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PubMed1988

Effect of tobacco smoking on the presence of asbestosis at postmortem and on the reading of irregular opacities on roentgenograms in asbestos-exposed workers.

A statistically significant association between cigarette smoking and radiologic readings of irregular opacities was observed in a case-control study of 430 South African asbestos miners (OR = 3.03; 95% confidence interval, 1.50; 6.11). In another case-control study of 487 dead South African asbestos miners, no positive association between smoking and autopsy findings for asbestosis was observed (OR = 0.50; 95% confidence interval, 0.20; 1.29). The association between greater than slight asbestosis (moderate and marked) and smoking (yes/no) was not significant (Fisher's exact test, p = 0.44), and the adjusted odds ratio was 1.25 with 95% confidence interval (0.20; 7.78). In addition, the certification in life for asbestosis, based on chest roentgenogram readings for irregular opacities, was also found to have a tendency to be related to smoking. Thus, the findings of these studies do not support the hypothesis that smoking is associated with the presence of asbestosis at autopsy or that smoking and asbestos dust act synergistically in producing asbestosis at autopsy. But the findings of this and other studies suggest that smoking does produce some change in the lung structure that can be visible on the roentgenogram and can be wrongly interpreted as irregular opacities caused by asbestosis.

Asbestos↗

PubMed1985

Asbestosis, pulmonary symptoms and functional impairment in shipyard workers.

A group of 339 male shipyard workers responded to an invitation via shipyards, unions, and news media to be studied for the presence of asbestosis and its functional effects. Of these, 288 were white or black, had begun working in shipyards at least 20 years earlier, and had satisfactory chest x-ray film findings; 257 underwent spirometric testing, and 199 had single-breath diffusing capacities for carbon monoxide (Dsb) determined. There were radiographic signs of asbestosis in 64 percent. Of these, 28 percent had parenchymal disease only, 37 percent had pleural disease only, and 35 percent had both. There was pleural calcification in 9 percent. In only 14 (8 percent) was the profusion of opacities greater than 1/1 by the International Labour Organization's criteria. Age was closely related to the duration of exposure to asbestos. Thus, 87 percent of the workers who had asbestosis were born from before 1900 to 1910, 70 percent of those born in 1911 to 1920 had asbestosis, 62 percent of those born in 1921 to 1930 had the disease, and 31 percent of those born in 1931 to 1940 had signs of asbestosis. Function in nonsmokers was not significantly different from the reference population except for alveolar volume; ex-smokers had significantly reduced forced expiratory volume in one second, flow rates, Dsb, and alveolar volume. The forced vital capacity and thoracic gas volume were normal. Shipyard workers who smoked resembled reference smokers except for significantly reduced alveolar volume. These shipyard workers had minimal to moderate asbestosis with much pleural disease and little functional impairment when compared to a smoking-specific reference population.

Adolescent↗

PubMed1986

Alveolitis of pulmonary asbestosis. Bronchoalveolar lavage studies in crocidolite- and chrysotile-exposed individuals.

