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PubMed1983

Circulating immune complexes and antiglobulins (IgG and IgM) in asbestos-induced lung fibrosis.

Thirty-nine asbestos workers were examined with respect to the presence of IgG and IgM antiglobulins and circulating immune complexes. The overall incidence of raised levels of IgM antiglobulins and immune complexes was 63 and 28%, respectively. In the group positive for immune complexes, IgM antiglobulins were found more frequently than in those asbestos workers lacking immune complexes. However, all cases with the highest levels of IgM antiglobulins had normal or only slightly elevated levels of immune complexes. IgG antiglobulin levels were not elevated in asbestos workers. Asbestos workers with IgG antinuclear antibodies had the highest incidence of elevated levels of immune complexes.

Adult↗

PubMed1991

High-resolution computed tomography of asbestos-related diseases.

There is growing evidence that HRCT can detect both interstitial and pleural disease in advance of conventional clinical or radiographic studies. Limited HRCT scans are roughly competitive in time and cost with 4-view radiographic examinations. The use of limited HRCT for large-scale screening of asbestos-exposed individuals is controversial. Hopefully this will be resolved as we gain greater understanding of the specificity of HRCT and establish guidelines for standardizing technique and interpretation. At present, limited HRCT scans can supplement the chest radiographic evaluation of subjects in whom there is equivocal parenchymal or pleural disease, unexplained abnormalities on pulmonary function tests, or significant coexisting pleural disease that precludes evaluation of the underlying parenchyma. Interstitial abnormalities on HRCT may be reasonably ascribed to asbestos exposure when there is clear historical documentation of significant, remote dust exposure or concomitant evidence of typical bilateral asbestos-related pleural disease. A subpleural distribution of interstitial abnormality in nondependent lung is important to establish the diagnosis of interstitial fibrosis. Although both unilateral pleural and parenchymal fibroses have been reported, lesions should generally be present bilaterally. In individuals with combined asbestos-cigarette smoke exposure in whom symptoms or functional abnormalities are present, HRCT may play a central role in distinguishing emphysematous lung destruction from the peripheral interstitial changes of asbestosis. Finally, in individuals with significant pleural or parenchymal fibrosis, focal lung masses may not be visible on chest radiographs. In these individuals, CT protocols that sample all regions of the thorax are appropriate.

Asbestosis↗

PubMed1993

Bronchoalveolar lavage and 99mTc-DTPA clearance as prognostic factors in asbestos workers with and without asbestosis.

The aims of this study are to investigate the change-over time of lung function and chest radiographic findings in patients with asbestosis (AS) and asbestos workers without asbestosis (AW). Secondly, to correlate these changes with broncho-alveolar lavage (BAL) profiles and with lung epithelial permeability, as detected by half-time lung-to-blood (t1/2 LB) clearance of an inhaled aerosol of diethylene triamine pentacetate labelled with technetium 99 (99mTc-DTPA) obtained a mean period of 4.2 yr (range 2.3-5.8) previously. Thirty-three patients with asbestosis and 24 asbestos workers with substantial asbestos exposure were followed-up. Nineteen healthy smokers (HS) with no asbestos exposure who were followed up for a mean period of 3.9 yr were taken as a control group for spirometric changes. Compared with AW, FEV1, FVC and TLCO were lower in AS (P < 0.0001 in each case). Smoker AS and AW had lower numbers (P < 0.03) and percentages (P < 0.004) of BAL lymphocytes and higher numbers (P < 0.04) and percentages (P < 0.02) of BAL neutrophils plus eosinophils than ex- and non-smokers. Annual declines of FEV1 (dFEV1 yr-1) and FVC (dFVC yr-1) in AS and AW were significantly greater than in HS and predicted annual declines (P < 0.002 in each case). Annual declines of TLCO (dTLCO yr-1) and KCO (dKCO yr-1) in AS and AW were significantly greater than predicted annual declines (P < 0.002 in each case). No significant differences were noted between AS and AW in annual declines in any lung function measurement. dTLCO yr-1, dKCO yr-1 were significantly greater in smokers than in ex- and non-smokers, (P < 0.05 and P < 0.04 respectively). Annual decline did not relate to base line values for any lung function measurement. Numbers and proportions of BAL lymphocyte were higher (P < 0.008 and P < 0.02, respectively) and numbers and proportions of BAL neutrophils and eosinophils were lower (P < 0.02 and P < 0.03, respectively) in patients in whom dTLCO yr-1 was less than 0.3 mmol min-1 kPa-1 than in patients in whom dTLCO yr-1 was more than 0.3 mmol min-1 kPa-1. dTLCO yr-1 inversely correlated with t1/2 LB; r = 0.51; (P < 0.008). Patients in whom the radiograph remained unchanged had higher numbers (P < 0.002) and percentages (P < 0.001) of BAL lymphocytes than patients in whom the radiograph deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1986

