Evaluation of Breathlessness in Asbestos Workers

P, Agostoni; Dd, Smith; Rb, Schoene; Ht, Robertson; Butler, John

doi:10.1164/arrd.1987.135.4.812

Cited by 40 publications

(16 citation statements)

References 12 publications

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“…These data are not in accordance with data obtained in previous studies, which showed a significant correlation between smoking and dyspnea in workers exposed to asbestos (3,8,30) . However, it is important to emphasize that, in the present study, obstructive disorder -moderate or severe -was considered an exclusion factor.…”

Section: Discussioncontrasting

confidence: 99%

“…In addition to the complexity of evaluation and classification, confounding factors hinder the establishment of a relationship between a subjective complaint and physiopathological alterations of the underlying disease (3) . Various authors have employed the MRC and 1984 AMA scales to evaluate dyspnea in workers exposed to asbestos (8,30,32) .…”

Section: Discussionmentioning

confidence: 99%

“…The most clinically relevant symptom is dyspnea (1,2) . Dyspnea is a symptom that is difficult to evaluate and measure, especially in occupational diseases, in which other factors such as age, sedentary lifestyle, smoking and concomitant cardiopulmonary diseases, may cause it to be misunderstood (3) . In addition, workers seeking to obtain pension benefits may overestimate dyspnea in their everyday activities (4)(5)(6) .…”

Section: Introductionmentioning

confidence: 99%

“…Various studies have been conducted in attempts to evaluate dyspnea in workers exposed to asbestos and its relationship to functional abnormalities in respiration. However, due to the difficulty in obtaining reliable data and the subjectivity of the information, results have varied considerably (3,(7)(8)(9) . The degree of functional impairment in the patients studied appears to be lower than that observed in other interstitial diseases, thereby making physiological reproducibility of subjective patients complaints uncertain (10,11) .…”

Section: Introductionmentioning

confidence: 99%

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Dispnéia crônica e alterações funcionais respiratórias em ex-trabalhadores com asbestose avaliados para concessão de benefício

Nápolis¹,

Sette²,

Bagatin³

et al. 2004

J. bras. pneumol.

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INTRODUÇÃO: A dispnéia é um sintoma de difícil avaliação, principalmente nas doenças ocupacionais. OBJETIVO: Avaliar a relação entre presença e intensidade de dispnéia crônica, e sua repercussão funcional em ex-trabalhadores com asbestose na avaliação de disfunção e incapacidade. MÉTODO: Escores de dispnéia pelas escalas Medical Research Council modificada, American Medical Association de 1984 e 1993 e Baseline Dyspnea Index foram obtidos em 40 ex-trabalhadores com diagnóstico de asbestose, os quais foram também submetidos a espirometria, medidas da capacidade de difusão pulmonar do monóxido de carbono e testes de exercício cardiopulmonar incremental e submáximo. RESULTADO: Dispnéia esteve presente em 72,5% e 67,5% dos indíviduos de acordo com as escalas do Medical Research Council e American Medical Association de 1984, respectivamente e em apenas 37,5% e 31,6% dos pacientes de acordo com as escalas American Medical Association de 1.993 e Baseline Dyspnea Index. Houve melhor concordância entre as escalas Medical Research Council e American Medical Association de 1993, e American Medical Association de 1984 e American Medical Association de 1993 quando as graduações "ausente" e "leve" foram agrupadas. Não foi observada relação significativa entre dispnéia de acordo com cada uma das escalas e presença de anormalidades funcionais no repouso e/ou exercício. CONCLUSÃO: O nível de concordância entre as escalas de dispnéia varia significativamente em indivíduos com asbestose. Há falta de relação dos índices de dispnéia com variáveis que avaliam disfunção respiratória em repouso e exercício.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Dispnéia crônica e alterações funcionais respiratórias em ex-trabalhadores com asbestose avaliados para concessão de benefício

Nápolis¹,

Sette²,

Bagatin³

et al. 2004

J. bras. pneumol.

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“…Complaints of dyspnea in patients with occupation-related pulmonary disorders often exceed objective findings, especially in claimants, and it is well recognized that accurate assessment of work capacity must consider that subjects may be limited by non-respiratory problems (7). Analysis of metabolic and ventilatory responses during exercise has significantly improved the quality of both occupational and non-occupational respiratory disease evaluation (8).…”

Section: Introductionmentioning

confidence: 99%

Differences between remaining ability and loss of capacity in maximum aerobic impairment

Neder

Nery

Bagatin

et al. 1998

Braz J Med Biol Res

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In the evaluation of exercise intolerance of patients with respiratory diseases the American Medical Association (AMA) and the American Thoracic Society (ATS) have proposed similar classifications for rating aerobic impairment using maximum oxygen uptake (VO 2 max) normalized for total body weight (ml min -1 kg -1 ). However, subjects with the same VO 2 max weight-corrected values may have considerably different losses of aerobic performance (VO 2 max expressed as % predicted). We have proposed a new, specific method for rating loss of aerobic capacity (VO 2 max, % predicted) and we have compared the two classifications in a prospective study involving 75 silicotic claimants. Logistic regression analysis showed that the disagreement between rating systems (higher dysfunction by the AMA/ATS classification) was associated with age >50 years (P<0.005) and overweight (P = 0.04). Interestingly, clinical (dyspnea score) and spirometric (FEV 1 ) normality were only associated with the VO 2 max, % predicted, normal values (P<0.01); therefore, in older and obese subjects the AMA/ATS classification tended to overestimate the aerobic dysfunction. We conclude that in the evaluation of aerobic impairment in patients with respiratory diseases, the loss of aerobic capacity (VO 2 max, % predicted) should be used instead of the traditional method (remaining aerobic ability, VO 2 max, in ml min -1 kg -1 ).

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