Changing Patterns in Asbestos-Induced Lung Disease

Jill Ohar, David A. Sterling, Eugene Bleecker, James Donohue

Research output: Contribution to journalArticle

63 Citations (Scopus)

Abstract

Study objectives: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. Design: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. Setting: Outpatient clinic. Participants: A total of 3383 asbestos-exposed workers referred for independent medical evaluation, including control subjects who lacked asbestos-specific radiograph abnormalities (n = 243), subjects with low International Labor Organization (ILO) scores (n = 2,685), high ILO scores (n = 312), bronchogenic cancer (n = 63), and mesothelioma (n = 80). Of these, 3,327 workers have specific smoking status information and 3,312 workers have lung volume measures. Interventions: Chest radiographs were interpreted by a certified B-reader, and abnormalities were quantified according to the ILO scoring system. Spirometry and lung volume measurement were performed. Subjects completed a self-administered questionnaire that was reviewed at the time of examination. Control subjects were screened on two separate occasions at least 10 years apart to exclude subclinical or slowly progressive asbestos-induced lung disease. Measurements and results: The mean age of the population was 65.1 ± 9.9 years, and the latency was 41.4 ± 10.1 years (± SD). Most subjects (41.8%) had normal pulmonary function. Obstruction was the most common pulmonary function abnormality (25.4%), followed by restriction (19.3%) and a mixed pattern (6.0%). Most subjects (79.4%) had low ILO scores. Benign pleural abnormalities were the only findings in 54% of subjects with low ILO score. Subjects with high ILO scores were older, smoked more, and had a longer latency than subjects with low ILO scores and control subjects. Smokers were younger, had a shorter latency, and had paradoxically greater ILO scores than nonsmokers. Subjects with bronchogenic cancer and mesothelioma had longer latencies than control subjects and subjects with benign asbestos-induced lung disease. Conclusions: Asbestos-induced lung disease today is characterized by low ILO scores, long latencies, greater disease magnitude in smokers, and a normal or obstructive pattern of pulmonary function abnormality. Spirometric evaluation in the absence of lung volume measurements caused misclassification that resulted in overestimation of the presence of a restrictive pattern of pulmonary function.

Original languageEnglish
Pages (from-to)744-753
Number of pages10
JournalChest
Volume125
Issue number2
DOIs
StatePublished - Feb 2004

Fingerprint

Asbestos
Lung Diseases
Lung
Lung Volume Measurements
Mesothelioma
Smoking
Spirometry
Ambulatory Care Facilities
Neoplasms
Thorax
Databases
Population

Keywords

  • Asbestosis
  • Obstructive lung disease
  • Occupational disease
  • Pulmonary function test

Cite this

Ohar, Jill ; Sterling, David A. ; Bleecker, Eugene ; Donohue, James. / Changing Patterns in Asbestos-Induced Lung Disease. In: Chest. 2004 ; Vol. 125, No. 2. pp. 744-753.
@article{147338c9ccbf44d89d20a1c59b1639e6,
title = "Changing Patterns in Asbestos-Induced Lung Disease",
abstract = "Study objectives: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. Design: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. Setting: Outpatient clinic. Participants: A total of 3383 asbestos-exposed workers referred for independent medical evaluation, including control subjects who lacked asbestos-specific radiograph abnormalities (n = 243), subjects with low International Labor Organization (ILO) scores (n = 2,685), high ILO scores (n = 312), bronchogenic cancer (n = 63), and mesothelioma (n = 80). Of these, 3,327 workers have specific smoking status information and 3,312 workers have lung volume measures. Interventions: Chest radiographs were interpreted by a certified B-reader, and abnormalities were quantified according to the ILO scoring system. Spirometry and lung volume measurement were performed. Subjects completed a self-administered questionnaire that was reviewed at the time of examination. Control subjects were screened on two separate occasions at least 10 years apart to exclude subclinical or slowly progressive asbestos-induced lung disease. Measurements and results: The mean age of the population was 65.1 ± 9.9 years, and the latency was 41.4 ± 10.1 years (± SD). Most subjects (41.8{\%}) had normal pulmonary function. Obstruction was the most common pulmonary function abnormality (25.4{\%}), followed by restriction (19.3{\%}) and a mixed pattern (6.0{\%}). Most subjects (79.4{\%}) had low ILO scores. Benign pleural abnormalities were the only findings in 54{\%} of subjects with low ILO score. Subjects with high ILO scores were older, smoked more, and had a longer latency than subjects with low ILO scores and control subjects. Smokers were younger, had a shorter latency, and had paradoxically greater ILO scores than nonsmokers. Subjects with bronchogenic cancer and mesothelioma had longer latencies than control subjects and subjects with benign asbestos-induced lung disease. Conclusions: Asbestos-induced lung disease today is characterized by low ILO scores, long latencies, greater disease magnitude in smokers, and a normal or obstructive pattern of pulmonary function abnormality. Spirometric evaluation in the absence of lung volume measurements caused misclassification that resulted in overestimation of the presence of a restrictive pattern of pulmonary function.",
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Ohar, J, Sterling, DA, Bleecker, E & Donohue, J 2004, 'Changing Patterns in Asbestos-Induced Lung Disease', Chest, vol. 125, no. 2, pp. 744-753. https://doi.org/10.1378/chest.125.2.744

Changing Patterns in Asbestos-Induced Lung Disease. / Ohar, Jill; Sterling, David A.; Bleecker, Eugene; Donohue, James.