Frequency, sensitivity and specificity of roentgenographic features of slight and moderate asbestos-related respiratory diseases.

The possibility of early detection of asbestos-related respiratory diseases was examined on the basis of four x-ray abnormalities, namely, pulmonary fibrosis, pleural plaque, diffuse pleural thickening and diaphragmatic calcification, in a group of workers exposed to chrysotile asbestos. The frequency of these phenomena was compared to the unexposed control group of similar distribution of number, sex and age. Besides the pleural plaques, which had a high specificity, the combination of minor x-ray abnormalities proved to be most characteristic of exposure to asbestos. The more frequent one of the abnormalities, the less specificity it had to asbestos exposure.

Asbestosis↗

PubMed1995

Asbestos-related radiographic changes by ILO classification of 10 x 10 cm chest X-rays in a screening of the general population.

A sample of 1388 10 x 10 cm chest X-rays from a previous population screening of males aged 40+ years were reevaluated by use of the ILO classification. There were 1036 films of subjects from an industrialized town, and 352 from a rural community. The observed rates of parenchymal changes (profusion > or = 1/0) at the reevaluation were 1.3% in the urban community and 3.4% in the rural community. The corresponding figures for pleural changes were 5.0% and 0.6%, respectively. Based on additional questionnaire information on asbestos exposure, it was found that the radiographic changes were probably related to past asbestos exposure for 2.3% of the subjects from the urban community and 0.6% from the rural community. In cases of asbestos-related illnesses the mean time since first exposure to asbestos was 35.9 years, whereas the mean duration of the exposures was 11.4 years. The results seem to indicate that the ILO reassessment of the radiographs was more sensitive in detecting pleural changes than the previous clinical screening of both small and large films.

Adult↗

PubMed1978

Formation of asbestos bodies under the influence of parenteral iron overload.

The effect of parenteral administration of iron (dextran) on the number of asbestos fibers in the lungs, formation of asbestos bodies and the development of interstitial fibrosis was studied in guinea pigs exposed intratracheally to anthophyllite dust. The treatment did not accelerate, either qualitatively or quantitatively, the formation of asbestos bodies or retard the development of interstitial fibrosis. The number of naked asbestos fibers was also similar in anthophyllite-inoculated animals to those similarly inoculated, but having had, additionally, a previous saturation with iron.

Animals↗

PubMed1981

A comparative study on the performance of asbestos-free depth-filters for removal of pyrogens from infusion fluids.

Three asbestos-free depth-filters were compared with traditionally used asbestos-containing depth-filters for chemical integrity, physical integrity and pyrogen retention. With chemical and physical integrity only minor differences between the various filter types were seen. One asbestos-free depth-filter, based on charcoal, showed poor pyrogen-retention; this might be due to a high flow rate used. Asbestos-free depth-filters based on kieselguhr or on a mixture of kaolin and alumina proved to be good alternatives; these filters have proved to be suitable for the removal of pyrogens from electrolyte- or carbohydrate-containing infusion fluids.

Chemical Phenomena↗

PubMed1983

Mortality among long-term employees of an Ontario asbestos-cement factory.

Mortality was studied among a group of 328 employees of an Ontario asbestos-cement factory who had been hired before 1960 and who had been employed for a minimum of nine years. The group of 87 men who had worked in the rock wool/fibre glass operations, or who had been otherwise minimally exposed to asbestos, had mortality rates similar to those of the general Ontario population, while the group of asbestos-exposed employees had all-cause mortality rates double those of the Ontario population, mortality rates due to malignancies five times higher than expected, and deaths attributed to lung cancer eight times more frequent than expected. According to the best evidence available, 10 of 58 deaths among the production workers were due to malignant mesothelioma and 20 to lung cancer. The men dying of mesothelioma were younger than the men dying of lung cancer with mean ages at death of 51 and 64 years respectively. An exposure model was constructed on the basis of the available air sampling data, and individual exposure histories were calculated. These exposure histories were used to investigate the exposure-response relationships for asbestos-associated malignancies.

