TY - JOUR
T1 - Changing Patterns in Asbestos-Induced Lung Disease
AU - Ohar, Jill
AU - Sterling, David A.
AU - Bleecker, Eugene
AU - Donohue, James
N1 - Funding Information:
Financial support was provided by the Selikoff Fund, Saint Louis University.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
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
UR - http://www.scopus.com/inward/record.url?scp=1242351688&partnerID=8YFLogxK
U2 - 10.1378/chest.125.2.744
DO - 10.1378/chest.125.2.744
M3 - Article
C2 - 14769760
AN - SCOPUS:1242351688
SN - 0012-3692
VL - 125
SP - 744
EP - 753
JO - Chest
JF - Chest
IS - 2
ER -