Bronchoalveolar lavage (BAL) findings in 27 individuals with crocidolite- or chrysotile-induced asbestosis were compared to BAL findings in 29 unexposed control subjects. Alveolitis, defined as an increase in the proportions and/or absolute numbers of inflammatory cells present in BAL fluid compared to values in control subjects, was present in 26 (96 percent) subjects with asbestosis. Most exhibited a neutrophil-eosinophil alveolitis, with neutrophil proportions increased to 7.4 +/- 0.7 percent and eosinophil proportions increased to 2.2 +/- 0.4 percent, compared to 2 +/- 0.5 percent and 0.4 +/- 0.01 percent, respectively, in control subjects (p less than 0.01 for both neutrophils and eosinophils). An increase in the total number of neutrophils and eosinophils per ml of lavage fluid was also seen (neutrophils 23 +/- 5 and eosinophils 13 +/- 4 per ml; p less than 0.05 compared to control subjects). Severity of the alveolitis, defined by the neutrophil or eosinophil proportions, was independent of a history of exposure to cigarette smoke. The pattern and severity of alveolitis in crocidolite- and chrysotile-induced asbestosis were similar. There was a significant correlation between duration of exposure to asbestos and neutrophil proportions (p less than 0.01). No significant difference in the severity of the alveolitis was observed between individuals with radiologic and physiologic evidence of asbestosis compared to those with asbestos exposure and crackles alone, suggesting that, in asbestosis as in other chronic interstitial lung diseases, radiologic and physiologic parameters do not reflect the severity of the alveolitis. This study demonstrates that a neutrophil-eosinophil alveolitis is present in individuals with crocidolite- and chrysotile-induced asbestosis, that this alveolitis is independent of cigarette smoking, and that the severity of the BAL changes is not reflected in radiologic and physiologic changes.

Asbestos↗

PubMed1977

[Comparison of descriptive expressions between ILO U/C international classification of radiographs of pneumoconiosis 1971 and Japanese classification of pneumoconiosis law in Japan 1960 in pulmonary asbestosis (author's transl)].

In the explanatory text of the ILO U/C International classification of Radiographs of Pneumoconiosis (1971) sent to Japan in 1973, items of its expression on pulmonary asbestosis were analyzed by the author. On the other hand, items of Japanese Asbestosis Classification of Pneumoconiosis Law were also analyzed. The ILO U/C International Classification of Radiographs of Pneumoconiosis (1971) have some confused words. As to pulmonary asbestosis, an expression of irregular opacities is used, but the fundamental X-ray opacities such as linear opacities are forgot in the description. The X-ray findings of the pulmonary asbestosis are divided into 3 types as s, t and u. It is, however, difficult in practice to divide X-ray findings of the pulmonary asbestosis into such types. The classification of X-ray findings of the pulmonary asbestosis in the Japanese Pneumoconiosis Law is based on the classification worked out by many investigators i; the past, providing for simplicity and ease of handling.

Aged↗

PubMed1978

Sputum cytology of asbestosis patients.

One hundred and fourteen patients with asbestosis, 59% of whom were chronic cigarette smokers, were subjected to a cytological sputum examination which showed: 36 workers (31.6%) with squamous metaplasia, 20 (17.5%) with benigh columnar cell atypia, 5 (4.4%) with benign dysplasia, 2 with suspicious cells for carcinoma, and 1 with anaplastic (microcellular) carcinoma. Clinically and histologically five lung cancers were verified, two of which were cytologically false negatives. All asbestosis patients with lung cancer were chronic smokers. Of the 114 asbestosis patients, 49 (43.0%) had ferruginous bodies in their sputum. The workers from an asbestos quarry more frequently had ferruginous bodies in their specimens than the other patients. Radiographically moderate and severe asbestosis cases showed squamous metaplasia more frequently than those with radiographically slight asbestosis. Most of the detected cellular atypias represented reversible alterations of the respiratory epithelium. It is, however, important to screen the sputum of older (greater than 40 years of age) smoking asbestos workers with benign and suspicious cellular atypias regularly because these alterations may represent the first step int he pathway to bronchogenic cancer. The results of this study did not answer the question of whether bronchial cancer of patients with asbestosis is curable if detected early with cytological methods.

Adult↗

PubMed1999

[Asbestosis].

