed in the liver that won’t dissolve in blood. Instead, it’s carried along by lipoproteins, tidy combinations of fat and protein that can take on cargo and sail through the bloodstream.
Low-density lipoproteins (LDLs) carry cholesterol out from the liver to all the cells. The LDLs dock and offload the cholesterol cargo at cell receptor sites. But the cells are only going to take so much—they have their limits, after all.
Excess cholesterol continues to travel around in the blood. The extra LDL packaging and the cholesterol can snag in the artery walls and contribute to the buildup of plaque. Excessively high levels of LDLs can contribute to atherosclerosis, or hardening of the arteries. The greatest contributor to high cholesterol levels is the cholesterol made in the liver from the fat we eat—particularly saturated fat.
High-density lipoproteins (HDLs) gather up and return unused cholesterol to the liver, where it’s removed from the blood and excreted from the body. HDLs work against hardening of the arteries, which is why they are often called “good” cholesterol.
Healthy eating habits (those involving with less dietary fat and cholesterol) and regular exercise help increase the amount of HDLs in your blood and reduce the amount of LDLs. Smoking, on the other hand, reduces desirable HDLs. Your total cholesterol level is measured from a blood sample as milligrams of total cholesterol per deciliter of blood (mg/dl). A total cholesterol reading of 200 mg/dl or lower is good; a reading of 240 mg/dl or higher needs attention because it is approaching an unhealthy level.
The Benefits of a Healthy Diet and Regular Exercise
High blood cholesterol can contribute to coronary heart disease, but by itself doesn’t cause it. While high blood cholesterol is a risk factor for coronary heart disease, it is merely one of several risk factors, and they should all be considered together, case by case.
If you were a man over 60 with a family history of heart disease, if you didn’t exercise, if you smoked and were overweight, and if your cholesterol reading was on the high side, you might be looking at a heart attack in the next five years. Treatment shouldn’t just focus on bringing down high cholesterol; it should be aimed at reducing all the risk factors you can control—smoking, diet, exercise, etc.
Isn’t There a Pill or Something? While there are, in fact, new medications to lower cholesterol, they are used as a last resort. If there’s a high probability of heart attack in the next five years due to your risk factors—and your cholesterol is high—then medication is a route worth exploring. But that’s something to work out with your doctor, only then after you’ve tried bringing your cholesterol down by other means.
How to Bring Down Your Cholesterol
You can often lower your cholesterol by making a few lifestyle adjustments. Here’s how:
- If you smoke, stop right now. If you don’t smoke, don’t start. Smoking reduces HDLs, the “good” cholesterol that you want to be as high as possible.
- Exercise regularly. Exercise reduces LDLs, the “bad” cholesterol, and increases HDLs, the good cholesterol.
- Drink alcohol in moderation.
- Reduce the fat intake in your diet. *Reduce the stress in your life.
- If you are overweight, try to lose those extra pounds.
Everything you do to reduce cholesterol helps you lose weight, lower blood pressure, and manage diabetes. Everything you do to lower blood cholesterol is good for your heart, helps prevent colon cancer, and benefits you as you grow older.
Men between 40 and 65 should have their cholesterol checked, and then consider a test every five years if all cholesterol levels are desirable and they are not at high risk for heart disease. Women between 50 and 65 should consider having their cholesterol checked, and then tested again in five-year intervals if all cholesterol levels are desirable and they are not at high risk for heart disease. Cholesterol screening is most important for people at high risk for heart disease.
Got More Questions? If you have questions after this examination is completed, ask your personal physician.
What Do the Cholesterol Numbers Mean?
The most commonly used cholesterol values are listed below. The rule of thumb: You want HDL to be high, while LDL should be low.
Desirable—All of the following: Total cholesterol below 200.
HDL cholesterol above 35. LDL cholesterol below 130.
Total-to-HDL ratio below 3.5 to 1. LDL-to-HDL ratio lower than 3 to 1.
Borderline High-Risk—One or more of the following:
Total cholesterol level of 200 to 239. LDL cholesterol level of 130 to159.
Total-to-HDL ratio of 3.5 to 4.5 to 1.
High-Risk—One or more of the following: Total cholesterol level of 240 or higher.
HDL cholesterol below 35. Total to HDL ratio of 4.5 to 1 or higher.
LDL or HDL ratio of 3 to 1 or higher.
The Low Cholesterol Diet Fats should make up no more than 30 percent of the calories you eat in a day, according to the American Heart Association. To make a more significant reduction in the amount of fat in your diet, aim for 20-25 percent.
Keep saturated fats to a minimum. They are found in animal products (meat, fish, poultry, eggs, butter, cheese) and in tropical oils (used in snack foods and baked goods).
Monounsaturated fats (olive oil, canola oil) can lower LDLs.
