Lung function not affected by asbestos exposure in workers with normal Computed Tomography scan

Schikowsky, Christian; Felten, Michael K.; Eisenhawer, Christian; Das, Marco; Kraus, Thomas

doi:10.1002/ajim.22717

Cited by 5 publications

(5 citation statements)

References 55 publications

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“…In the present study, D LCO /VA was not sensitive, confirming the results of van der Lee et al [36] and Hughes & Pride [37] where the transmission coefficient D LCO / VA had no diagnostic added value compared to the parameters D LCO and VC for the detection of diffuse parenchymal diseases. In accordance, Schikowsky et al [38] showed no impairment of D LCO /VA and no reduction in VC in subjects formerly exposed to asbestos. In difference, the D LCO results were not presented.…”

Section: Discussionsupporting

confidence: 70%

Relations between vital capacity, CO diffusion capacity and computed tomographic findings of former asbestos-exposed patients: a cross-sectional study

Preisser

Schlemmer

Herold

et al. 2020

J Occup Med Toxicol

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Background: Asbestos-related lung diseases are one of the leading diagnoses of the recognized occupational diseases in Germany, both in terms of their number and their socioeconomic costs. The aim of this study was to determine whether pulmonary function testing (spirometry and CO diffusion measurement (D LCO)) and computed tomography of the thorax (TCT) are relevant for the early detection of asbestos-related pleural and pulmonary fibrosis and the assessment of the functional deficiency. Methods: The records of 111 formerly asbestos-exposed workers who had been examined at the Institute for Occupational and Maritime Medicine, Hamburg, Germany, with data on spirometry, D LCO and TCT were reviewed. Workers with substantial comorbidities (cardiac, malignant, silicosis) and/or pulmonary emphysema (pulmonary hyperinflation and/or TCT findings), which, like asbestosis, can lead to a diffusion disorder were excluded. The remaining data of 41 male workers (mean 69.8 years ±6.9) were evaluated. The TCT changes were coded according to the International Classification of High-resolution Computed Tomography for Occupational and Environmental Respiratory Diseases (ICOERD) by radiologists and ICOERD-scores for pleural and pulmonary changes were determined. Correlations (ρ), Cohens κ and accuracy were calculated. Results: In all 41 males the vital capacity (VC in % of the predicted value (% pred.)) showed only minor limitations (mean 96.5 ± 18.0%). The D LCO (in % pred.) was slightly reduced (mean 76.4 ± 16.6%; median 80.1%); the alveolar volume related value (D LCO /VA) was within reference value (mean 102 ± 22%). In the TCT of 27 workers pleural asbestos-related findings were diagnosed whereof 24 were classified as pulmonary fibrosis (only one case with honey-combing). Statistical analysis provided low correlations of VC (ρ = − 0.12) and moderate correlations of D LCO (− 0.25) with pleural plaque extension. The ICOERD-score for pulmonary fibrosis correlated low with VC (0.10) and moderate with D LCO (− 0.23); D LCO had the highest accuracy with 73.2% and Cohens κ with 0.45. D LCO /VA showed no correlations to the ICOERD-score. The newly developed score, which takes into account the diffuse pleural thickening, shows a moderate correlation with the D LCO (ρ = − 0.35, p < 0.05).

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Section: Discussionsupporting

confidence: 70%

Relations between vital capacity, CO diffusion capacity and computed tomographic findings of former asbestos-exposed patients: a cross-sectional study

Preisser

Schlemmer

Herold

et al. 2020

J Occup Med Toxicol

View full text Add to dashboard Cite

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“…Another study used a study design similar to ours to compare respiratory function test by cumulative exposure to asbestos, among subjects exposed to 49 f/mL-year on average, a level more than 10 times higher than that experienced by our study subjects. After excluding subjects with an abnormal CT scan, there was no correlation between cumulative exposure or duration of exposure, and lung function parameters and airways resistance [23].…”

Section: Discussionmentioning

confidence: 85%

Pulmonary Function and CT Scan Imaging at Low-Level Occupational Exposureto Asbestos

Satta

Serra

Meloni

et al. 2019

IJERPH

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Background: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. Results: Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19–0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95–5.07). Exposure was elevated among maintenance workers, compared to other jobs (p = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18–54.5). Conclusions: Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.

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“…New HRCT findings are revealing additional imaging characteristics important to the diagnosis of occupational lung disease [67][68][69][70]. A negative chest CT also proves useful in excluding disease [71]. The International Classification of High-Resolution Computed Tomography for Occupational and Environmental Respiratory Diseases recently demonstrated correlation with physiologic testing [72].…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Occupational Lung Diseases

Imaging¹,

Cox

Chung

et al. 2020

Journal of the American College of Radiology

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Lung function not affected by asbestos exposure in workers with normal Computed Tomography scan

Abstract: Our results confirm the well-known correlation between lung function, smoking habits, and BMI. However, we found no significant association between lung function and asbestos exposure.

Cited by 5 publications

References 55 publications

Relations between vital capacity, CO diffusion capacity and computed tomographic findings of former asbestos-exposed patients: a cross-sectional study

Relations between vital capacity, CO diffusion capacity and computed tomographic findings of former asbestos-exposed patients: a cross-sectional study

Pulmonary Function and CT Scan Imaging at Low-Level Occupational Exposureto Asbestos

ACR Appropriateness Criteria® Occupational Lung Diseases

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