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PubMedDate not supplied

Computed tomography--a reliable diagnostic modality in pulmonary asbestosis.

Forty-six individuals with documented asbestos exposure were studied by computed tomography as part of their initial evaluation. CT sections were compared to standard chest radiographs and pulmonary function tests. The results showed computed tomography to be able to detect early signs of asbestosis in patients with inconclusive conventional radiographs or intact pulmonary function tests, the same as to demonstrate extensive pulmonary pathology in long-standing cases.

Adult↗
PubMed1994

Lung crackle characteristics in patients with asbestosis, asbestos-related pleural disease and left ventricular failure using a time-expanded waveform analysis--a comparative study.

The aim of this study is to investigate lung crackle characteristics by time-expanded waveform (TEW) analysis in patients with asbestosis (AS), asbestos-related pleural disease (ARPD) and left ventricular failure (LVF). TEW was performed on a 33 s recording from each of 40 patients (12 AS, 17 ARPD and 11 LVF). They were 38 men and two women. Crackles on TEW were counted during inspiration and expiration, and the timing of clusters of crackles with respect to inspiration and expiration was noted. A total of 1117 crackles were identified. The initial deflection width (IDW) and the two cycle duration (2CD) were calculated for all crackles within one respiratory cycle for each patient (total of 298 crackles). Crackles were detected by TEW in all patients with AS, in seven patients with ARPD and in nine patients with LVF. Crackles in AS were mainly fine, mid- to late-inspiratory. Crackles in LVF took three patterns; in the first there were repetitive mid- to late inspiratory crackles similar to those seen in AS except that the crackles in LVF tended to be medium and coarse as well as fine (three patients); in the second crackles started early in inspiration followed by a crackle-free period then by another cluster of crackles lasting to the end of inspiration and to the early third of expiration (four patients) and in the third there were repetitive expiratory crackles with no or few inspiratory crackles (two patients). Crackles in ARPD generally took the configuration of fine crackles but another type of crackle preceded by a sharp deflection followed by an M-shape oscillation then by the largest oscillation was also found. IDW and 2CD for inspiratory crackles in ARPD were shorter than those in AS and LVF (for IDW P < 0.009 and P < 0.003 compared with AS and LVF respectively and for 2CD, P < 0.006 and P < 0.003 compared with AS and LVF respectively). IDW and 2CD in AS tended to be shorter than these for LVF but these results did not reach statistical significance. It is concluded that many differences exist between crackles in AS, LVF and ARPD. Differences in nature and timing of crackles may reflect differences in the pathophysiology and mechanism giving rise to lung crackles in these conditions. TEW provides informations of diagnostic value.

Adult↗
PubMed1979

Computed tomography in pulmonary asbestosis.

Attention is drawn to the signs of asbestosis on computed axial tomography and comparison made with findings in conventional radiology in 36 patients. CT was found to be significantly more sensitive in the detection of both pleural and parenchymal disease apart from thickened fissures. A possible sign of early mesothelioma is mentioned and an encasing variety of pleural thickening described. Perfusion changes which may represent a 'pre-radiological' interstitial fibrosis are discussed.

Asbestosis↗
PubMed1991

Dehydroepiandrosterone inhibits the spontaneous release of superoxide radical by alveolar macrophages in vitro in asbestosis.

Asbestosis is characterized by an alveolar macrophage alveolitis with injury and fibrosis of the lower respiratory tract. Alveolar macrophages recovered by bronchoalveolar lavage spontaneously release exaggerated amounts of oxidants including superoxide anion and hydrogen peroxide that may mediate alveolar epithelial cell injury. Dehydroepiandrosterone (DHEA) is a normally occurring adrenal androgen that inhibits glucose-6-phosphate dehydrogenase, the initial enzyme in the pentose phosphate shunt necessary for NADPH generation and superoxide anion formation. In this regard, we hypothesized that DHEA may reduce asbestos-induced oxidant release. DHEA added in vitro to alveolar macrophages lavaged from 11 nonsmoking asbestos workers significantly reduced superoxide anion release. DHEA was measured in bronchoalveolar lavage and found to be similar to serum concentrations. DHEA is an antioxidant and potential anticarcinogenic agent that may have a therapeutic role in reducing the increased oxidant burden in asbestos-induced alveolitis of the lower respiratory tract.