What is an Asbestos Screening?
An asbestos screening is a medical evaluation and educational session for sheet metal workers who may have been exposed to asbestos.
Is an Asbestos Screening the Same as a Complete Physical?
No. During a normal screening, individuals get a brief physical examination. In the case of asbestos, the exam focuses only on the heart and lungs. A screening does not take the place of regular examinations with your private physician.
What Else is Included in an Asbestos Screening?
Each screening involves a brief physical exam including a review of the individual’s medical history and work history concerning exposure to asbestos. Also included is a chest X-ray and a spirometry test, which measures lung capacity and function. The last part of the screening is an educational session about the potential health effects of asbestos and how to avoid future exposure to it. It is also an opportunity to ask questions about any other work hazard.
Are the Test Results Confidential?
Yes. Each participant gets a personal letter with his or her individual results. This letter is not sent to anyone else without the individual’s written permission.
How Long Does it Take to Get Results Back?
Individual results will be sent out about four to eight weeks after the screening, depending on the screening physician or clinic.
What if the Screening Tests Show a Problem?
If screening results show evidence of asbestos-related disease, we suggest that you schedule a follow-up meeting with the union; information will be shared regarding continuing care and legal rights at this meeting, with physicians and attorneys on hand to answer questions.
Diseases from Asbestos
There are several medical diseases that occur as a result of asbestos exposure. The ones of greatest concern and importance are pleural plaques, asbestosis, lung cancer, colon cancer, and mesothelioma.
Pleural plaques are also called pleural fibrosis, pleural thickening, and pleural asbestosis. A majority of people with heavy exposure to asbestos develop pleural abnormalities. The pleura is a thin lining that surrounds the lung. Inhaled asbestos fibers travel to the outside of the lung and cause a scar to form in this lining. When they reach a certain size they are visible on chest X-rays as a plaque. Most of these plaques alone do not cause significant disability, but they do show that significant exposure has occurred and that other asbestos-related diseases may be present. Some types of plaques can cause loss of lung function as well. Based on information from studies in New York and Boston, as well as results from the national sheet metal screening program, about half of all sheet metal workers with 30 years of exposure will have pleural plaques.
Parenchymal Asbestosis (Pulmonary Asbestosis)
Parenchymal asbestosis is a scar formation in lung material itself. These scars can interfere with lung function, because they block the transport of oxygen from the air in the lungs into the blood vessels that travel through the lungs. Oxygen can only cross the membranes of the lung if the membranes are thin; asbestosis causes them to thicken. The extent of scar formation determines the amount of shortness of breath that results. Some persons can have mild scarring and have little loss of exercise capacity; others with more extensive disease get out of breath with mild exertion.
As a general rule, the greater the exposure the more the disease, but some people seem to form scars more or less readily and so we see a variety of disease from the same exposure. These scars are visible on X-rays in most cases, although in early stages of disease the scars can be too small to detect. There is a system of grading the degree of disease on the X-ray called the ILO classification. Physicians who have received special training in this system are called “A” or “B” readers. Each X-ray is scored on the type of scar formation and the density of the scars.
The scars are also detected on pulmonary function testing. Asbestosis makes the lung stiffer and smaller, so the volume of air in the lungs is decreased. Oxygen transport as measured by “diffusion capacity” is also decreased. Once again, the changes can be subtle, and test results should be interpreted by someone with experience in asbestos-related diseases.
Once this scar formation takes place it is irreversible. If exposure to asbestos ceases, the scarring does not usually progress, although in a small number of individuals it does get worse. Because of the damage to the lungs, a person with asbestosis is at increased risk of lung infections and should get regular medical care along with influenza vaccines.
Lung Cancer and Respiratory Cancers
Lung cancer is a serious problem for asbestos workers. In general, insulators (a heavy exposure group) working in the trade for 20 years and have never smoked have a risk that is five times that of a non-asbestos worker. However, an insulator who smokes has a 50–90-fold increase in risk; cigarettes and asbestos act together to cause cancer. Evidence shows that if an insulator quits smoking his/her risk of cancer falls over several years back to the range of the nonsmoker. Because the effect of the asbestos is irreversible, one of the most important changes any worker exposed to asbestos can make is to quit smoking. The risk of cancer of the larynx is also increased by asbestos exposure.
Colon Cancer and Gastrointestinal Cancer
There is also a higher incidence of cancers of the gastrointestinal tract among asbestos workers. In people exposed to asbestos for more than 20 years, the rate of colon cancer is increased by a factor of two. It is important for all sheet metal workers to have regular checkups to detect early signs of colon cancer.
