Asbestos, ergot drugs and the pleura

Our plain-English summary of Asbestos, ergot drugs and the pleura, by P. Camus, G. Hillerdal, P. De Vuyst (The European Respiratory Journal, 1998).

The study

• Authors: P. Camus, G. Hillerdal, P. De Vuyst
• Journal: The European Respiratory Journal
• Published: 1998;11(6):1427
• Type of article: Comment, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editor, not a research study. It gave no patient counts, case details or statistics, though the authors mentioned further unpublished cases they were following. The authors returned to their earlier editorial on two papers about pleural effusion or thickening in former asbestos workers given the ergot drug bromocriptine. Drawing partly on those cases, they wrote that bromocriptine-related loss of lung function was quite aggressive and often recovered only partly after the drug was stopped. They proposed that compensation boards ask former asbestos workers about bromocriptine or other ergot use, especially when pleural changes progressed rapidly, and seek earlier chest X-rays. They urged caution about stopping the drug in Parkinson's disease. After withdrawal, they suggested evaluating lung function at 6 to 12 months. They proposed that any remaining restrictive defect then be ascribed to asbestos and compensated, even though the drug might have caused the deterioration. They said that their belief that lung function should stabilize or recover by then, if the drug was the cause, remained to be documented. They also announced a case registry.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor (correspondence) offering opinions and proposals; no original study
• Who was studied: No group was formally studied. The letter concerns former asbestos workers who developed pleural disease while taking bromocriptine. It draws on two published papers and on the authors' own unpublished cases, which are not counted or described.
• Exposure: Former asbestos exposure (no fiber type named) combined with intake of bromocriptine or other ergot drugs
• Main results:
  • These are the authors' impressions, not measured data, based on the cited papers and their unpublished cases: bromocriptine-induced loss of lung function was quite aggressive and, more often than not, recovered only partially after the drug was stopped.
• The authors' conclusion: The authors proposed that compensation boards should systematically ask former asbestos workers about bromocriptine or other ergot exposure and should look for earlier chest X-rays. They proposed that the drug be withdrawn, with caution in Parkinson's disease, and that lung function be followed and evaluated at 6 to 12 months. They proposed that any residual restrictive lung function defect at that point be ascribed to asbestos and compensated, even though the drug may be the cause of the deterioration, in keeping with the medicolegal principles of benefit of the doubt and globalization of impairment. They asked the European Respiratory Society's occupational health group to issue recommendations, and they opened a confidential case registry.
• Limitations the authors state:
  • The authors stated that their belief remains to be documented. That belief is that lung function should have stabilized or recovered by 6 to 12 months if the drug was the cause.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleura.

Related studies

• Asbestos, ergot drugs and the pleura — P. De Vuyst, P. Pfitzenmeyer, et al. (1997)
• Pleural disease during treatment with bromocriptine in patients previously exposed to asbestos — G. Hillerdal, J. Lee, et al. (1997)
• Pleural effusion during bromocriptine exposure in two patients with pre-existing asbestos pleural plaques: a relationship? — C. Knoop, M. Mairesse, et al. (1997)
• 'Black Spots' and hyaline pleural plaques on the parietal pleura of 150 urban necropsy cases — K. Mitchev, P. Dumortier, et al. (2002)
• Asbestos-related lesions of the pleura: parietal plaques compared to diffuse thickening studied with chest roentgenography, computed tomography, lung function, and gas exchange — G. Hillerdal, P. Malmberg, et al. (1990)
• Imaging of the pleura — N.L. Müller (1993)

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