Apical Pleuropulmonary Changes in Persons Exposed to Asbestos - Experience from 40 Patients.
NIOSH 1990 Nov:845-845
Apical pleuropulmonary changes occurring among persons occupationally exposed to asbestos (1332214) were examined. Forty persons with apical pleural thickening at least 5 millimeters thick visible on their chest X-rays were seen at a respiratory clinic in Uppsala, Sweden. They were among approximately 1600 patients who were treated at the clinic because of bilateral radiographic pleural changes through 1986. The mean age that the apical pleural thickening was first detected was 60 years. The mean latency period was 32 years. The apical changes occurred on the right side in 20 patients, on the left side in four, and on both sides in 15. Computed tomography performed on five patients showed that the lesions were primarily pleural but were compressing the lung parenchyma. Some fibrous strands from the thickened pleura were penetrating the lung. The lesions progressed over time. A tuberculin test was performed in 25 patients and was positive in 13. In eight, tissue samples obtained by bronchoscopy were negative for tuberculosis after culturing. The other five received a course of tuberculosis treatment. Complete lung function test data were available for 21 subjects. Vital capacity (VC) and total lung capacity (TLC) were significantly decreased in all subjects. On average VC and TLC were decreased to 62 and 68% of their predicted values, respectively. The author concludes that upper lobe changes are a fairly rare manifestation of asbestos exposure. Apical pleural thickening seems to be as pathognomonic to asbestos as pleural plaques.
X-ray-analysis; Chest-X-rays; Asbestos-workers; Lung-lesions; Pulmonary-function; Lung-disorders; Occupational-medicine;
DHHS (NIOSH) Publication No. 90-108
Infectious Diseases; Disease and Injury;
Proceedings of the VIIth International Pneumoconioses Conference