Asbestos-induced pleural fibrosis and impaired lung function.
Schwartz-DA; Fuortes-LJ; Galvin-JR; Burmeister-LF; Schmidt-LE; Leistikow-BN; LaMarte-FP; Merchant-JA
Am Rev Respir Dis 1990 Feb; 141(2):321-326
An investigation was conducted of the association between asbestos (1332214) induced pleural fibrosis and lung function impairment in sheet metal workers. The evaluation group consisted of 1211 male members of the Sheet Metal Workers International Association, mean age 57.1 years. Of these, 99.7% were Caucasian and 27.8% were retired. The subjects completed an American Thoracic Society questionnaire, gave smoking histories, and performed pulmonary function testing. Chest X-rays were also obtained and read for pneumoconiosis using the International Labor Organization system for classifying opacities. A total of 334 subjects had pleural fibrosis. Seventy eight percent of these had circumscribed plaques and 22% diffuse pleural thickening that involved the costophrenic angle. The subjects with fibrosis tended to be older, retired, to have more experience in the sheet metal trade, and to have more pack years smoking than those with normal lungs. Both forms of pleural fibrosis were associated with significant decreases in 1 second forced expiratory volume (FEV1) and forced vital capacity (FVC). Only diffuse pleural thickening was associated with slight decreases in the FEV1/FVC ratio. Linear multivariate analysis indicated that both circumscribed plaques and diffuse pleural thickening were significantly associated with decreases in FVC, but not with the FEV1/FVC ratio. After adjusting for potential confounders such as age, exposure, latency, and pack years smoking, the effect of diffuse pleural thickening on FVC decrements was approximately twice that of circumscribed pleural plaques. The authors conclude that pleural fibrosis in asbestos exposed workers is independently associated with decrements in pulmonary function that are suggestive of an underlying restrictive defect.
NIOSH-Grant; Lung-fibrosis; Chest-X-rays; Metal-workers; X-ray-diagnosis; Lung-function; Mathematical-models; Statistical-analysis; Asbestos-dust; Occupational-exposure; Respiratory-system-disorders
Internal Medicine University of Iowa Pulmonary Disease Division Iowa City, IA 52242
Pulmonary System Disorders
American Review of Respiratory Disease
University of Iowa, Iowa City, Iowa