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PubMed1992

A comparison of radiographic interpretation of silica exposed workers using the 1963 and the 1986 Chinese roentgenodiagnostic criteria of pneumoconioses.

As part of a larger study relating to silica exposure, silicosis, and lung cancer mortality in Chinese mine and factory workers, 1936 old posterior-anterior chest X-rays were re-interpreted according to the 1986 Chinese Roentgenodiagnostic Criteria of pneumoconioses. Each film was independently read by three individuals from a panel of eleven radiologists, and this reading was compared to the original one. Subsequent to the independent readings, a groups of three readers interpreted the films together, called the consensus readings. Comparisons were made by Chinese stage of pneumoconiosis. For the entire cohort, there was a crude agreement of 57.4% between the old and the new interpretations. Agreement within one step of full agreement was 92.5%. The interpretations done by median reading and by consensus were very similar. In general, there was a tendency for the old readings to be slightly higher compared to the new interpretations. This tendency was most marked in the tin mines, followed in decreasing order by the iron/copper mines, the potteries, and the tungsten mines. The agreement between the old and new interpretations is felt to be satisfactory.

Humans↗

PubMed1985

The inorganic dust pneumoconioses.

Collectively, the pneumoconioses represent a spectrum of pulmonary diseases initiated by inorganic dust exposure. Although multiple humoral and cellular immune alterations have been demonstrated in these interstitial and commonly fibrotic lung diseases, the exact role of immune changes in disease pathogenesis presently is undefined. Insight into disease mechanisms may have to await the careful characterization of suitable animal models, along with analysis of local, human bronchopulmonary immune responses through the vehicle of bronchoalveolar lavage.

Asbestosis↗

PubMed1993

Use of chest radiographs in epidemiological investigations of pneumoconioses.

The International Labour Organisation (ILO) classification of radiographs of pneumoconioses was developed to limit variation in classification of parenchymal abnormalities. In this study the manner in which chest radiographs were interpreted in 134 investigations reported in four peer reviewed journals during the five year period 1985-90 was examined. The approach for applying the ILO system was poorly described in most studies. For example, of 86 investigations using more than one reader, 66.3% described the method of reconciliation, but methods were not consistent among investigations. Our results indicate a number of potential problems in application of the ILO system, and gaps in existing recommendations that should be considered.

Decision Making↗

PubMed1995

Uncommon pneumoconioses: CT and pathologic findings.

PURPOSE: To correlate the computed tomographic (CT) features of pneumoconioses with histologic findings. MATERIALS AND METHODS: Thin-section CT scans obtained in 48 patients with a history of occupational exposure to dust and radiographic changes suggestive of pneumoconiosis were retrospectively reviewed. Histologic samples were available in 22 cases. RESULTS: The most common CT features were as follows: in 21 arc welders, ill-defined micronodules concentrated in the centrilobular regions (n = 15); in 19 graphite workers, small nodular hyperattenuating areas (n = 17) (ill defined or well defined, corresponding to macular lesions along the walls of bronchioles and nodules, respectively), interlobular septal thickening (n = 11), and large hyperattenuating areas (n = 10); in aluminum pneumoconiosis, predominant reticular (n = 2), nodular (n = 2), and upper-lobe fibrosis (n = 2); and in hard-metal pneumoconiosis, multilobular ground-glass attenuation and consolidation with shrinkage (corresponding to marked intra-alveolar desquamation and multinucleated giant cells with mural mononuclear cell infiltrate). CONCLUSION: Predominant findings are characteristic in each type of pneumoconiosis and are depicted at thin-section CT.

Adult↗

PubMed1982

Electron microscopic investigations on dust penetration into the pulmonary interstitium in experimental pneumoconioses.

Pneumoconioses produced by intratracheal applications of various dusts (quartz, coal, cadmium and lead sulfide) in rats were investigated by electron microscopy in order to follow the pathway of the dust particles from the alveoli into the pulmonary interstitium. As postulated by Spencer in 1977 on the basis of light microscopic investigations, the dust particles produce necroses of the alveolar septae ('alveolar ulcers'). TWo forms of necroses appear to occur: with a less severe dust exposure, individual pneumocytes and their basement membrane are destroyed by dust particles. Dust-laden, macrophages are deposited here which are displaced into the stroma after re-epithelization of the alveolar defect. On the other hand, with massive dust exposure, almost all pneumocytes of the affected alveoli become necrotic. The affected alveoli collapse and are replaced by connective tissue, so that the dust is situated in the connective tissue stroma. A transcellular penetration of the dust particles into the pulmonary interstitium or an immigration of dust-laden macrophages into the pulmonary stroma through the intercellular junctions of intact pneumocytes was not observed in any of the pneumoconiosis models.

Animals↗

PubMed1998

New composite ('quadrant') standard films for classifying radiographs of pneumoconioses.

120 chest radiographs of dust exposed persons were classified twice by each of 39 physicians, and three times by 37 of them. All film readers used both the 22 standard films accompanying the current International Labour Office's (1980) Classification of Radiographs of Pneumoconioses, and a modified set that reproduced selected parts from some of them as quadrants of full-size films. Variability within and between readers in small opacity profusion classifications was high, but similar when using the two sets of standards. Some readers recognised irregularly shaped small opacities more frequently, in low profusion categories, when using the quadrant standards. Small rounded opacities were classified more frequently higher on the scale when using the current standards. The effects found were small although the test films included a high proportion with some small opacities. It is concluded that use of the new quadrant standards is unlikely to introduce any important bias into results from occupational health surveys.

Bias↗

PubMedDate not supplied

New perspective in the imaging of pneumoconioses.