Adult↗

PubMed1986

Hazards of lung biopsy in asbestos workers.

An investigation into the problem of the frequency and hazards of lung biopsy in asbestos workers was performed in two ways. The first study was into the frequency of lung biopsy among 2907 long term asbestos insulation workers in 1981-3 and the second was into the frequency of fatal complications of lung biopsy in 168 deaths from asbestosis among 2271 consecutive deaths of asbestos insulation workers 1967-76. Only 25 (0.9%) of the 2907 asbestos insulation workers reported having had either an open lung biopsy, a needle biopsy, or a transbronchial biopsy. Seven (24%) of these men suffered difficulties as a result of the biopsy. Lung biopsies had been performed on 14 of the 168 workers who died of asbestosis. Three (21%) of these 14 patients had died within 30 days of biopsy as a direct result of the procedure. In most cases there is no need for lung biopsy to establish a diagnosis of asbestosis; generally, it may be defined by history of exposure, clinical and radiological findings, and other well established non-invasive diagnostic procedures. Certainly, legal and compensation recommendation for biopsy should be considered with the possibility of death in mind. If biopsy is performed precautions should be taken, including adequate observation in hospital.

Asbestosis↗

PubMed1988

Correlation between fibre content of the lung and disease in east London asbestos factory workers.

The lungs from 36 past workers at an east London asbestos factory who had died from asbestos related disease were compared with lung tissue from 56 matched control patients being operated on in east London for carcinoma of the lung, correlating the severity of asbestosis and the presence of pulmonary carcinoma or mesothelioma of the pleura or peritoneum with an asbestos exposure index and type and amount of mineral fibre in the lungs. Asbestosis was associated with far heavier fibre burdens than mesothelioma. There was also a striking difference in the degree of asbestosis between the subjects with mesothelioma and those with carcinoma of the lung, the asbestosis being more severe in the latter. A further finding was that crocidolite and amosite were strongly associated with asbestosis, carcinoma of the lung complicating asbestosis, and mesothelioma, whereas no such correlation was evident with chrysotile or mullite. It is suggested that more emphasis should be placed on the biological differences between amphibole and serpentine asbestos fibre.

Asbestosis↗

PubMed2004

Asbestos-related pleuropulmonary diseases: evaluation with low-dose four-detector row spiral CT.

PURPOSE: To evaluate the depiction of lung and pleural asbestos-related lesions with low-dose four-detector row spiral computed tomography (CT). MATERIALS AND METHODS: Eighty-three male workers with a mean duration of occupational exposure to asbestos of 18 years underwent CT as part of a medicolegal investigation. CT examination included low-dose multi-detector row spiral CT of the entire thorax, with reconstruction of contiguous 5-mm-thick images, and thin-section CT, which served as the reference standard for the detection of pleural and parenchymal asbestos-related abnormalities. Two main groups of abnormalities were identified: (a) pleural plaques and diffuse pleural thickening and (b) thickened interstitial short lines, curvilinear subpleural lines, ground-glass opacity with or without bronchiectasis, and honeycombing. The frequencies of the depiction of these abnormalities on the low-dose multi-detector row images and the thin-section images were compared by using the McNemar test. RESULTS: No significant differences were observed between the low-dose and thin-section CT images in the depiction of either (a) parietal pleural fibrosis consisting of pleural plaques (identified in 67 [81%] vs 65 [78%] workers, P =.157), which appeared mainly as thick, calcified pleural linear structures; or (b) features of parenchymal fibrosis, which consisted of various combinations of intralobular and septal lines (identified in 12 [14%] vs 13 [16%] workers, P =.564), subpleural curvilinear lines (identified in 10 [12%] vs eight [10%] workers, P =.157), and ground-glass opacity with (identified in six [7%] vs six [7%] workers) or without (identified in five [6%] vs three [4%] workers, P =.317) traction bronchiectasis. A honeycombing pattern was depicted on only the thin-section CT images (P <.001). Emphysema (identified in 26 [31%] vs 14 [17%] workers at low-dose and thin-section CT, respectively; P <.001) and noncalcified nodules (identified in 18 [22%] workers vs one [1%] worker, P <.001) were depicted significantly more frequently on the low-dose images than on the thin-section images. CONCLUSION: Low-dose multi-detector row spiral CT accurately depicts asbestos-related disease.