Asbestosis is a rare pneumoconiosis secondary to inhalation of asbestos fibers. It follows sufficient professional exposures (more than 25 fibers x years/ml). The mean latency is 20 years. Clinical symptoms include exertion dyspnea, crackles and clubbing. Chest radiography the performances of which have been enhanced by the use of the ILO score shows fine reticular or reticulonodular opacities which predominate in pulmonary bases often in association with benign pleural abnormalities. An ILO score equal or higher than 1/1 is suggestive of asbestosis in the context of a compatible professional history. Pulmonary function is typical of diffuse interstitial lung disease. High resolution CT is the most performance investigation in particular in presence of asbestosis either minimal or of recent origin. The diagnosis of asbestosis is based on the professional exposure, a compatible interstitial lung and pleural disease and the exclusion of alternative hypothesis. The diagnosis can be comforted by bronchoalveolar lavage (cytology and biometeorology). Various evolutions are possible: stability, progression to respiratory insufficiency, increased incidence of bronchial carcinoma. Life expectancy is reduced in severe cases. There is no efficient medical treatment. Asbestosis is recognized as a professional disease. A better recognition of asbestosis necessitates a performance policy of depistage in populations with significant present or past exposure and an appropriate diagnostic strategy including high-resolution-CT.

Asbestosis↗

PubMed2002

[The incidence of asbestosis in Poland].

The aim of the work was to analyze the incidence of occupational asbestosis. The analysis covered all cases of asbestosis reported to the Central Register of Occupational Diseases during the years 1970-2001. The cases were classified by patients' gender, age, place of employment, duration and magnitude of exposure to asbestos dust. In all, 1779 cases of asbestosis were registered, including 1200 male cases. During the period under study, a growing number of diagnosed cases were observed (from several cases in the early 1970s to several dozens in the 1990s). During the period of 32 years, the average incidence was 0.5 cases per 100,000 employees, and asbestosis contributed in 5.4% to all occupational pneumoconioses. The majority of asbestosis cases was diagnosed in workers employed in the plants of asbestos processing (38.3%) and asbestos-cement products, followed by foundries (13.1%) and shipyards (10.5) workers. The mean age of asbestosis patients was 55 years, and the average duration of employment under exposure to asbestos was about 21 years. The data recorded in the certificates of occupational disease show that asbestos dust concentrations at workplaces ranged from 1.4 to 38.3 mg/m3 (median, 3.8 mg/m3). Shipyard workers were exposed to the highest (Me = 8.0 mg/m3) and asbestos-cement workers to the lowest (Me = 2.8 mg/m3) concentrations.

Adult↗

PubMed1984

Asbestosis, the nervous system and cancer.

Asbestosis patients have a high cumulative risk of cancer: four of ten asbestosis patients develop cancer. Paraneoplastic involvement of the nervous system, peripheral neuropathy in particular, is often encountered in cancer patients, even at very early stages of the disease. In order to estimate the occurrence of paraneoplastic neuropathy among asbestosis patients, we formed a small cohort (115 asbestosis patients, mean age 56 years, mean duration of exposure to asbestos 21 years) in 1979. Neurological examination revealed slight peripheral neuropathy in 44 (39%) of the patients, 24 (22%) of whom also had central nervous system signs (disturbances in gait and posture, memory and fine movements). The prevalence of peripheral neuropathy among asbestosis patients was higher than among various referent patients (fibrosing alveolitis, diagnosed solvent poisoning and gynaecological carcinoma). No significant differences were found between the patients with and without peripheral neuropathy regarding the following parameters: pulmonary function tests, tumour markers (CEA, ferritin, beta-2-microglobulin), antinuclear antibodies, C3, C4 and circulating immune complexes. Nevertheless, at group level, the asbestosis patients had increased levels of the three tumour markers. Estimates based on the data accumulated so far (10 cancer patients) show that within three years we shall probably have a sufficient number of cancer cases to draw some conclusions about the value of neuropathy in the early diagnosis of occupational cancer.

Adult↗

PubMed1983

[Radiographic and xeroradiographic case finding in asbestosis].

