Spirometric abnormalities in 2573 asbestos insulators with long term exposure: effects of smoking history and radiographic abnormalities.
Miller A; Lilis R; Godbold J; Chan E; Selikoff IJ
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA. Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 90-108, 1990 Sep; (Pt I):704-708
A study was done on 2573 insulators with long term exposure to asbestos (1332214) to determine relationships between smoking history, radiographic abnormalities and spirometric abnormalities. Lung function was assessed using a computerized rolling seal spirometer. Nonsmoking was defined as less than one cigarette per day, not more than ten cigarettes a day for not more than 6 months, or smoking only cigars or pipes without inhaling. Nonsmokers (19.7%) did not differ from current smokers (33.5%) and exsmokers (46.9%) in mean age (58.6 and 57.3 years, respectively), mean duration from onset of exposure (36.3 and 34.9 years, respectively) and years exposed (32.0 and 31.6 years, respectively). Forced vital capacity and forced expiratory volume in 1 second were reduced in current smokers and exsmokers and to a lesser extent in nonsmokers. Normal pulmonary function was noted in 43.9%, 31.2% and 17.0% of nonsmokers, exsmokers and current smokers, respectively. Prevalence rates of restrictive impairment alone and small airways dysfunction were similar for all smoking categories, while overt obstruction and combined impairment were most prevalent in smokers and least prevalent in nonsmokers. Frequencies of restrictive and combined impairments were greatest in workers with both parenchymal and pleural disease (48.2% of subjects). Obstruction was more likely in workers with only parenchymal disease (11.7%). Restriction was more likely for pleural disease only (24.1% of workers) than for isolated parenchymal disease. Nonsmoking was more likely for subjects with normal function regardless of radiographic category, and smoking was more likely for those with obstructive or combined impairments. Increased duration of exposure was associated with increased frequencies of restriction and combined impairment and decreased frequency of normal function. The authors conclude that these results demonstrate the important effect of pleural fibrosis on lung function in this population.
Insulation workers; Occupational exposure; Asbestos products; Long term exposure; Lung function; Chest X rays; Pulmonary function tests; Cigarette smoking; Respiratory system disorders
DHHS (NIOSH) Publication No. 90-108
Proceedings of the VIIth International Pneumoconioses Conference, August 23-26, 1988, Pittsburgh, Pennsylvania, USA