Aged↗

PubMed2006

Asbestos-induced and smoking-related disease: apportioning pulmonary function deficit by using thin-section CT.

PURPOSE: To retrospectively correlate the extent of individual diseases seen at thin-section computed tomography (CT) with pulmonary function in an initial group of patients with asbestos-related parenchymal disease (asbestosis) and to test these findings in a subsequent group of patients whose CT scans were retrospectively identified. MATERIALS AND METHODS: This retrospective study had Institutional Review Board approval; informed consent was not required. The study included 133 individuals who had been exposed to asbestos. In the initial study group (81 patients; 79 men, two women; median age, 67 years), two observers used a CT scoring system to quantify the extent of pulmonary fibrosis, diffuse pleural thickening, small-airways disease, and emphysema. Multivariate equations were formulated by using independent CT variables to predict changes in total lung capacity (TLC) and carbon monoxide diffusing capacity (Dlco). The validity of these equations was then tested in a subsequent group of patients (52 patients; all men; median age, 60 years). RESULTS: At thin-section CT, the extent of asbestos-induced pleuropulmonary disease and emphysema correlated significantly with physiologic impairment (P<.001). Combined CT variables predicted 58% and 57% of the variability in TLC and Dlco, respectively, despite considerable variation in the proportion of coexisting pathologic conditions. When predictive equations with CT variables derived from the initial study group were applied to the subsequent study group, predicted TLC (rho=0.75, P<.001) and Dlco (rho=0.64, P<.001) correlated strongly with measured values. CONCLUSION: The proposed CT system provides a semiquantitative method for assessing the relative contribution of asbestos-induced pleuropulmonary disease and smoking-related emphysema to functional impairment.

Aged↗

PubMed1989

High resolution computed tomography and lung function in asbestos-exposed workers with normal chest radiographs.

Asbestos-exposed persons with normal chest radiographs can demonstrate parenchymal abnormalities on high resolution computed tomography (HRCT). We reviewed the HRCT, clinical presentation, and results of pulmonary function tests in 169 asbestos-exposed workers with normal chest radiographs (ILO less than 1/0). The HRCT was normal or near normal in 76 subjects (Group 1), abnormal but indeterminate for asbestosis in 36, and abnormal and suggestive of asbestosis in 57 (Group 2). The indeterminate subjects were excluded from further analysis. The subjects in Groups 1 and 2 were not significantly different in their duration of asbestos exposure, latency, smoking history, or in measurements of airflow obstruction (FEV1/FVC% and %FEV1). Both the vital capacity percent predicted and diffusing capacity percent predicted were significantly lower in the abnormal subjects (Group 2) than in the normal subjects (Group 1) (79.0 versus 86.2, p = 0.005; 78.2 versus 87.1, p = 0.024; independent t test). We conclude that in asbestos-exposed subjects with normal chest radiographs, HRCT can identify a group of subjects with significantly reduced lung function indicative of restrictive lung disease when compared with a group with normal or near-normal HRCT.

Adult↗

PubMed1987

Evaluation of breathlessness in asbestos workers. Results of exercise testing.

We studied 120 asbestos-exposed workers seeking compensation for asbestos-related ventilatory impairment who were referred to us for evaluation of their complaint of dyspnea. We reviewed history, chest radiographs, pulmonary function studies, and exercise tests. The workers were 59.9 +/- 9.5 (mean +/- SD) yr of age and their first asbestos exposure had been 34.4 +/- 10 yr prior to the study; 63% were smokers, 19% were ex-smokers, and 18% were nonsmokers. Chest radiographs were normal in 4%, showed only pleural disease in 35%, only parenchymal diseases in 5%, and pleuroparenchymal disease in 56%. Restrictive pulmonary function abnormalities were present in 25% of the workers, and obstructive abnormalities were present in 27%. Because the impairment of one of several organ systems (i.e., ventilatory, cardiac, pulmonary vascular, or peripheral circulatory) may limit exercise performance, we designed an exercise test score in an attempt to identify the system causing the limitation. No abnormal limitation was detectable in half (49.2%) of the subjects. Only 26% had a ventilatory limitation, which was much more frequent in smokers (32%) than in nonsmokers (9%) (p less than 0.05). Unexpectedly, rather more (37%) had a cardiac rather than a ventilatory limitation. We conclude that the complaint of dyspnea in these asbestos-exposed workers was usually not caused by a ventilatory dysfunction.