Statistical researches were carried out on subject samples exposed to asbestosis risk with the aim of investigating the advantages of xeroradiographic methods when applied to the early diagnosis of this occupational disease. In the initial phase of the research, the aim was to quantify the statistical incidence of minimum asbestosis. Thus the frequency of initial forms was compared with developed forms in 750 subjects working with amianthus cement. These subjects had been homogeneously exposed to asbestosis risk (as research on the environment in the factory confirmed), and over a period of 10 years had been checked radiographically at the Clinica del Lavoro of the University of Pavia. This first phase of the research confirmed the remarkable incidence of the disease. In the subsequent phase, the radiographs of 200 subjects with asbestosis were studied. The aim was to quantify the frequency of the different radiological symptoms of the disease. In the final phase of the research, both traditional radiographs and xeroradiographs were obtained on 51 subjects exposed to asbestosis risk with pulmonary alterations, although with no (or not significant) radiographic techniques in the early diagnosis of asbestosis would thus become clear. For protective reasons, the use of xeroradiography is proposed not for mass screening but only for controlled investigations. Xeroradiography can evidence plaques or pleural fibrous alterations, which would not be shown on traditional radiographs. It also allows more satisfactory examination of the small fibrous parenchymal opacities at the base of the lungs. On the other hand, additional controlled examinations of the same subjects, even when use was made of projections for pleural backgrounds and lordotic projections for the parietal pleurae, reduced earlier favorable statistics by half. However, the wide range of xeroradiography can evidence nearly all radiographic symptoms in a single xeroradiograph. This greatly facilitates routine examination while providing more satisfactory iconographic data for subsequent medico-legal discussion.

Asbestosis↗

PubMed1990

Evidence for an amphibole asbestos threshold exposure for asbestosis assessed by autopsy in South African asbestos miners.

In an attempt to determine whether there exists a threshold asbestos dose below which asbestosis does not occur, data on 807 men who had worked on amphibole asbestos mines and undergone autopsy were analysed. When exposure was expressed as fibre-years no asbestosis was found at autopsy when exposure was up to 2 fibre-years, even after 31-45 years of residence time. In the group exposed to greater than 2-5 fibre-years asbestosis was found. When exposure was expressed as average fibre concentration asbestosis occurred below 2 fibres per ml (f ml-1) and the prevalence increased with residence time. In conclusion, if a threshold dose for asbestosis does exist it is at approximately 2 fibre-years if off-shift exposure is ignored.

Adolescent↗

PubMed1993

Total lung capacity in asbestosis: a comparison of radiographic and body plethysmographic methods.

The effect of asbestosis on lung volumes was studied in 46 workers by measuring total lung capacity (TLC), forced vital capacity, vital capacity, and residual volume using two standard methods: body plethysmography and radiographic lung area. Nine men had neither irregular opacities of any International Labour Office profusion category nor pleural abnormalities; 9 had pleural abnormalities only, 19 had irregular opacities only; and 9 had pulmonary asbestosis with pleural plagues. Of the 28 with irregular opacities, 18 had moderate or advanced asbestosis (category 2/1 or greater). The radiographic method gave a mean TLC of 8.11 L and the body plethysmographic mean was 8.09 L. Thus, the radiographic and plethysmographic methods produced virtually identical mean values for TLC and for residual volume 3.84 L and 3.8 L and residual volume/TLC, 47.3 and 47.3, respectively. Lung volumes measured by body plethysmography and by x-ray area were the same in each of the four radiographic categories of asbestosis. The air trapping and normal or slightly elevated TLC, which characterize asbestosis in men who have smoked cigarettes, are revealed by both methods. The radiographic method, when adequate measures are taken to obtain full inspirations, effectively duplicates the body plethysmographic method but is quicker and simpler, particularly for field studies.

Adult↗

PubMed1988

Current issues regarding the pathobiology of asbestosis: a chronologic perspective.