Mesothelioma is a rare cancer of the pleura (lung lining) and the peritoneum (abdomen lining) that occurs in people exposed to asbestos. It is almost impossible to treat and is usually fatal. Although asbestos workers get mesothelioma at a rate far greater than non-exposed people, it is still a much more rare disease than lung cancer. Pleural plaques are not cancer, nor do they turn into mesothelioma. They both occur in the lining of the lung, but they are separate diseases.
What is Your Risk?
All these diseases occur more frequently in heavily exposed populations; much of the information comes from studies of insulators. We can then try to estimate the risk of disease in other groups by estimating the relative degree of exposure.
There is no safe level for exposure to a carcinogen. Risk of disease will only lessen—not disappear—as exposure lessens. Although asbestos is currently used less frequently than years ago it is present in buildings constructed through the early 1970s and still used for brake and clutch linings among other uses. Those who work in buildings with asbestos insulation (on duct work, pipes, structural steel, in roofing materials, etc.) must be aware of the special precautions needed for the handling of asbestos.
Prostate Cancer Screening
The prostate is a small male reproductive system gland located between the bladder and the rectum, and produces fluid that makes up part of a man’s semen. It is possible for cancer cells to begin to grow in this gland, leading to prostate cancer.
Men with prostate cancer often don’t know they have it, because it is possible to have the condition for years without developing any symptoms. Screening tests allow doctors to check for prostate cancer in men who do not have such symptoms.
The following information will help you to understand the screening process for prostate cancer and make sense of the recommendations offered by different medical groups. Your final decision regarding whether you should be screened for prostate cancer should be made with the help of your doctor.
How Common is Prostate Cancer?
Prostate cancer is very common. In fact, in the United States, prostate cancer is the most commonly diagnosed cancer outside of skin cancer. One in every five men in this country will develop prostate cancer before his death.
Prostate cancer tends to develop slowly. Most men live with prostate cancer for a long time without any problems or symptoms, and many never experience any problems at all. Men who do have symptoms often find them troublesome, and the symptoms sometimes interfere with daily life. Symptoms of prostate cancer include blood in the semen or urine, pain during ejaculation, and difficulty urinating.
Survival rates following treatment are higher when the cancer does not spread outside the prostate. When the cancer is confined to the prostate, or only in the area around the prostate, almost all men survive. When the cancer has spread throughout the body, about a third of men live for more than five years.
Who Gets Prostate Cancer?
Although it can’t be predicted who will develop prostate cancer, there are several risk factors for the disease. You are more likely to develop prostate cancer:
- If you have a family history of the disease
- If you are African-American
- As you become older
It is possible that there are other risk factors for prostate cancer, including a high-fat diet. More research is needed to understand all of the risk factors for prostate cancer.
Benign Prostatic Hyperplasia
Another disease that becomes more common as men age is benign prostatic hyperplasia (BPH). Some of the symptoms of BPH are similar to prostate cancer, but BPH is not caused by cancer. Rather, BPH is caused by the abnormal growth of benign (non-cancerous) prostate cells. The prostate gland becomes enlarged and can push against the bladder and the urethra, causing problems with urination. No studies have shown a direct link between BPH and prostate cancer, and it is important to realize that urinary problems in older men are much more likely to be caused by BPH than by prostate cancer. If you are experiencing urinary problems, talk to your doctor.
What Types of Screening Tests are Used to Detect Prostate Cancer?
There are two main types of screening tests for prostate cancer: (1) the digital rectal exam and (2) measurement of prostate-specific antigen in the blood. Often, both screening tests are used together.
- Digital rectal exam (DRE): For this test, the doctor puts on gloves, lubricates one finger, and inserts that finger into the man’s rectum. Because the prostate is located near the rectum, the doctor is able to feel the prostate through the rectum wall and check for any unusually hard or lumpy areas. If any unusual areas are found during the DRE, the doctor will recommend further testing to determine the cause.
- Prostate-specific antigen (PSA): Prostate-specific antigen is a protein made by cells in the prostate. Most of the PSA made in the prostate leaves the body in semen, but a small amount enters the bloodstream. For PSA screening, a test is taken to measure levels of PSA in the blood. An elevated level of PSA in the blood can mean that a man has prostate cancer. BPH or an infection in the prostate can also raise PSA levels. Because of this, prostate cancer can’t be diagnosed with the PSA test alone. Instead, PSA screening is used to determine if further testing is necessary.
If screening tests suggest that you might have prostate cancer, your doctor may recommend an ultrasound exam and/or biopsy. During ultrasound, sound waves are used to create pictures of the prostate. Signs of cancer are sometimes visible in these images. During a biopsy, a small amount of prostate tissue is removed. The tissue is examined for the presence of any cancerous cells.
What are the Benefits of Screening for Prostate Cancer?
