Chest Imaging and Lung Function Impairment After Long-Term Occupational Exposure to Low Concentrations of Chrysotile

Spyratos, Dionisios; Chloros, Diamantis; Haidich, Bettina; Dagdilelis, Loukas; Markou, S.; Sichletidis, Lazaros

doi:10.1080/19338244.2011.578681

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…This imprecision has led to considerable debate regarding the pathogenicity of different fiber types (Gwinn, 2011; Gwinn et al, 2011; Lenters et al, 2011). While the debate is not completely resolved, current studies continue to support the contention that at least for extended exposures, chrysotile has the ability to induce both cancer and pulmonary/pleural fibrosis (Spyratos et al, 2012; van der Bij et al, 2013; Wang et al, 2013). There is, however, quite a bit of evidence that, at similar exposures, amphibole asbestos is more pathogenic, especially in terms of scarring of the lung parenchyma and pleura (Donaldson et al, 2010; Mossman et al, 2011).…”

Section: Discussionmentioning

confidence: 94%

Amphibole, but not chrysotile, asbestos induces anti-nuclear autoantibodies and IL-17 in C57BL/6 mice

Ferro

Zebedeo

Davis

et al. 2013

Journal of Immunotoxicology

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Exposure to amphibole asbestos has been associated with production of autoantibodies in mice and humans, and increases the risk of systemic autoimmune disease. However, epidemiological studies of chrysotile exposure have not indicated a similar induction of autoimmune responses. To demonstrate this difference in controlled exposures in mice, and to explore possible mechanistic explanations for the difference, C57BL/6 mice were exposed intratracheally to amphibole or chrysotile asbestos, or to saline only. Serum antinuclear antibodies (ANA), antibodies to extractable nuclear antigens (ENA), serum cytokines, and immunoglobulin isotypes were evaluated 8 months after the final treatment. The percentages of lymphocyte sub-sets were determined in the spleen and lungs. The results show that amphibole, but not chrysotile, asbestos increases the frequency of ANA/ENA in mice. Amphibole and chrysotile both increased multiple serum cytokines, but only amphibole increased IL-17. Both fibers decreased IgG1, without significant changes in other immunoglobulin isotypes. Although there were no gross changes in overall percentages of T- and B-cells in the spleen or lung, there was a significant increase in the normally rare populations of suppressor B-cells (CD19+, CD5+, CD1d+) in both the spleen and lungs of chrysotile-exposed mice. Overall, the results suggest that, while there may be an inflammatory response to both forms of asbestos, there is an autoimmune response in only the amphibole-exposed, but not the chrysotile-exposed mice. These data have critical implications in terms of screening and health outcomes of asbestos-exposed populations.

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Section: Discussionmentioning

confidence: 94%

Amphibole, but not chrysotile, asbestos induces anti-nuclear autoantibodies and IL-17 in C57BL/6 mice

Ferro

Zebedeo

Davis

et al. 2013

Journal of Immunotoxicology

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“…Only two of the studies ( Clin et al, 2011 ; Rui et al, 2004 ) adjusted for BMI in their statistical evaluations. Adjustment for smoking was more common (10 studies), while five ( Clark et al, 2014 ; Clin et al, 2011 ; Rui et al, 2004 ; Spyratos et al, 2012 ; Van Cleemput et al, 2001 ) included adjustments for asbestos exposure ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…In one of the two higher quality HRCT studies that adjusted for confounders, Spyratos et al (2012) found that, while FVC and FEV 1 were lower in those with pleural plaques ( n = 29) than those with no abnormalities ( n = 37), when results were adjusted for age, smoking, and duration of asbestos exposure, FVC and FEV 1 were non-statistically increased in individuals with pleural plaques. In the other, Rui et al (2004) found non-significant slight decreases in lung function over time in people with pleural plaques compared to people without.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of pleural plaques and lung function

Kerper

Lynch

et al. 2014

Inhalation Toxicology

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ContextUS EPA proposed a Reference Concentration for Libby amphibole asbestos based on the premise that pleural plaques are adverse and cause lung function deficits.ObjectiveWe conducted a systematic review to evaluate whether there is an association between pleural plaques and lung function and ascertain whether results were dependent on the method used to identify plaques.MethodsUsing the PubMed database, we identified studies that evaluated pleural plaques and lung function. We assessed each study for quality, then integrated evidence and assessed associations based on the Bradford Hill guidelines. We also compared the results of HRCT studies to those of X-ray studies.ResultsWe identified 16 HRCT and 36 X-ray studies. We rated six HRCT and 16 X-ray studies as higher quality based on a risk-of-bias analysis. Half of the higher quality studies reported small but statistically significant mean lung function decrements associated with plaques. None of the differences were clinically significant. Many studies had limitations, such as inappropriate controls and/or insufficient adjustment for confounders. There was little consistency in the direction of effect for the most commonly reported measurements. X-ray results were more variable than HRCT results. Pleural plaques were not associated with changes in lung function over time in longitudinal studies.ConclusionThe weight of evidence indicates that pleural plaques do not impact lung function. Observed associations are most likely due to unidentified abnormalities or other factors.

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“…HRCT[ 24 25 26 27 28 29 30 31 32 ] has been evaluated for screening of nonmalignant asbestos-induced lung disease and is considered to be a more sensitive tool. The recent literature has also documented that chest HRCT findings significantly correlate with pulmonary function and mortality.…”

Section: Discussionmentioning

confidence: 99%

Asbestos-induced lung disease in small-scale clutch manufacturing workers

Gothi

Gahlot

Sah

et al. 2016

Indian J Occup Environ Med

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Background:The crocidolite variety of asbestos is banned. However, chrysotile, which is not prohibited, is still used in developing countries in making products such as clutch plate. Fourteen workers from a small-scale clutch plate-manufacturing factory were analyzed for asbestos-induced lung disease as one of their colleagues had expired due to asbestosis.Aims:This study was conducted to evaluate the awareness of workers, the prevalence and type of asbestos-induced lung disease, and the sensitivity and specificity of diffusion test.Materials and Methods:History, examination, chest radiograph, spirometry with diffusion, and high resolution computed tomography (HRCT) thorax was performed in all the workers. The diagnosis of asbestos-induced lung disease was suspected on the basis of HRCT. This was subsequently confirmed on transbronchial lung biopsy (TBLB).Results:None of the workers had detailed information about asbestos and its ill effects. Eleven out of 14 (71.42%) workers had asbestos-induced lung disease. All 11 had small airway disease (SAD). Three had SAD alone, 6 had additional interstitial lung disease (ILD), and 2 patients had additional ILD and chronic obstructive pulmonary disease. Sensitivity and specificity of residual volume (RV) or total lung capacity (TLC) for detecting SAD was 90% and 100%, respectively, and that of diffusion capacity of lung for carbon monoxide (DLCO) for detecting ILD was 100%.Conclusion:The awareness about asbestos in small-scale clutch-plate manufacturing industry is poor. The usage of chrysotile should be strictly regulated as morbidity and mortality is high. DLCO and RV/TLC are sensitive and specific in detecting nonmalignant asbestos induced lung disease.

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Chest Imaging and Lung Function Impairment After Long-Term Occupational Exposure to Low Concentrations of Chrysotile

Cited by 12 publications

References 19 publications

Amphibole, but not chrysotile, asbestos induces anti-nuclear autoantibodies and IL-17 in C57BL/6 mice

Amphibole, but not chrysotile, asbestos induces anti-nuclear autoantibodies and IL-17 in C57BL/6 mice

Systematic review of pleural plaques and lung function

Asbestos-induced lung disease in small-scale clutch manufacturing workers

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