In: Chest, Vol. 125, No. 2, 02.2004, p. 744-753.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Changing Patterns in Asbestos-Induced Lung Disease

AU - Ohar, Jill

AU - Sterling, David A.

AU - Bleecker, Eugene

AU - Donohue, James

PY - 2004/2

Y1 - 2004/2

N2 - Study objectives: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. Design: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. Setting: Outpatient clinic. Participants: A total of 3383 asbestos-exposed workers referred for independent medical evaluation, including control subjects who lacked asbestos-specific radiograph abnormalities (n = 243), subjects with low International Labor Organization (ILO) scores (n = 2,685), high ILO scores (n = 312), bronchogenic cancer (n = 63), and mesothelioma (n = 80). Of these, 3,327 workers have specific smoking status information and 3,312 workers have lung volume measures. Interventions: Chest radiographs were interpreted by a certified B-reader, and abnormalities were quantified according to the ILO scoring system. Spirometry and lung volume measurement were performed. Subjects completed a self-administered questionnaire that was reviewed at the time of examination. Control subjects were screened on two separate occasions at least 10 years apart to exclude subclinical or slowly progressive asbestos-induced lung disease. Measurements and results: The mean age of the population was 65.1 ± 9.9 years, and the latency was 41.4 ± 10.1 years (± SD). Most subjects (41.8%) had normal pulmonary function. Obstruction was the most common pulmonary function abnormality (25.4%), followed by restriction (19.3%) and a mixed pattern (6.0%). Most subjects (79.4%) had low ILO scores. Benign pleural abnormalities were the only findings in 54% of subjects with low ILO score. Subjects with high ILO scores were older, smoked more, and had a longer latency than subjects with low ILO scores and control subjects. Smokers were younger, had a shorter latency, and had paradoxically greater ILO scores than nonsmokers. Subjects with bronchogenic cancer and mesothelioma had longer latencies than control subjects and subjects with benign asbestos-induced lung disease. Conclusions: Asbestos-induced lung disease today is characterized by low ILO scores, long latencies, greater disease magnitude in smokers, and a normal or obstructive pattern of pulmonary function abnormality. Spirometric evaluation in the absence of lung volume measurements caused misclassification that resulted in overestimation of the presence of a restrictive pattern of pulmonary function.

AB - Study objectives: To determine patterns in asbestos-induced lung diseases found in older, less exposed workers. Design: Review of a database evaluating lung function, smoking status, form of asbestos-induced lung disease, and radiograph abnormalities. Setting: Outpatient clinic. Participants: A total of 3383 asbestos-exposed workers referred for independent medical evaluation, including control subjects who lacked asbestos-specific radiograph abnormalities (n = 243), subjects with low International Labor Organization (ILO) scores (n = 2,685), high ILO scores (n = 312), bronchogenic cancer (n = 63), and mesothelioma (n = 80). Of these, 3,327 workers have specific smoking status information and 3,312 workers have lung volume measures. Interventions: Chest radiographs were interpreted by a certified B-reader, and abnormalities were quantified according to the ILO scoring system. Spirometry and lung volume measurement were performed. Subjects completed a self-administered questionnaire that was reviewed at the time of examination. Control subjects were screened on two separate occasions at least 10 years apart to exclude subclinical or slowly progressive asbestos-induced lung disease. Measurements and results: The mean age of the population was 65.1 ± 9.9 years, and the latency was 41.4 ± 10.1 years (± SD). Most subjects (41.8%) had normal pulmonary function. Obstruction was the most common pulmonary function abnormality (25.4%), followed by restriction (19.3%) and a mixed pattern (6.0%). Most subjects (79.4%) had low ILO scores. Benign pleural abnormalities were the only findings in 54% of subjects with low ILO score. Subjects with high ILO scores were older, smoked more, and had a longer latency than subjects with low ILO scores and control subjects. Smokers were younger, had a shorter latency, and had paradoxically greater ILO scores than nonsmokers. Subjects with bronchogenic cancer and mesothelioma had longer latencies than control subjects and subjects with benign asbestos-induced lung disease. Conclusions: Asbestos-induced lung disease today is characterized by low ILO scores, long latencies, greater disease magnitude in smokers, and a normal or obstructive pattern of pulmonary function abnormality. Spirometric evaluation in the absence of lung volume measurements caused misclassification that resulted in overestimation of the presence of a restrictive pattern of pulmonary function.

KW - Asbestosis

KW - Obstructive lung disease

KW - Occupational disease

KW - Pulmonary function test

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