Some of the issues considered by medical societies when developing prostate cancer screening recommendations are:
- Prostate cancer is common in the United States and can cause troublesome symptoms. If it spreads, prostate cancer can be fatal.
- Studies have shown that DRE and PSA tests can help detect prostate cancer.
- Finding prostate cancer at an early stage might allow men and their doctors to explore treatment options that prevent cancer spread and improve survival rates. However, more studies are needed to better understand whether screening for prostate cancer helps men remain healthy and live longer.
- Screening tests for prostate cancer are not very accurate. If a man is found to have an elevated PSA level, additional testing must be done to determine whether cancer is actually present (diagnostic testing). The need for these additional diagnostic tests can be worrisome, and there are risks involved, even though the man may not have prostate cancer at all. Needle biopsy is a common diagnostic test and carries a small risk of infection or bleeding.
- The results of screening and diagnostic tests for prostate cancer are not always correct. Screening tests and biopsies for prostate cancer can give “false negative” results. This means that the test results will be negative for cancer when, in fact, the results should be positive. So, not every man with prostate cancer will have cancer detected using available screening and diagnostic tests. It is also possible for a PSA test to give a “false positive” result. This means that the test shows that a man may have prostate cancer, when he actually does not have it. Doctors usually do not know how quickly the cancer will grow in men with prostate cancer. Many men have slow-growing prostate cancer that is unlikely to cause any symptoms or spread within their lifetimes. It is also unclear how effective treatment for prostate cancer is—more studies are needed regarding surgery, radiation, and other forms of treatment. Many men who have slow-developing prostate cancer that is found early do not need treatment at all. Especially for older men or those with additional medical problems, doctors may suggest “watchful waiting.” Watchful waiting means that the patient and his doctor monitor the cancer but do not treat it. If a man and his doctor decide to treat prostate cancer, most treatments have risks and side effects. The doctor will not know if treatment will actually cure the prostate cancer; however, if a man does have a fast-growing prostate cancer, treatment may save his life. Common treatments for prostate cancer are radical prostatectomy—surgery to remove the prostate—and radiation therapy. These treatments can cause complications including urinary incontinence (an inability to control urine flow), erectile dysfunction (an inability to have an erection needed for sexual intercourse) or strictures (narrowing of the urethra) and, in rare cases, fatality. Most doctors think that men who will probably live less than ten years after the surgery should not have a radical prostatectomy.
What Does the Medical Community Have to Say About Prostate Cancer Screening?
Several medical societies have published recommendations for prostate cancer screening. It might surprise you to know that they do not all recommend exactly the same screening practices. Although it is often true that recommendations for medical societies differ from one another, this does not mean that one society is correct and the others are wrong. In the case of prostate cancer, it is unclear whether the benefits of screening and treatment for prostate cancer outweigh the risks and costs involved. Medical societies consider the evidence available from studies and create their best recommendations.
* The American Cancer Society and the American Urological Association recommend that health care providers offer PSA and DRE testing yearly, beginning at age 50, to men who are expected to live at least 10 years. Men at high risk, such as African-Americans and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age, should begin testing at a younger age (45 years). They recommend that men and their healthcare providers discuss the potential benefits, side effects, and questions about early prostate cancer detection and treatment so that men can make informed decisions about testing.
- The American College of Preventive Medicine (ACPM) recommends against routine-population DRE and PSA screening. ACPM recommends that men age 50 or older, who are expected to live at least 10 years, be given information about the potential benefits and risks of screening, and the limitations of current evidence. ACPM recommends that doctors help men make their own choices about screening based on personal preference.
- The American College of Physicians recommends that health care providers give men information about the benefits and risks of prostate cancer screening to help them make decisions based on personal preference.
- The U.S. Preventive Services Task Force (appointed by the federal government) recommends against routine screening for prostate cancer; this recommendation is currently under review.
While there are differences among the medical society recommendations, most agree that the decision to screen for prostate cancer is a personal choice that should be based on education, discussions between a man and his doctor, and a firm understanding of the issues. As more information about screening and treatments for prostate cancer becomes available, medical societies may change their recommendations. For instance, recent data show that the rate of death from prostate cancer is decreasing. This may mean that the use of prostate cancer screening, as well as improvements in care, are helping men with prostate cancer live longer lives.
However, more studies are needed to truly understand the role of screening in improving survival with prostate cancer. Extensive studies are currently in progress in the United States and Europe to provide more evidence.
How Do I Make a Decision About Prostate Cancer Screening?
It is important to keep in mind that medical societies consider the male population as a whole — not individual patients—when they are making recommendations for prostate cancer screening. None of the medical societies recommends against any individual man being screened for prostate cancer. You and your doctor should consider your own risk factors, medical history, and personal concerns to develop a plan for prostate cancer screening that is appropriate for you.