Asbestosis↗
PubMed1986

Asbestos bodies and the diagnosis of asbestosis in chrysotile workers.

It has been suggested that because chrysotile asbestos forms asbestos bodies poorly, use of the traditional histologic requirements (diffuse interstitial fibrosis plus asbestos bodies) for the diagnosis of asbestosis, may lead to an underdiagnosis of this condition in workers exposed only to chrysotile. We examined lungs from 25 chrysotile miners with diffuse interstitial fibrosis. Asbestos bodies were found easily in histologic section using hematoxylin and eosin stains in all cases. Mineralogic analysis of four cases showed that 46 of 72 (64%) bodies isolated and examined contained chrysotile cores, and 21 of 72 (29%) bodies contained cores of the amphiboles tremolite and actinolite. By contrast, tremolite and actinolite constituted the majority of uncoated fibers in these cases. The mean length for bodies formed on chrysotile was 35 micron, and for bodies formed on tremolite or actinolite, 36 micron. We conclude that (1) the usual histologic criteria for the diagnosis of asbestos are applicable to chrysotile-exposed workers; (2) in workers with occupational chrysotile exposure, bodies form readily on this mineral; and (3) asbestos bodies in these lungs reflect the presence of long asbestos fibers.

Asbestos↗
PubMed1977

Adenocarcinoma of the rete testis: a review of the literature and presentation of a case with associated asbestosis.

Although scattered reports of adenocarcinoma of the rete testis have previously appeared and criteria for the diagnosis of this tumor have been defined, previous cases have not been described in sufficient detail to provide an organized account of the nature and behavior of this neoplasm. The present report describes a case followed to autopsy and provides conclusive evidence that it is of rete testis origin. Previously reported cases of rete testis carcinoma are reviewed and the salient features summarized, showing that the tumor has a definite clinical and histologic pattern and that the prognosis appears poor. The present case occurred in a patient with severe pulmonary asbestosis. This association is unique, and its significance remains speculative.

Aged↗
PubMed1986

Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa.

To determine whether exposure to crocidolite is associated with excess mortality, the authors calculated standardized mortality ratios based on deaths in South African crocidolite mining districts from 1968 to 1980 for selected causes of death. Contiguous districts were used as controls. To take account of background geographic variability, they divided the control districts into groups of population size similar to those of the crocidolite mining districts. Standardized mortality ratios in crocidolite mining districts were elevated for asbestosis and/or mesothelioma, and cancer of the lung and stomach. These findings could not be explained by background geographic variability in mortality and are likely to be due to exposure to South African crocidolite during mining and milling or to environmental contamination. The increased standardized mortality ratios for stomach cancer are of particular interest, since excess deaths have not previously been shown in individuals exposed to crocidolite alone.

Adolescent↗
PubMed1988

Asbestosis among electricians.

In a cross-sectional study of a small group of non-shipyard electricians, the prevalence of asbestosis, defined as irregular opacities of at least 1/0 profusion, was found to be 15% overall and 25% after 20 years of service. Irregular opacities occurred more frequently among smokers. Cost estimates for asbestos-related disease should include construction electricians in the populations at risk.

Adult↗
PubMed1983

Generalized fibrosis associated with pulmonary asbestosis.

An autopsy case of pulmonary asbestosis with fibrosis of various organs was reported. Pulmonary carcinoma and glomerulonephritis were complicated. Asbestos bodies (ABs) and fibers (AFs) were identified in the organs with fibrosis such as the lung, liver, kidney, heart, and thyroid gland by electron microscopy and digestion method. Moreover, we identified AFs in the spleen by electron microscopy which had been resected due to idiopathic portal hypertension six years previously. It is suggested that AFs can be transported to various organs and persist for a long period of time to cause pathological changes there.

Asbestosis↗
PubMedDate not supplied

An autopsy case of malignant mesothelioma associated with asbestosis.

