Lung function and respiratory symptoms in subjects with asbestos‐related disorders: A cross‐sectional study

Abstract

The prevalence of respiratory symptoms and lung function impairment was studied in a sample of men from a population screening of asbestos-related disorders. When the rates were adjusted for age and smoking habits, 83 subjects with lung fibrosis had an increased prevalence of respiratory symptoms, in particular, phlegm when coughing and breathlessness grades 1-3. Among 200 subjects under 70 years of age who had pleural plaques only, a statistically significant increase was observed in the prevalence of breathlessness grade 1 compared to an external reference population. Among 98 asbestos-exposed subjects who had normal chest X-rays, there was an increase in the prevalence of breathlessness grade 2, cough during the day, and phlegm when coughing. There was a higher proportion of subjects with lung fibrosis who were below 80% of the predicted values for forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) than in the other groups. There was also a higher proportion of subjects with pleural plaques only who were below 90% of the predicted value for FVC than in a group of 90 subjects without asbestos exposure. In accordance with previous studies, these results indicate that pleural plaques in asbestos workers may be of greater importance as a clinical feature than has been recognized in the past.

Are pleural plaques an appropriate endpoint for risk analyses?

“…They found that there was a significant association between angina pain and the presence of pleural and parenchymal abnormalities. Another exception was reported by Hilt et al (1987) who studied a cohort of asbestos exposed persons and found that among 200 subjects less than 70 years of age who had pleural plaques only, a statistically significant increase was observed in the prevalence of breathlessness grade 1 (light) after adjustment for smoking compared to an external reference population. The most recent study that addresses chest pain in asbestos exposed workers with pleural plaques is that of Park et al (2011).…”

“…With very few exceptions (Cramond & Casserly, 2006;Hilt et al, 1987;Mukherjee et al, 2000;Myers, 2012) investigators have concluded that most subjects with pleural plaques are nearly always asymptomatic (Ameille & Letourneux, 1999;Broderick et al, 1992;Christen et al, 1997;Crane et al, 2005;Crapo, 2005;Dweik & Mazzone, 2010;Fishwick & Barber, 2014;Hillerdal, 1997Hillerdal, , 2001Hillerdal & Henderson, 1997;IIAC, 2008;Järvholm & Larsson, 1988;Jones, 1997;Meirelles et al, 2005;Mohr, 2012;Montes et al, 2005;Park et al, 2011;Roach et al, 2002;Rubin, 1986;Utell & Maxim, 2010). For example: Broderick et al (1992) studied an asbestos exposed population of sheet metal workers and examined the relationship between circumscribed plaque and four symptoms; dyspnea upon hurrying or walking up a slight hill (DOE), dyspnea worse than peers while walking (DSP), chest pain and cough.…”

Effects of asbestos-related pleural disease on pulmonary function.

“…An increased prevalence of pleural plaque formation has been observed in asbestos-e xposed populations (1)(2)(3)(4)(5)(6). While asbestos exposure has declined in recent decades the prevalence of pleural plaques appears to be rising, especially among males and older age groups (7).…”

An 11-year longitudinal study of the occupational dust exposure and lung function of polyvinyl chloride, cement and asbestos cement factory workers.

“…The heavy smokers in all the exposure groups had FVC and FEVl.o predicted values that were lower than those of the nonsmokers-light smokers; these differences remained constant with length of employment. Cessation of asbestos exposure for about 10 years did not seem to change lung function decline.Key terms: asbestos and smoking interaction, asbestos exposure, lung function after cessation of asbestos exposure, lung function change, total dust concentration.The effect of asbestos exposure on lung function has been reported in several cross-sectional (10,12,(17)(18)(19) 22) and a few longitudinal (2, 11,13,20,21) studies. The latter have usually been based on two surveys.…”

“…The effect of asbestos exposure on lung function has been reported in several cross-sectional (10,12,(17)(18)(19) 22) and a few longitudinal (2, 11,13,20,21) studies. The latter have usually been based on two surveys.…”