The 'Helsinki criteria' for attribution of lung cancer to asbestos exposure: how robust are the criteria?

摘要

The "Helsinki Criteria" were put forward as "state-of-the-art" criteria for the diagnosis and attribution of certain lung and pleural disorders to asbestos exposure by a group which convened in Helsinki in 1997, and were further updated in 2004. The Helsinki Criteria were purported to be the work of a "consensus conference" whose purpose was to develop guidelines for diagnosing individual cases of asbestos-related diseases. Interestingly, the documents that have resulted from the meeting bear a striking resemblance to the review articles written by Henderson et al several years prior to the meeting, one of which in fact is not a scientific reference at all but a legal briefing book. The recommended criteria are increasingly being used for medicolegal purposes, often by "experts" indiscriminately, with no specific knowledge as to how they were derived and how they should be applied. In fact, the article uses a considerable amount of medicolegal jargon and despite the appellation of "consensus conference" is clearly slanted toward a particular medicolegal viewpoint.