An autopsy case of malignant mesothelioma with asbestosis caused by asbestos exposure for 17 years is reported. Autopsy revealed that mesothelioma spread extensively in all serosal tissues including pleura, pericardium, diaphragm, peritoneum and tunica vaginalis testis. Histopathologically, most of the tumor showed an epithelial form, but sarcomatous and microcystic patterns were also observed. The tumor cells had abundant glycogen and hyaluronic acid and, immunohistochemically, they were positive for cytokeratin, vimentin and epithelial membrane antigen (EMA). Long, slender microvilli were characteristically observed in these tumor cells. All of these data were compatible with malignant mesothelioma. Procollagen type I (procol.l) immunostaining was performed to reveal the mesenchymal character of mesothelioma. Both epithelial-type cells and sarcomatous-type cells showed positive staining for procol.l, although the latter showed stronger immunoreactivity. Immunostaining for procol.l was found to be one of the useful tools for distinguishing mesothelioma from adenocarcinoma. Using an extraction method for asbestos fibers, asbestos bodies were found in many tissues including lymph nodes, liver, small intestine, spleen, kidney, testis and pleura, in addition to lung parenchyma. Although multiple tumor metastases from an undetermined primary site is not ruled out, 'multifocal tumorigenesis' is suspected from the widespread deposit of asbestos fibers.

Aged↗
PubMed1979

Radiographic progression of asbestosis: preliminary report.

In a collaborative study with the Pneumoconiosis Medical Panel, 232 asbestos workers were seen between 1967 and 1975. During this time, 50 of the 232 (21.5%) workers dies, 33 (13.8%) from respiratory disease probably related to asbestos exposure [10 (4.3%) pleural mesothelioma, three (1.3%) peritoneal mesothelioma, 10 (4.3%) asbestosis, 10 (4.3%) carcinoma of the lung]. Of the 182 survirors, 119 were recalled for other studies, and follow-up data were obtained as additional information at the same time, over a 1--7 year period. Paired radiographs were read, and 21 patients (17.6%) had worsened. As expected, the frequency of progression increased with a longer follow-up time, so that about one third of the subjects displayed progression after a minimum follow-up of 6 years. Ten of 73 patients (13.6%) had progressed in 3 years or less and may be defined as rapid progressors. No particular clinical feature distinguished clearly between progressors and nonprogressors, but there was a trend toward a greater frequency and higher titer of ANA among the progressors in this group. There was also a higher frequency of progression in those who were initially classified radiographically as 1/1 of 1/2 than in those with other initial radiographic appearances. This pilot study is now forming the basis for a larger, longer-term comprehensive survey.

Antibodies, Antinuclear↗
PubMed1985

Compensation, radiographic changes, and survival in applicants for asbestosis compensation.

The survival of 354 claimants for compensation for pulmonary asbestosis among former workers of the Wittenoom crocidolite mine and mill in Western Australia has been examined. There were 118 deaths up to December 1982. The median time between start of work and claim for compensation was 17 years. The standardised mortality ratio (SMR) for deaths from all causes was 2.65 (p less than 0.0001). The SMR for pneumoconiosis was 177.2 (p less than 0.0001), bronchitis and emphysema 2.6 (p = 0.04), tuberculosis 44.6 (p less than 0.0001), respiratory cancer (including five deaths from malignant pleural mesothelioma) 6.4 (p less than 0.0001), gastrointestinal cancer 1.6 (p = 0.22), all other cancers 1.6 (p = 0.17), heart disease 1.4 (p = 0.07), and all other causes 2.18 (p = 0.004). Plain chest radiographs taken within two years of claiming compensation were found for 238 subjects and were categorised independently by two observers according to the International Labour Organisation criteria without knowledge of exposure or compensation details. Profusion of radiographic opacities, age at claiming compensation, work in the Wittenoom mill, and degree of disability awarded by the pneumoconiosis medical board were significant predictors of survival, but total estimated exposure to asbestos was not. Radiographic profusion and degree of disability were, however, predictable by total exposure. The median survival from claim for compensation was 17 years in subjects with ILO category 1 pneumoconiosis, 12 years in category 2, and three years in category 3.

Asbestos↗
PubMed1986

Relation between pathological grading and lung fibre concentration in a patient with asbestosis.

