Abstract
Purpose
To characterize asbestosis today and to clarify the indications for high-resolution computed tomography (HRCT) in the surveillance of heavily exposed workers.
Methods
Six hundred and twenty-seven workers were screened and HRCT findings were classified and divided in two groups: pulmonary fibrosis (n = 86) and no fibrosis (n = 541).
Results
Most (65/86 = 76%) of the detected fibrosis cases were mild. The magnitude of asbestos exposure showed an unexpected inverse relation with fibrosis. In multivariate analyses, age, forced expiratory volume in 1 s/forced vital capacity ratio, and poor diffusing capacity were associated with HRCT fibrosis, but asbestos exposure was not.
Conclusions
Asbestosis seems to be characterized by mild fibrosis today even in heavily exposed workers. To avoid radiation exposure in HRCT, age and lung function data may be used only to a limited extent to select imaging candidates. Selection and recollection biases may distort the relation between asbestos exposure and fibrosis.
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References
Aberle DR, Gamsu G, Ray CS (1988) High-resolution CT of benign asbestos-related diseases: clinical and radiographic correlation. AJR 151:883–891
Algranti E, Mendonca EMC, DeCapitani EM, Freitas JBP, Silva HC, Bussacos MA (2001) Non-malignant asbestos-related diseases in Brazilian asbestos-cement workers. Am J Ind Med 40:240–254
Begin R, Ostiguy G, Filion R, Colman N, Bertrand P (1993) Computed tomography in the early detection of asbestosis. Br J Ind Med 50:689–698
Gamsu G, Aberle DR, Lynch D (1989) Computed tomography in the diagnosis of asbestos-related thoracic disease. J Thorac Imaging 4:61–67
Harding AH, Darnton A, Wegerdt J, Mc Elvenny D (2009) Mortality among British asbestos workers undergoing regular medical examinations (1971–2005). Occup Environ Med, epub
Harkin TJ, McGuinness G, Goldring R, Cohen H, Parker JE, Crane M, Naidich DP, Rom WN (1996) Differentiation of the ILO boundary chest roentgenograph (0/1 to 1/0) in asbestosis by high-resolution computed tomography scan, alveolitis, and respiratory impairment. J Occup Environ Med 38(1):46–52
Hughes JM, Weill H (1991) Asbestosis as a precursor of asbestos related lung cancer: results of a prospective mortality study. Br J Ind Med 48:229–233
Huuskonen MS, Koskinen K, Tossavainen A, Karjalainen A, Rinne J-P, Rantanen J (1995) Finnish institute of occupational health asbestos program 1987–1992. Am J Ind Med 28:123–142
Huuskonen O, Kivisaari L, Zitting A, Taskinen K, Tossavainen A, Vehmas T (2001) High-resolution computed tomography classification of lung fibrosis for patients with asbestos-related disease. Scand J Work Environ Health 27(2):106–112
International Labour Organisation (1986) Asbestos convention, 1986, no. 162. www.ilo.org/public/english/protection/safework/cis/oshworld/ilostd/c162.htm
Koskinen K, Pukkala E, Martikainen R, Reijula K, Karjalainen A (2002) Different measures of asbestos-exposure in estimating risk of lung cancer and mesothelioma among construction workers. J Occup Environ Med 44:1190–1196
Kusaka Y, Hering KG, Parker JE (2005) International classification of HRCT for occupational and environmental respiratory diseases. Springer, Tokyo
Mastrangelo G, Ballarin MN, Bellini E et al (2009) Asbestos exposure and benign asbestos diseases in 772 formerly exposed workers: dose-response relationships. Am J Ind Med 52:596–602
Meurman L, Kiviluoto R, Hakama M (1974) Mortality and morbidity among the working population of anthophyllite asbestos miners in Finland. Brit J Ind Med 31:105–112
Miller A (1993) Pulmonary function in asbestosis and asbestos-related pleural disease. Environ Res 61:1–18
Neri S, Antonelli A, Falaschi F, Boraschi P, Baschieri L (1994) Findings from high resolution computed tomography of the lungs and pleura of symptom free workers exposed to amosite who had normal chest radiographs and pulmonary function tests. Occup Environ Med 51:239–243
Neri S, Boraschi P, Antonelli A, Falaschi F, Baschieri L (1996) Pulmonary function, smoking habits, and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos. Am J Ind Med 30:588–595
Ohar J, Sterling DA, Bleecker E, Donohue J (2004) Changing patterns in asbestos-induced lung disease. Chest 125:744–753
Oksa P, Suoranta H, Koskinen H, Zitting A, Nordman H (1994) High-resolution computed tomography in the early detection of asbestosis. Int Arch Occup Environ Health 65:299–304
Paris C, Benichou J, Raffaelli C et al (2004) Factors associated with early-stage pulmonary fibrosis as determined by high-resolution computed tomography among persons occupationally exposed to asbestos. Scand J Work Environ Health 30(3):206–214
Paris C, Martin A, Letourneux M, Wild P (2008) Modelling prevalence and incidence of fibrosis and pleural plaques in asbestos-exposed populations for screening and follow-up: a cross-sectional study. Environ Health 7:30
Paris C, Thierry S, Brochard P et al (2009) Pleural plaques and asbestosis: dose and time-response relationships based on HRCT data. Eur Respir J 34:72–79
Piirilä P, Lindqvist M, Huuskonen O et al (2005) Impairment of lung function in asbestos-exposed workers in relation to high-resolution computed tomography. Scand J Work Environ Health 31(1):44–51
Selikoff IJ, Hammond EC, Seidman H (1980) Latency of asbestos disease among insulation workers in the United States and Canada. Cancer 46(12):2736–2740
Staples CA, Gamsu G, Ray CS, Webb WR (1989) High resolution computed tomography and lung function in asbestos-exposed workers with normal chest radiographs. Am Rev Respir Dis 139:1502–1506
Vehmas T, Kivisaari L, Huuskonen M, Jaakkola MS (2005) Scoring CT/HRCT findings among asbestos-exposed workers: effects of patients age, body mass index and common laboratory test results. Eur Rad 15:213–219
Vierikko T, Järvenpää R, Autti T et al (2007) Chest CT screening of asbestos-exposed workers: lung lesions and incidental findings. Eur Respir J 29:78–84
Viljanen AA (1982) Reference values for spirometric, pulmonary diffusing capacity and body plethysmographic studies. Scand J Clin Lab Invest 42(suppl 159):1–50
Wang X, Yano E, Wang Z, Wang M, Christiani DC (2006) Adverse effects of asbestos exposure and smoking on lung function. Am J Ind Med 49:337–342
Welch LS, Haile E, Dement J, Michaels D (2007) Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2004. Chest 131:863–869
Acknowledgments
This work was financially supported by the Tuberculosis Foundation of Tampere and by Competitive Research Funding of the Pirkanmaa Hospital District, Tampere University Hospital. We wish to thank Dr. Taina Autti for help with image interpretation.
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The authors declare that they have no conflict of interest.
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Vierikko, T., Järvenpää, R., Toivio, P. et al. Clinical and HRCT screening of heavily asbestos-exposed workers. Int Arch Occup Environ Health 83, 47–54 (2010). https://doi.org/10.1007/s00420-009-0462-1
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DOI: https://doi.org/10.1007/s00420-009-0462-1