Asbestosis is a pneumoconiosis that results from the inhalation of asbestos fibers. There is a body of evidence that implicates the alveolar macrophage in the pathogenesis of asbestosis because of its prominence in asbestos-related histologic lesions. Injury to the alveolar epithelium also may contribute to the pathogenesis of asbestosis. Evidence is presented to suggest that pulmonary fibrosis may result from the persistent release of inflammatory mediators (chemoattractants, lysosomal enzymes, toxic oxygen radicals, arachidonic acid metabolites, interleukins, and fibroblast growth factors) at sites of asbestos deposition. Histologic features of asbestosis can be detected within months after the initial contact with asbestos. In contrast, the stigmata of asbestos-related disease usually are not radiologically detectable, even by the most sensitive imaging techniques, until after a latency period of at least a decade, and often considerably longer. There is, therefore, a long diagnostic delay between the time when asbestosis is histologically detectable and when it is radiographically detectable.

Asbestos↗

PubMed1994

The detection of increased amounts of the extracellular domain of the epidermal growth factor receptor in serum during carcinogenesis in asbestosis patients.

Overexpression of the epidermal growth factor receptor (EGFr) has been implicated in the pathogenesis of a wide variety of human malignancies and may be related to asbestos-induced carcinogenesis. Overexpression of the EGFr can be detected immunologically by quantitation of the extracellular domain (ECD) in the extracellular fluid in vitro and in serum in vivo. An enzyme-linked immunosorbent assay (ELISA) for the EGFr ECD was used to examine banked serum samples of 38 asbestosis patients who subsequently developed cancer, 72 age-sex-race-smoking-asbestos exposure matched asbestosis controls without cancer, and 20 age-sex-race-smoking matched nonasbestosis noncancer controls. The mean serum level for the EGFr ECD in the cancer cases (636 +/- 299 fmol/ml) was statistically significantly elevated (P < 0.05) in comparison to the mean level in the asbestosis controls (546 +/- 147 fmol/ml) or the nonasbestosis controls (336 +/- 228 fmol/ml). Defining a positive elevation of the serum EGFr ECD as any value more than 2 standard deviations above the nonasbestosis control mean, 7 (18%) of the cancer cases were positive compared to 4 (6%) of the asbestosis controls and one (5%) of the nonasbestosis controls. In addition, all of these cancer cases had positive serum samples prior to the time of disease diagnosis (average = 5.1 years). These results suggest that serum EGFr ECD may be elevated at an early stage of carcinogenesis in some asbestosis patients and that further prospective study of the utility of this biomarker is warranted.

Adult↗

PubMed1998

Asbestos lung burden and asbestosis after occupational and environmental exposure in an asbestos cement manufacturing area: a necropsy study.

OBJECTIVE: The largest Italian asbestos cement factory had been active in Casale Monferrato until 1986: in previous studies a substantial increase in the incidence of pleural mesothelioma was found among residents without occupational exposure to asbestos. To estimate exposure to asbestos in the population, this study evaluated the presence of histological asbestosis and the lung burden of asbestos fibres (AFs) and asbestos bodies (ABs). METHODS: The study comprises the consecutive series of necropsies performed at the Hospital of Casale Monferrato between 1985 and 1988. A sample of lung parenchima was collected and stored for 48 out of 55 necropsies. The AF concentration was measured with a TEM electron microscope with x ray mineralogical analysis. The ABs were counted and fibrosis evaluated by optical microscopy. The nearest relative of each subject was interviewed on occupational and residential history. Mineralogical and histological analyses and interviews were conducted in 1993-4. RESULTS: Statistical analyses included 41 subjects with AF, AB count, and interview. Subjects without occupational exposure who ever lived in Casale Monferrato had an average concentration of 1500 AB/g dried weight (gdw); Seven of 18 presented with asbestosis or small airway lung disease (SAL). G2 asbestosis was diagnosed in two women with no occupational asbestos exposure. One of them had been teaching at a school close to the factory for 12 years. Ten subjects had experienced occupational asbestos exposure, seven in asbestos cement production: mean concentrations were 1.032 x 10(6) AF/gdw and 96,280 AB/gdw. Eight of the 10 had asbestosis or SAL. CONCLUSION: The high concentration of ABs and the new finding of environmental asbestosis confirm that high asbestos concentration was common in the proximity of the factory. Subjects not occupationally exposed and ever living in Casale Monferrato tended to have higher AB concentration than subjects never living in the town (difference not significant). The concentrations of ABs and AFs were higher than those found in other studies on nonoccupationally exposed subjects.

