Asbestos-induced pleural disease

Our plain-English summary of Asbestos-induced pleural disease, by S.L. Nishimura, V.C. Broaddus (Clinics in Chest Medicine, 1998).

The study

• Authors: S.L. Nishimura, V.C. Broaddus
• Journal: Clinics in Chest Medicine
• Published: 1998;19(2):311-29
• Type of article: Review
• Cited by: 39 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos-induced pleural disease has become the most common manifestation of asbestos exposure. Asbestos has an unusual affinity for the pleural space and leads to plaques, benign effusions, fibrosis, and malignant mesothelioma. The explanation for its affinity for the pleura may lie in part with new evidence showing that asbestos fibers can accumulate in certain regions of the parietal pleura at higher concentrations than in the lung. With the control of industrial exposures to asbestos, the incidence of this disease should decrease, with the incidence of mesothelioma peaking in the years 2000 to 2020. Nonetheless, the toxic features of asbestos including shape, chemical composition, and surface characteristics should be understood to avoid toxicity in fibers used to replace asbestos and to know the risks of low level exposures from asbestos currently in our environment.

In plain English

This article was a narrative review, not an original study. The authors summarized newer published research on pleural disease caused by asbestos. They described four forms: pleural plaques, benign asbestos pleurisy (pleural effusion), pleural fibrosis and mesothelioma. The review covered both fiber families: the amphiboles, including crocidolite and amosite, and chrysotile, the only serpentine fiber. Drawing on other researchers' studies, it reported several findings. Plaques can be found in up to 50% of asbestos-exposed workers. Benign effusions were the most common manifestation in the first 20 years after exposure, affecting at least 3.7% of indirectly exposed and 7% of heavily exposed workers. Large plaques (over 4 cm) have been associated with an increased risk of mesothelioma. The review cited forecasts that mesothelioma would peak in the United States in 2000 at 2300 cases and in the United Kingdom in 2020. The authors called asbestos the major single cause of mesothelioma. They concluded that fibers gathering in the pleural tissue itself appear more likely to play an important role in pleural disease. They also stated that asbestos toxicity appears to come from a combination of fiber shape, chemical composition and surface characteristics.

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: Narrative review of published studies on asbestos-related pleural disease
• Who was studied: No study population of its own; the review covered published research on four asbestos-related pleural conditions: plaques, pleurisy, fibrosis and mesothelioma
• Exposure: Asbestos in general, including the amphiboles (commercially used crocidolite and amosite; tremolite, anthophyllite and actinolite as contaminants) and the serpentine fiber chrysotile
• Main results:
  • Citing another study, the review reported that pleural plaques can be found in up to 50% of asbestos-exposed workers
  • Citing another study, the review reported that benign effusions were the most common manifestation of asbestos exposure in the first 20 years after exposure, with a prevalence of at least 3.7% in indirectly exposed workers
  • The same cited study reported a prevalence of benign effusion of 7% in heavily exposed workers
  • Citing another study, the review reported that large pleural plaques (over 4 cm) have been associated with an increased risk of developing mesothelioma; malignant transformation has never been shown in a plaque
  • Citing epidemiologic studies, the review reported a forecast that United States mesothelioma incidence would peak in 2000 at 2300 cases
  • Citing United Kingdom assessments, the review reported a forecast that mesothelioma incidence there would continue to increase and peak in 2020
  • Citing a study of nonsmoking asbestos-exposed workers, the review reported that diffuse pleural thickening was associated with a decrease in lung volume
  • The authors described asbestos as the major single cause of mesothelioma, with no known contribution from other sources, including cigarette smoke
  • The authors stated that asbestos toxicity appears to be caused by a combination of fiber shape, chemical composition and surface characteristics
• The authors' conclusion: The authors concluded that fibers accumulating in the pleural tissue appear more likely to play an important causal role in pleural diseases, especially those arising in the parietal pleura such as plaques and mesothelioma

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Fibrosis, Malignant Mesothelioma, Pleura, Parietal Pleura, Mesothelioma.

Related studies

• Changing patterns in asbestos-induced lung disease — P. De Vuyst, P.A. Gevenois, et al. (2004)
• The validity of static lung compliance in asbestos-induced diseases — J. Schneider, R. Arhelger, et al. (2012)
• Changing patterns in asbestos-induced lung disease — J. Ohar, D.A. Sterling, et al. (2004)
• Asbestos-induced and smoking-related disease: apportioning pulmonary function deficit by using thin-section CT — S.J. Copley, Y.C. Lee, et al. (2007)
• Apoptosis and asbestos-induced disease: Is there a connection? — V.C. Broaddus (2001)
• Pathogenesis of experimentally induced asbestos mesothelioma in rats — L.A. Vasilieva, L.N. Pylev, et al. (1998)

Browse more research in Clinics in Chest Medicine, or return to medical research.