Asbestos inhalation and nonmalignant abnormalities of the chest

Our plain-English summary of Asbestos inhalation and nonmalignant abnormalities of the chest, by P.E. Epstein (Seminars in Roentgenology, 1992).

The study

• Author: P.E. Epstein
• Journal: Seminars in Roentgenology
• Published: 1992;27(2):85-93
• Type of article: Review
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004966).

In plain English

This 1992 article by a University of Pennsylvania physician was a narrative review, not a new study. It collected no data of its own. It described asbestos fiber types, how workers were exposed, what happens to fibers in the lung, nonmalignant chest disease, diagnosis and treatment. The author wrote that the delay between first exposure and disease is typically 20 years or more. Citing earlier studies, the author reported that estimates of pleural thickening after occupational exposure ranged from 10% to 60% among various populations. The author stated that pleural plaques and mild-to-moderate pleural thickening cause no symptoms. Benign asbestos pleural effusions were described as sometimes appearing as early as 5 years after first exposure. The author argued that the term asbestosis should be reserved for fibrosis of the lung tissue itself and not used for pleural plaques. The author also stated that steroids and immunosuppressive drugs do not help asbestosis. Relying on cited work, the author wrote that there is no evidence fibrotic disease will occur at the OSHA limit of 0.2 fibers per cubic centimeter. The author concluded that precision in diagnosis and in the language used to describe it is particularly important.

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
• Who was studied: No study population. The article reviewed published literature (29 references) on asbestos exposure and nonmalignant chest disease.
• Exposure: Asbestos in general. Covers chrysotile (serpentine; said to be about 90% of commercial use in the United States) and the amphiboles crocidolite, amosite, anthophyllite, tremolite and actinolite. Described exposure settings were asbestos textile manufacture, shipbuilding, the insulation trades, and household exposure from work clothes.
• Main results:
  • The author described the latency period for asbestos-related chest abnormalities as typically 20 years or more.
  • Citing other studies, the author reported estimates of pleural thickening after occupational asbestos exposure ranging from 10% to 60% among various populations.
  • The author stated that pleural plaques and mild-to-moderate pleural thickening produce no symptoms. Severe, extensive pleural fibrosis that restricts lung expansion was described as a rare exception.
  • Benign asbestos-related pleural effusions were described as occurring sometimes as early as 5 years after initial exposure.
  • The author stated that the term asbestosis should be reserved for fibrosis of the lung tissue, not pleural thickening or plaques.
  • The author stated that steroids and immunosuppressive agents are ineffective for asbestosis.
  • Relying on cited work, the author stated there is no evidence that fibrotic disease will occur at the OSHA exposure limit of 0.2 fibers per cubic centimeter of air.
• The authors' conclusion: The author concluded that precision in diagnosis, and in the language used to communicate the diagnosis, is particularly important for asbestos-related changes.

Related studies

• Risk and significance of chest radiograph and pulmonary function abnormalities in an elderly cohort of former nuclear weapons workers — M.A. Mikulski, P.G. Hartley, et al. (2011)
• Spirometric impairments in long-term insulators. Relationships to duration of exposure, smoking, and radiographic abnormalities — A. Miller, R. Lilis, et al. (1994)
• Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS) — J. Szeinuk, C.W. Noonan, et al. (2017)
• Chest pain in asbestos-exposed individuals with benign pleural and parenchymal disease — S. Mukherjee, N. de Klerk, et al. (2000)
• Surgical treatment of asbestos-related disease of the chest — L.P. Faber (1988)
• Asbestos-related chest diseases: plain radiographic findings — W.T. Miller, W.B. Gefter, et al. (1992)

Browse more research in Seminars in Roentgenology, or return to medical research.