Adult↗

PubMed1988

Functional similarities of asbestosis and cryptogenic fibrosing alveolitis.

The pathological features in the lung in asbestosis and cryptogenic fibrosing alveolitis are similar. Patients with asbestosis, however, appear to have less severe impairment of transfer factor (TLCO) than those with fibrosing alveolitis for a given level of radiographic abnormality when assessed on the basis of the International Labour Organisation (ILO) profusion score. The impairment of lung function in the two disorders has been compared in more detail in 29 patients with asbestosis and 25 with fibrosing alveolitis, arterial oxygen desaturation during exercise being used to define the severity of the disorders. Arterial oxygen saturation (ear oximeter) and oxygen uptake were measured during incremental exercise on a cycle ergometer. TLCO (single breath technique) and total lung capacity (TLC, plethysmograph) were measured. Chest radiographs were graded for profusion according to the ILO international classification. Patients with asbestosis had significantly higher mean values for TLCO and TLC and lower mean profusion scores than those with fibrosing alveolitis. When stratified for the degree of arterial oxygen desaturation, however, no significant differences were found in TLCO, TLC, or profusion score between the two disorders. To the extent that arterial oxygen desaturation with exercise reflects the morphological severity of the disease, these results suggest that, for a given degree of interstitial lung disease, asbestosis and cryptogenic fibrosing alveolitis are functionally and radiologically similar.

Asbestosis↗

PubMed1993

Diagnosis of asbestosis by a time expanded wave form analysis, auscultation and high resolution computed tomography: a comparative study.

BACKGROUND: Crackles are a prominent clinical feature of asbestosis and may be an early sign of the condition. Auscultation, however, is subjective and interexaminer disagreement is a problem. Computerised lung sound analysis can visualise, store, and analyse lung sounds and disagreement on the presence of crackles is minimal. High resolution computed tomography (HRCT) is superior to chest radiography in detecting early signs of asbestosis. The aim of this study was to compare clinical auscultation, time expanded wave form analysis (TEW), chest radiography, and HRCT in detecting signs of asbestosis in asbestos workers. METHODS: Fifty three asbestos workers (51 men and two women) were investigated. Chest radiography and HRCT were assessed by two independent readers for detection of interstitial opacities. HRCT was performed in the supine position with additional sections at the bases in the prone position. Auscultation for persistent fine inspiratory crackles was performed by two independent examiners unacquainted with the diagnosis. TEW analysis was obtained from a 33 second recording of lung sounds over the lung bases. TEW and auscultation were performed in a control group of 13 subjects who had a normal chest radiograph. There were 10 current smokers and three previous smokers. In asbestos workers the extent of pulmonary opacities on the chest radiograph was scored according to the International Labour Office (ILO) scale. Patients were divided into two groups: 21 patients in whom the chest radiograph was > 1/0 (group 1) and 32 patients in whom the chest radiograph was scored < or = 1/0 (group 2) on the ILO scale. RESULTS: In patients with an ILO score of < or = 1/0 repetitive mid to late inspiratory crackles were detected by auscultation in seven (22%) patients and by TEW in 14 (44%). HRCT detected definite interstitial opacities in 11 (34%) and gravity dependent subpleural lines in two (6%) patients. All but two patients with evidence of interstitial disease or gravity dependent subpleural lines on HRCT had crackles detected by TEW. In patients with an ILO score of > 1/0 auscultation and TEW revealed mid to late inspiratory crackles in all patients, whereas HRCT revealed gravity dependent subpleural lines in one patient and signs of definite interstitial fibrosis in the rest. In normal subjects crackles different from those detected in asbestosis were detected by TEW in three subjects but only in one subject by auscultation. These were early, fine inspiratory crackles. CONCLUSION: Mid to late inspiratory crackles in asbestos workers are detected by TEW more frequently than by auscultation. Signs of early asbestosis not apparent on the plain radiograph are detected by TEW and HRCT with similar frequency. off

Asbestosis↗

PubMed1988

Increased pulmonary gamma interferon production in asbestosis.