The fibre concentration and extent and severity of fibrosis have been analysed in 48 specimens from the left lung of a patient with asbestosis. Two different methods of fibre analysis were used. The results obtained by transmission electron microscopy were 2-2.5 times higher than those obtained by scanning electron microscopy. Low temperature ashed samples showed on average twice the number of fibres obtained after wet digestion of the samples. The transmission electron microscope detected considerably shorter fibres than the scanning electron microscope. Low temperature ashing produced also shorter fibres compared with the wet digestion procedure. A statistically significant correlation between fibre concentration and the grade of fibrosis was found only for low temperature ashed samples analysed in the transmission electron microscope. When dividing the lung into nine anatomical compartments and pooling the grade of fibrosis and the fibre concentration data within each compartment, an even better correlation was obtained.

Aged↗
PubMed1986

Prevalence of radiographic asbestosis in crocidolite miners and millers at Wittenoom, Western Australia.

An estimate has been made of the prevalence of unrecognised pneumoconiosis in former crocidolite workers from Wittenoom, Western Australia. All plain chest radiographs relating to a one in six random sample (1025 men) of all former Wittenoom workers who had never entered a compensation claim to the Pneumoconiosis Medical Board of Western Australia were sought from Perth teaching hospitals and from the Perth Chest Clinic where compulsory examination of all workers in the mining industry takes place. Radiographs were recovered for 83% of the men and read independently by two observers. By means of logistic regression analysis a current prevalence of parenchymal abnormality (defined as a radiographic profusion of small opacities of category 1/0 or greater on the ILO classification) of nearly 20% was calculated after adjustment for age, time since first exposure, and cumulative exposure level. One hundred men randomly selected from those known to be alive in the sample were invited to attend for a new radiographic examination. Seventy four men attended and the predicted prevalence was confirmed. It is estimated from these data that there were between 450 and 900 former Wittenoom workers in Australia at the end of 1980 who had radiographic abnormality consistent with pneumoconiosis but had not claimed compensation or had asbestosis diagnosed. The data are consistent with there being no threshold dose of crocidolite exposure for the development of radiographic abnormality in this group.

Adult↗
PubMed1989

Asbestosis occurring after brief inhalational exposure: usefulness of bronchoalveolar lavage in diagnosis.

A case of clinically and radiologically typical asbestosis manifesting in a 55 year old man occurred 36 years after a brief exposure period of less than one year. A transbronchial lung biopsy was performed but the samples were considered non-diagnostic. The diagnosis was supported by the use of bronchoalveolar lavage to obtain alveolar samples and scanning electron microscopy-energy dispersive x ray analysis of fibres found in the bronchoalveolar lavage fluid which showed a predominance of amosite.

Asbestos↗
PubMed1991

Asbestosis as a precursor of asbestos related lung cancer: results of a prospective mortality study.

A prospective mortality study of 839 men employed in the manufacture of asbestos cement products in 1969 examined lung cancer risk in relation to lung fibrosis seen on chest x ray film, controlling for age, smoking, and exposure to asbestos. Twenty or more years after hire, no excess of lung cancer was found among workers without radiographically detectable lung fibrosis, even among long term workers (greater than or equal to 21.5 years); nor was there a trend in risk by level of cumulative exposure to asbestos among such workers. By contrast, employees with small opacities (greater than or equal to 1/0; ILO classification) experienced a significantly raised risk of lung cancer (nine observed deaths v 2.1 expected), even though their exposures to asbestos were similar to the exposures of long term workers without opacities. In this population, excess risk of lung cancer was restricted to workers with x ray film evidence of asbestosis, a finding consistent with the view that asbestos is a lung carcinogen because of its fibrogenicity.

Adult↗
PubMed1991

Asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma in an insulation worker.

Asbestos associated diseases consist of both benign and malignant conditions. A rare constellation of asbestosis, laryngeal carcinoma, and malignant peritoneal mesothelioma occurring in a patient with long term occupational exposure to airborne asbestos fibres is presented. The observation illustrates the powerful disease-causing potential of occupational exposure to asbestos. A brief discussion of multiple primary neoplasms associated with exposure to asbestos is also presented.

Aged↗