Longitudinal pattern of reported respiratory symptoms and accelerated ventilatory loss in asbestos-exposed workers.
Brodkin-CA; Barnhart-S; Checkoway-H; Balmes-J; Omenn-GS; Rosenstock-L
Chest 1996 Jan; 109(1):120-126
A study was conducted examining the longitudinal pattern of respiratory symptoms and ventilatory function in asbestos (1332214) exposed workers. Changes in forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) associated with development, resolution, or persistence of symptoms of cough, phlegm, wheeze, and dyspnea were prospectively examined over a 3 to 5 year period in 446 asbestos exposed male workers. No significant association was identified between symptoms reported initially and accelerated loss of FVC or FEV1. In contrast, the pattern of reported symptoms during the followup period was strongly associated with an accelerated loss of ventilatory capacity; significant differences were seen for wheeze and phlegm in relation to FVC and for cough, phlegm, and wheeze in relation to FEV1. Following adjustment for baseline ventilatory capacity, age, smoking and asbestos related factors, significantly greater ventilatory losses, ranging from 28 milliliters/year in FEV1 for newly developed dyspnea to 67 milliliter/year in FVC for developed wheeze, were seen compared with asymptomatic subjects. The authors conclude that the development or persistence of respiratory symptoms over time is more predictive of future ventilatory loss than the initial presence of symptoms.
NIOSH-Author; Lung-function; Asbestos-workers; Clinical-symptoms; Respiratory-system-disorders; Pulmonary-function-tests; Occupational-respiratory-disease;
Author Keywords: asbestos; cough; dyspnea; questionnaires; spirometry
Carl A. Brodkin, University of Washington, Occupational & Environmental Health Program, 325 9TH Ave, ZA-66, Seattle, WA 98104