Asbestos and the Pleura

Cugell, David W.; Kamp, David W.

doi:10.1378/chest.125.3.1103

Cited by 178 publications

(151 citation statements)

References 86 publications

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“…The male:female ratio was approximately 3:1, likely due to occupational exposure [8]. Eighty per cent of MPM patients have a history of asbestos exposure, but only 2% to 10% of the individuals with heavy, prolonged asbestos exposure develop MPM [9]. The combined role of genetics and asbestos exposure in familial aggregation is debated [10][11][12] and has been discussed in two extensive literature reviews [13,14].…”

Section: Introductionmentioning

confidence: 99%

XRCC1 and ERCC1 variants modify malignant mesothelioma risk: A case–control study

Betti

Ferrante

Padoan

et al. 2011

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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Section: Introductionmentioning

confidence: 99%

XRCC1 and ERCC1 variants modify malignant mesothelioma risk: A case–control study

Betti

Ferrante

Padoan

et al. 2011

Mutation Research/Fundamental and Molecular Mechanisms of Mutag

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“…Thus, in people employed in the later period, smoking is the likely factor contributing to the progression of the parenchymal changes. It has been well documented in the literature that parenchymal changes progress over many years from the start of exposure and their progress has been observed many years after the exposure [13][14][15]. The risk of progression rises with longer time elapsed from the exposure to the first examination.…”

Section: Discussionmentioning

confidence: 99%

Progression of small, irregular opacities in chest radiographs of former asbestos workers

Świątkowska¹,

Sobala²,

Szubert³

2012

International Journal of Occupational Medicine and Environmental Health

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Objectives: Pulmonary parenchymal changes appear many years after the start of exposure to asbestos and their progression has been observed to continue many years after cessation of the exposure. The aim of the present analysis is to assess the risk of progression of radiological changes in the respiratory system, based on long-term follow-up of groups of workers occupationally exposed to asbestos dust. Materials and Methods: The analysis included 3144 individuals voluntarily applying for a medical examination in 2000-2010, who had performed at least two radiographs of the chest. Probability of progression in subsequent studies was based on the evaluation of radiographs for the presence of small, irregular type s, t, u opacities in the parenchymal lung tissue with profusion categories as specified in the classification of ILO, 1980. Multistate hidden Markov model was used in the statistical analysis. Results: In the group of patients, small irregular opacities with a profusion of 1/1 or higher occurred in 640 (20%) patients in the first examination, and in 918 (29%) patients in the last examination. No parenchymal changes were observed in 1360 (43%) patients in the first examination (opacity profusion category 0/0), and in 645 (20%) patients in the last examination. The risk of progression of radiographic changes in former workers of asbestos processing plants is higher in smokers, from profusion category 0 to 1 -by 30% (HR = 1.30, 95% CI: 1.15-1.47), from profusion category 1 to 2 -by 50% (HR = 1.50, 95% CI: 0.92-2.45). The risk of progression of parenchymal changes decreases in the workers employed in subsequent calendar years: for category changes from 1 to 2, the decrease is nearly 40% for every 10 years of subsequent employment (HR = 0.60, 95% CI: 0.45-0.80). The probability of the progression increases with longer latency period: for change of category from 1 to 2, the increase is about 20% (HR = 1.19, 95% CI: 1.00-1.42) per 10 years of employment for blue collar workers. The risk of the 1 to 2 category progression is significant, nearly 2.5-fold higher in the workers employed in the asbestos-processing textile industry. Conclusions: Our results show that the risk of progression of pulmonary parenchymal fibrotic processes was higher in the smokers, workers employed during the earlier calendar years of the discussed period, those with longer latency period, blue collar workers involved directly in the production processes, and employees of the asbestos cement and/or textile industries.

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“…Benign asbestos pleural effusion is usually unilateral and characterised by an exudative effusion typically occurring within 15 years of asbestos exposure, but may arise much later [40]. Effusions may be asymptomatic or associated with breathlessness and chest pain and in around one-third of cases high levels of eosinophils are present within the fluid [41]. Pleural biopsies are required to exclude malignancy, and radiological follow-up over a 2-year period with chest CT is recommended in view of the need to establish whether there is progressive abnormality and pleural thickening.…”

Section: Renalmentioning

confidence: 99%

The management of benign non-infective pleural effusions

et al. 2016

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The evidence base concerning the management of benign pleural effusions has lagged behind that of malignant pleural effusions in which recent randomised trials are now informing current clinical practice and international guidelines.The causes of benign pleural effusions are broad, heterogenous and patients may benefit from individualised management targeted at both treating the underlying disease process and direct management of the fluid. Pleural effusions are very common in a number of non-malignant pathologies, such as decompensated heart failure, and following coronary artery bypass grafting. Pleural fluid analysis forms an important basis of the diagnostic evaluation, and more specific assays and imaging modalities are helpful in specific subpopulations.Options for management beyond treatment of the underlying disorder, whenever possible, include therapeutically aspirating the fluid, talc pleurodesis and insertion of an indwelling pleural catheter. Randomised trials will inform clinicians in the future as to the risks and benefits of these options providing a guide as to how best to manage patient symptoms in this challenging clinical setting. @ERSpublications Benign pleural effusion management is challenging and based on limited evidence. Treatment options are discussed http://ow.ly/10EOSN

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Asbestos and the Pleura

Cited by 178 publications

References 86 publications

XRCC1 and ERCC1 variants modify malignant mesothelioma risk: A case–control study

XRCC1 and ERCC1 variants modify malignant mesothelioma risk: A case–control study

Progression of small, irregular opacities in chest radiographs of former asbestos workers

The management of benign non-infective pleural effusions

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