Asbestosis↗

PubMedDate not supplied

The Swedish experience with asbestos: history of use, diseases, legislation, and compensation.

After World War II, large quantities of asbestos were imported to Sweden and used in construction and ship building. In 1976, the use of asbestos was for practical purposes prohibited. Today, the only exposures are environmental, from asbestos in place and when buildings are demolished or rebuilt, and there are very strict rules for such work. Consequently, it is assumed that the asbestos-related diseases will gradually disappear from society, but due to the long latency time, about 100 mesotheliomas still occur every year in Sweden, and so far there is no certain sign of a decrease in incidence. Compensation is from the state via general insurance and consists basically of compensation for lost income and medical costs.

Asbestosis↗

PubMedDate not supplied

Asbestos in Italy.

Asbestos-related diseases remain common in Italy due to past exposures that were tolerated by a government distracted and manipulated by multinational asbestos corporations. The incidence of asbestos-related cancers has taken on almost epidemic proportions, for example, in Casale Monferrato in northwest Italy, where Eternit remained in operation until 1985, and in Monfalcone in northeast Italy, where naval dockyards and related activities created pollution. Authorities took action only after public protests, trade union pressures, and campaigning by the families of victims. Now that a ban exists in Italy, it is vital that it be fully enforced to reverse the epidemic of mesothelioma, lung cancer, and other asbestos-related diseases.

Asbestosis↗

PubMedDate not supplied

The epidemic of asbestos-related diseases in New Zealand.

New Zealand is a small country with a big asbestos disease problem. The lack of action on warnings in the 1960s and 1970s has led to epidemics of mesothelioma and asbestosis, which can be clearly documented via the death and cancer registers. In addition, an uncertain number of lung cancers due to asbestos exposure has occurred. The epidemic started in the 1980s, and will eventually have cost the lives of at least 2000 to 3000 workers. Prevention against ongoing exposures from asbestos installed in buildings is essential, and another key issue for New Zealand is to ensure that fair workers' compensation is provided to all victims of asbestos diseases.

Asbestosis↗

PubMed2006

Tumor suppressor gene alterations in patients with malignant mesothelioma due to environmental asbestos exposure in Turkey.

BACKGROUND: Environmental asbestos exposure can cause the grave lung and pleura malignancies with a high mortality rate, and it is also associated with increased rate of other organ malignancies. Asbestos exposure can develop genotoxic effects and damage in the pleura and lungs. OBJECTIVE: In this study, we aimed to determine tumor suppressor gene (TSG) loss in genomic DNA which was isolated from pleural fluid and blood samples of patients with Malignant Pleural Mesothelioma (MPM) due to environmental asbestos exposure. DESIGN AND PATIENTS: Prospective study of period from 2001 to 2003 in 17 patients with MPM. METHODS: A total of 12 chromosomal regions were researched by comparing genomic DNA samples isolated from blood and pleural effusion (using PCR, and polyacrylamide gel electrophoresis denaturizing), on 2 different chromosomes which have 9 different polymorphic determinants at 6q and 3 different polymorphic determinants at 9p using molecular genetic methods on 13 patients clinico-pathologically diagnosed MPM. RESULTS: Loss of Heterozygosity (LOH) was determined at D6S275 in one patient, at D6S301 in another, at D6S474 in 2, at ARG1 in 2, at D6S1038 in 2 and at D6S1008 in 3 patients. In 7 (54%) of the 13 patients, we found LOH in at least one site. No LOH was determined at any informative loci in 6 patients. Of the 13 patients, no investigated markers were determined at 9p. CONCLUSION: In this study, genomic DNA samples obtained from MPM patients with asbestos exposure revealed that they contained important genotoxic damage. We found no other study on this subject at molecular level in pleural effusion either in Turkey or in the Med-line literature. We believe that this study will provide important support for other research into molecular-genetic variations, both on this subject and other malignancies, and may also constitute a base for early diagnosis and gene therapy research in the future.

Journal Article↗