Asbestos-related disease in plumbers and pipefitters employed in building construction

Our plain-English summary of Asbestos-related disease in plumbers and pipefitters employed in building construction, by N.L. Sprince, L.C. Oliver, T.C. McLoud (Journal of Occupational Medicine., 1985).

The study

• Authors: N.L. Sprince, L.C. Oliver, T.C. McLoud
• Journal: Journal of Occupational Medicine.
• Published: 1985;27(10):771-5
• Cited by: 41 articles, as counted by NIH iCite
• Read it: PubMed
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000511).

Abstract

Asbestos-related disease in a group of 153 plumbers and pipefitters employed in building construction was assessed by means of a cross-sectional prevalence study. Study methods were medical questionnaire, spirometry, measurement of diffusing capacity, physical examination of the chest, and chest roentgenogram. The major finding was bilateral pleural thickening in 28 (18.3%) of the participants. Unilateral pleural thickening was found in 12 subjects (7.8%). Small irregular opacities of profusion 1/0 or greater were found in 12 subjects (7.8%). Bilateral pleural thickening was associated with both age and time since first asbestos exposure, while unilateral pleural thickening was associated only with age. Decreases in forced vital capacity (percent predicted) were associated with duration of exposure. The most prevalent abnormality found was bilateral pleural thickening, which is more specific for asbestos exposure than is unilateral pleural thickening.

In plain English

This cross-sectional prevalence study examined plumbers and pipefitters in building construction from one union local. In 1982 and 1983, 160 active and retired members volunteered; results covered 153 white male participants. Methods included questionnaires, breathing tests, chest examinations and chest X-rays. No asbestos air sampling results were available; exposure was measured as years in the trade. Of these men, 28 (18.3%) had pleural thickening on both sides (bilateral) and 12 (7.8%) on one side (unilateral). Twelve men (7.8%) also had small irregular lung opacities of profusion 1/0 or greater. Bilateral thickening was found in 27 of 86 men (31.4%) more than 20 years from first exposure and 1 of 67 (1.5%) of the others. It was associated with duration of exposure, time since first exposure and age, while unilateral thickening was associated only with age. Lower forced vital capacity, as a percentage of predicted value, was associated with duration of exposure. The authors concluded that asbestos-related disease was present and that bilateral pleural thickening was the most common finding. Volunteers had longer exposure than non-participants, so results may overestimate prevalence.

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: Cross-sectional prevalence study using a medical questionnaire, spirometry, diffusing capacity, physical examination of the chest and chest X-rays.
• Who was studied: 160 plumbers and pipefitters from one union local were examined (111 in 1982, 49 in 1983). They were 147 of 288 active workers and 13 of 62 retired workers, all volunteers. Results were reported for 153 white male participants.
• Exposure: Asbestos exposure in pipe work in building construction and remodeling. This included mixing asbestos cement, working next to pipecoverers and fireproofing applicators, removing asbestos insulation from pipe, and using asbestos blankets near welding. No air sampling results were available. Duration of exposure was defined as total years worked as a plumber and pipefitter. Fiber types were not named.
• Main results:
  • Of the 153 white male participants, 28 (18.3%) had bilateral pleural thickening.
  • 12 participants (7.8%) had unilateral pleural thickening.
  • 12 participants (7.8%) had small, irregular opacities of profusion 1/0 or greater.
  • The 12 men with small opacities overlapped with the pleural groups: two of them had bilateral and two had unilateral pleural thickening.
  • Among the 86 participants with more than 20 years since first exposure, 27 (31.4%) had bilateral and 9 (10.5%) had unilateral pleural thickening.
  • Among the 67 participants with 20 or fewer years since first exposure, 1 (1.5%) had bilateral and 3 (4.5%) had unilateral pleural thickening.
  • In logistic regression controlling for pack-years and age, bilateral pleural thickening was associated with duration of exposure (p = .0025).
  • In another logistic regression model controlling for pack-years and age, bilateral pleural thickening was associated with time since first exposure (latency) (p = .0172).
  • Unilateral pleural thickening was significantly associated only with age (p = .0116), not with duration of exposure (p = .5532).
  • FVC percent predicted was associated with duration of exposure (p = .0058) but not with pack-years (p = .1555).
  • Parenchymal abnormalities had a significant but negative association with duration of exposure (p = .0432), controlling for pack-years and age.
• The authors' conclusion: The authors concluded that the study demonstrated asbestos-related diseases in this group of plumbers and pipefitters employed in building construction. They found that bilateral pleural thickening was the most prevalent finding.
• Limitations the authors state:
  • Participation was voluntary, so the sample was self-selected, and the results may overestimate the prevalence of asbestos-related diseases in the whole population.
  • Nonparticipants had shorter durations of exposure and shorter time since first exposure than participants.
  • There was no suitable control group, which made the low-profusion small opacities hard to interpret.
  • Normal shadows at the edges of the chest X-ray may be wrongly read as small plaques. The authors offered this as a possible explanation for the poor link between unilateral thickening and exposure.

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: Pipefitter, Spirometry, Diffusing Capacity (DLCO), Bilateral, Pleural Thickening, Asbestos Exposure.

Related studies

• Lung health among plumbers and pipefitters in Edmonton, Alberta — P.A. Hessel, L.S. Melenka, et al. (1998)
• Respiratory morbidity in workers exposed to asbestos in the primary manufacture of building materials — T.G. Robins, M.A. Green (1988)
• Occupational dermatoses and allergy to metals in Polish construction workers manufacturing prefabricated building units — M. Kieć-Swierczyńska (1990)
• Exposure of sheet-metal workers to asbestos during the construction and renovation of commercial buildings in New York City. A case study in social medicine — E. Drucker, D. Nagin, et al. (1987)
• Asbestos-related diseases in construction carpenters — M. García-Closas, D.C. Christiani (1995)
• The prevalence of pleural plaques and/or pulmonary changes among construction workers in Okayama, Japan — T. Kishimoto, K. Morinaga, et al. (2000)

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