In order to determine if disordered cellular immune processes are present in the lungs of persons with asbestosis, we performed bronchoalveolar lavage (BAL) on 26 patients with either crocidolite- or chrysotile-induced pulmonary asbestosis and measured the spontaneous release of gamma interferon (IFN gamma), a marker of increased cellular immune activity. For comparison, 18 control subjects and 7 patients with active pulmonary sarcoidosis were also studied. Recovered BAL cells were cultured for 24 h (5 x 10(6)/ml), and the supernatant was assayed for interferon by determining inhibition of cytopathic effect on encephalomyocarditis virus-induced lysis of WISH cells and characterized by monoclonal anti-IFN gamma antibody inhibition. Nine (35%) patients with asbestosis released increased amounts of IFN gamma, up to 320 units/ml, the levels seen in the sarcoidosis patients. All control subjects released less than or equal to 10 units/ml. All interferon released was IFN gamma. In asbestosis patients, IFN gamma production was not related to a history of cigarette smoking, there was no significant difference in the ratio of helper/inducer (Leu-3) to suppressor/cytotoxic (Leu-2) cells in IFN gamma producers compared to non-IFN gamma producers (p greater than 0.05), and IFN gamma production correlated significantly with serum IgG levels (p less than 0.001) but not with the levels of IgM, IgA, antinuclear factor, or rheumatoid factor. These data suggest that active cellular immune processes are present in the lungs of a proportion of patients with asbestosis.

Asbestosis↗

PubMed2005

Asbestosis in an asbestos composite mill at Mumbai: a prevalence study.

BACKGROUND: Of an estimated 100,000 workers exposed to asbestos in India, less than 30 have been compensated. The reasons for such a small number are: refusal by management sponsored studies to grant medical certifications to workers suffering from occupational diseases, lack of training for doctors in diagnosis of occupational lung diseases, deliberate misdiagnosis by doctors of asbestosis as either chronic bronchitis or tuberculosis and the inherent class bias of middle class doctors against workers. The aim of the study was to identify workers suffering from Asbestosis (parenchymal and pleural non-malignant disease) among the permanent workers of the Hindustan Composites Factory and assess their disability and medically certify them, whereupon they could avail of their basic rights to obtain compensation and proper treatment. METHODS: The study was conducted by the Occupational Health and Safety Centre and the Workers' Union. Asbestosis was diagnosed if they had an occupational history of asbestos exposure for at least 15 years and showed typical radiographic findings. RESULTS: Of 232 workers in the factory, 181 participated in the survey. 22% of them had asbestosis. All the asbestos affected workers had at least 20 years of exposure. 7% had rhonchi, 34% had late basal inspiratory rates, 82% had more than 80% of Forced Expiratory Volume in the first second (FEV1)/Forced Vital capacity (FVC) ratio and 66% had FVC less than 80% of the predicted value. On radiology 7% had only pleural disease, 10% had both pleural and parenchymal disease and 82% had only parenchymal disease. The association of pleural disease with chest pain was statistically significant. CONCLUSION: We found the prevalence of asbestosis among exposed workers to be less than that anticipated for the number of years of exposure due to "Healthy Worker Effect". We suggest that all affected asbestos workers (including those who have been forced to leave) in India be medically certified and compensated. We also recommend better control of asbestos use in India. We also implore the management to provide all information about the work process and its hazards, conduct medical checkups as mandated by law and give the medical records to the workers.

Adult↗