Respiratory findings among ironworkers: results from a clinical survey in the New York metropolitan area and identification of health hazards from asbestos in place at work.

Abstract

Diseases associated with asbestos are prevalent in the construction trades primarily as the result of the previously widespread use of insulation materials containing asbestos in the building industry. Workers in metal related trades, who are employed at construction sites, but who do not routinely use such materials in their work, may also be at risk for asbestos hazards. To assess such risk, a clinical survey was conducted on 869 ironworkers from the New York metropolitan area. A high prevalence of abnormalities on chest radiographs was found. Three hundred and twenty nine (38%) of the examined workers had pleural abnormalities on their chest radiographs consistent with asbestos induced effects. The prevalence of radiographic abnormalities indicating interstitial lung disease was low (7%) as was the prevalence of restrictive pulmonary function impairment (7%). Association was found between forced vital capacity (FVC) and pleural abnormalities on chest radiographs. Although ex-smokers appeared to have the highest prevalence of abnormalities, regression analyses showed that duration of employment in the ironworkers' trade was the most important factor associated with them.

Lung function impairment in relation to asbestos-induced pleural lesions with reference to the extent of the lesions and the initial parenchymal fibrosis

“…The lung function parameters most frequently studied with reference to asbestos-induced pleural lesions are TLC, FVC, and FEV 1 . In agreement with our conclusions, an effect of asbestos-induced pleural lesions on these parameters has been reported by many authors (8,(15)(16)(17)(18)(19)(20). Nevertheless, other authors (11,13,21) have not found a poorer lung function in the presence of pleural lesions.…”

“…DLCO impairment was associated with parenchymal fibrosis. Nor did we find any significant effect of pleural lesions on FEF 25-75 or FEF 75 , as reported by Fischbein et al (20), Kilburn & Warshaw (23), and Hillerdal et al (24). Nevertheless, we showed that parenchymal fibrosis has a significant effect on these parameters.…”

Non‐malignant asbestos‐related diseases in Brazilian asbestos‐cement workers

“…This was especially apparent for pleural thickening but, even for asbestosis that has a marked dose±response behaviour [Peto, 1978;Nicholson et al, 1982], latency time showed a stronger association. The same ®ndings were shown in a number of asbestos exposed workforces [Fischbein et al, 1991;Lilis et al, 1991;Jakobsson et al, 1995]. The assumption of a linear scale for the reported exposure in the different jobs in the A/C plant for deriving cumulative exposure might have been wrong.…”

“…Bourbeau et al [1990], reported the association of pleural thickening with SOB, but ORs were signi®cant only for SOB in strenuous exertion, possibly because of the small number of subjects in the group. Other large asbestos-exposed cohorts showed that the presence of pleural thickening was also associated with SOB [Broderick et al, 1991;Fischbein et al, 1991;Lilis et al, 1991]. In one of the cohorts, the association was signi®cant only with added asbestosis [Lilis et al, 1991].…”

Pleural plaques, asbestos exposure, and asbestos bodies in bronchoalveolar lavage fluid

“…Pleural plaques are considered to be a relatively sensitive indicator of asbestos exposure in the general population. Their prevalence increases at lower doses than the prevalence of small irregular opacities and diffuse pleural thickening [Neuberger, 19891. Recent studies reported a marked preponderance of pleural over parenchymal abnormalities in workers who used asbestos-containing products in their jobs [Lilis et al, 1980;Sprince et al, 1985;Lundorf et al, 1987;Fischbein et al, 1991;Becklake, 19911. Pleural plaques with no other asbestos-related abnormalities were also observed in general population surveys in men engaged in occupations with intermittent exposure as well as in individuals who had only household or environmental asbestos exposure [Ohyagi et al, 1985;Hillerdal, 19911.…”