Abstract
OBJECTIVES: To analyse quantitatively the relations of spirometric lung function (forced vital capacity (FVC)) to radiographic interstitial pulmonary fibrosis (assessed by the International Labour Organisation (ILO) profusion score of small irregular opacities) in two large workforces exposed to different intensities of asbestos. These analyses consider the question whether a similar profusion score n differently exposed workers is associated with a similar effect on lung function. METHODS: Surveys of two workforces, insulators (n = 2611) and sheet metal workers (n = 1245), by the same investigators allowed comparison of the effects of the two levels of exposure to asbestos. The two groups were of similar age and had similar percentages of non-smokers and smokers. All radiographs were read by the same expert reader. RESULTS: Consistent with their less continuous and less intense exposure to asbestos, metal workers had: (a) far less frequent radiographic asbestosis (profusion score > or = 1/0, 17.5% v 59.6% for insulators): (b) less severe radiographic asbestosis (only 1.1% had scores > or = 2/1 v 13.3% of insulators); (c) a similar slope to that seen in insulators for the relation between FVC and profusion score when pleural thickening was absent; (d) less frequent pleural fibrosis (36% v 75%); and (e) less frequent restrictive impairment (23% v 33%). In both insulators and metal workers, lung function was below normal even when lung fields were normal, FVG fell with increasing profusion, it was lower in smokers and in those with pleural thickening at comparable profusion scores, and these was no difference in FVC between scores 0/1 and 1/0. CONCLUSION: The decrease in FVC with increasing profusion score in both workforces as well as the similar slopes for the relation between FVG and profusion score and the similar FVG at similar scores in the absence of pleural thickening confirm the ILO profusion score as an acceptable assessment of pulmonary fibrosis.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Crapo R. O., Morris A. H., Gardner R. M. Reference spirometric values using techniques and equipment that meet ATS recommendations. Am Rev Respir Dis. 1981 Jun;123(6):659–664. doi: 10.1164/arrd.1981.123.6.659. [DOI] [PubMed] [Google Scholar]
- Lilis R., Miller A., Godbold J., Benkert S., Wu X., Selikoff I. J. Comparative quantitative evaluation of pleural fibrosis and its effects on pulmonary function in two large asbestos-exposed occupational groups--insulators and sheet metal workers. Environ Res. 1992 Oct;59(1):49–66. doi: 10.1016/s0013-9351(05)80225-7. [DOI] [PubMed] [Google Scholar]
- Lilis R., Miller A., Godbold J., Chan E., Selikoff I. J. Radiographic abnormalities in asbestos insulators: effects of duration from onset of exposure and smoking. Relationships of dyspnea with parenchymal and pleural fibrosis. Am J Ind Med. 1991;20(1):1–15. doi: 10.1002/ajim.4700200102. [DOI] [PubMed] [Google Scholar]
- Lilis R., Selikoff I. J., Lerman Y., Seidman H., Gelb S. K. Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking. Am J Ind Med. 1986;10(5-6):459–470. doi: 10.1002/ajim.4700100504. [DOI] [PubMed] [Google Scholar]
- Miller A., Lilis R., Godbold J., Chan E., Selikoff I. J. Relationship of pulmonary function to radiographic interstitial fibrosis in 2,611 long-term asbestos insulators. An assessment of the International Labour Office profusion score. Am Rev Respir Dis. 1992 Feb;145(2 Pt 1):263–270. doi: 10.1164/ajrccm/145.2_Pt_1.263. [DOI] [PubMed] [Google Scholar]
- Miller A., Lilis R., Godbold J., Chan E., Wu X., Selikoff I. J. Spirometric impairments in long-term insulators. Relationships to duration of exposure, smoking, and radiographic abnormalities. Chest. 1994 Jan;105(1):175–182. doi: 10.1378/chest.105.1.175. [DOI] [PubMed] [Google Scholar]
- Miller A., Thornton J. C., Warshaw R., Bernstein J., Selikoff I. J., Teirstein A. S. Mean and instantaneous expiratory flows, FVC and FEV1: prediction equations from a probability sample of Michigan, a large industrial state. Bull Eur Physiopathol Respir. 1986 Nov-Dec;22(6):589–597. [PubMed] [Google Scholar]
- Morris J. F., Koski A., Johnson L. C. Spirometric standards for healthy nonsmoking adults. Am Rev Respir Dis. 1971 Jan;103(1):57–67. doi: 10.1164/arrd.1971.103.1.57. [DOI] [PubMed] [Google Scholar]
- Selikoff I. J., Lilis R. Radiological abnormalities among sheet-metal workers in the construction industry in the United States and Canada: relationship to asbestos exposure. Arch Environ Health. 1991 Jan-Feb;46(1):30–36. doi: 10.1080/00039896.1991.9937426. [DOI] [PubMed] [Google Scholar]