The plain, posteroanterior chest radiograph using the International Labour Office classification has been a critical element in the radiologic diagnosis of pneumoconioses. But advances in imaging technology, including high-resolution computed tomography, assure more objective diagnostic information. High-resolution computed tomography can separate nonpleural structures and abnormalities from true pleural disease; it also leaves little room for false interpretation of suspected parenchymal disease because it permits cross-sectional imaging of the lung parenchyma to the submillimeter level without overlap of the surrounding structures. The value of high-resolution computed tomography is already recognized by some courts involved in litigation over asbestos-related disease.

Aged↗

PubMed1992

The 1980 ILO classification of radiographs of the pneumoconioses.

The 1980 ILO classification of radiographs of the pneumoconioses has undergone revision and improvement in response to increases in knowledge and international concerns. Its goal is to standardize the reading and reporting of radiographic manifestations of the inhalation of dust so that international epidemiologic comparisons are possible. It remains an imperfect instrument, but "... although total elimination of variation is impossible, some measure of control can be achieved."

Humans↗

PubMedDate not supplied

Comparative study of the variations of the phagocytic capacity of polymorphonuclear leukocytes and of total plasma antioxidants in patients with pneumoconioses and lung cancer.

A comparative, preliminary study of the phagocytic capacity of polymorphonuclear leukocytes, and of the total plasma antioxidants was carried out in a group of workers professionally exposed to mineral dusts and in a group of patients with lung cancer. Both groups exhibited advanced respiratory failure stages II and III. The phagocytic capacity of polymorphonuclear leukocytes was found significantly increased in workers with pneumoconioses and moderately increased in patients with lung cancer. On the other hand, the peroxides and total plasma antioxidants exhibited great individual variations. Thus in lung cancer it was observed that peroxides had a tendency to decrease and antioxidants to increase. The individual study of the variations of these three parameters might be able to differentiate the reversible from the irreversible stages of the respiratory changes.

Adolescent↗

PubMed1995

The pneumoconioses.

Most recent studies have indicated that the incidence and prevalence of the mineral pneumoconioses have been declining as dust control has improved, This finding is particularly true for coal workers' pneumoconiosis, asbestosis, and silicosis. Although the present preoccupation with molecular biology and immunology has led to a spate of studies of the mechanisms involved in the development of these conditions, and although many advances have been made, no convincing complete elucidation of these mechanisms has evolved. Meanwhile, the "paratoxicologic fringe," supported by the National Institute of Occupational Safety and Health and the Environmental Protection Agency, has been presenting the notion that almost every naturally occurring or synthesized mineral ranging from aluminum to silica is a carcinogen. Much of the evidence produced by this consortium has been found wanting, especially in regard to the alleged hazards of talc, beryllium, and silica.

Animals↗

PubMed1979

[Use of the ILO/UC International classification of radiographs of pneumoconioses in 302 subjects exposed to asbestos (author's transl)].

The object of the ILO/UC International Classification of Pneumoconioses and the general instructions for its use in asbestos respiratory diseases have been set forth. The ILO 1979 classification has been used in four groups of asbestos exposed subjects : two groups were hospitalized and two groups were at work. All the subjects have been investigated by a hospitalized and two groups were at work. All the subjects have been investigated by a standardized questionnaire on occupational history, PA and lateral chest X-rays and, for most them, by ferruginous bodies counting either in sputum or in bronchoalveolar lavage. The most frequent radiological signs were parenchymal fibrosis, pleural thickening, pleural calcification and diaphragmatic straightness. The fibrosis and the diaphragmatic straightness were related to the length of the exposure. Up to 20-29 years since the onset of exposure, the frequency of radiological signs was : diaphragmatic straightness more frequent than fibrosis which was more frequent than pleural thickening, which was more frequent than calcification. But the frequency of only two signs, pleural straightness and fibrosis, appeared significant after 10 years of exposure. The value of these four radiological signs as biological indicators of asbestos exposure is discussed.

Adult↗

PubMedDate not supplied

The pneumoconioses.

The pneumoconioses are by and large industrial diseases, although casual contact may be important on occasion, particularly with asbestos. The effect of dust on the lung ranges from only radiographic changes to severe functional impairment. Destruction and fibrosis of lung parenchyma may be the end result in severe disease. Great improvement has been made in recent years in the control of dust in the numerous situations where it may cause disease. We are still faced with evaluating existing standards of particle concentration in air breathed by workers and establishing safe limits and better control of the particles placed into the general environment. Undoubtedly, there are other particulates which potentially can cause lung disease of which we are not aware. Of even more concern is the realization that a latent period of 20 years or so may be necessary for physicians to become aware of the pathologic process. Every physician who sees patients with pulmonary problems must inquire regarding a history of dust exposure and be prepared to interpret that history.

Asbestosis↗

PubMed1980

Elemental content in alveolar septa in various pneumoconioses.

The elemental content of alveolar septa in various pneumoconioses was examind for a possible relationship to interstitial fibrosis. Silicon content, as well as heavy metal content, were evaluated to deterrmine possible interrelationships between the various inorganic dusts. Silicon levels were determined on the basis of silicon-sulphur ratios to accommodate for differences in tissue mass. A study of the variation of silicon-sulphur ratios in silicotics and normal individuals showed no false positives by our diagnostic criteria. A study of 11 cases of siderosis revealed that silicon was not responsible for the fibrosis as previously believed. An analysis of the lungs of 25 non-silicotic fibroses revealed that silicon-sulphur ratios were within normal limits. This technique should be useful in quantitating high exposure to certain dusts and in studying the relationship of such dusts to fibrosis.

Electron Probe Microanalysis↗

PubMed1959