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PubMed1985

Signs of asbestosis and impaired pulmonary function in women who worked in shipyards.

Fifteen of 71 women (21.1%) who had worked in shipyards before May, 1961 had radiographic signs of asbestos disease. There were irregular opacities in the lung parenchyma in seven and pleural disease in eight, two of whom had pleural calcifications. The 71 women who volunteered to be studied had a mean age of 61.5 years. Chronic bronchitis was diagnosed in 21%, 71% had dyspnea on climbing two flights of stairs, and 42% had wheezing. These prevalences were 50% higher than in wives of shipyard workers. In 50 white women, mean values for expiratory flow rates, log (FEF25-75) and log (FEF75-85), were decreased for non-, ex- and current smokers as compared to normal nonsmokers. Ex-smokers and current smokers showed the greater effects. Diffusing capacity (DLCOsb) and alveolar volume (ALV) were also reduced in all three smoking categories. Comparison to a reference population without asbestos exposure showed that for current, ex- and nonsmoking subgroups, there were significant reductions in log (FEF25-75), DLCOsb, and ALV for nonsmokers, reductions in FEV1, log (FEV25-75), and log (FEF75-85) in ex-smokers, and reduced ALV in current smokers. These decreases may reflect a locality effect. Further studies are recommended.

Age Factors↗
PubMed1986

Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking.

A cohort of 1,117 asbestos insulation workers was established in 1963 and has been prospectively followed since then. Chest X-ray abnormalities detected at the initial medical examination, and interpreted according to the International Labour Office Classification of Radiographs of Pneumoconioses are reported in this paper. The prevalence of all radiographic abnormalities (pleural and pulmonary) increased with duration from onset of asbestos exposure. A positive smoking history was associated with a significantly higher prevalence of small irregular opacities indicating interstitial pulmonary fibrosis. Such an association was not found for pleural fibrosis. The possible mechanisms which underlie the effect of smoking on asbestos-induced interstitial fibrosis seem to be of much less importance in the development of pleural fibrosis. Progression of radiographic changes over the 20-year interval 1963-1983 will be separately reported as will the predictive significance of these changes.

Adult↗
PubMed1994

High-resolution computed tomography in the early detection of asbestosis.

A group of 21 former asbestos sprayers was studied with high-resolution computed tomography (HRCT), and the findings were compared with radiographic, exposure and lung function variables. HRCT was superior to plain radiography in detecting parenchymal and pleural changes. It showed changes indicative of lung fibrosis, especially septal lines and parenchymal bands, in 9 of the 12 subjects (75%) with a plain radiographic category of 0/0 in the International Labour Office (ILO) 1980 classification of radiographs of pneumoconioses. The HRCT findings were classified according to a method developed by the authors, and an HRCT parenchymal score was calculated. The HRCT revealed pleural plaques in 19 of the 21 (90%) asbestos sprayers, whereas plain radiography detected pleural plaques in only 5 (24%) sprayers. Changes in the visceral pleura were detected twice as often with HRCT as with plain radiography. In the group without radiographic evidence of lung fibrosis (ILO < 1/0) and without evidence of emphysema in either the radiographs or the HRCT examination, there was a correlation between the HRCT parenchymal score and diffusion capacity (r = -0.64, P = 0.03) and total lung capacity (r = -0.61, P = 0.04). This finding indicates that parenchymal changes seen only with HRCT are of clinical importance. The study strongly suggests that for asbestos-exposed workers with an ILO classification of < 1/0 and functional impairment, an HRCT examination should always be considered.

Adult↗