Atherosclerotic and pleural calcifications are related among asbestos-exposed workers

Our plain-English summary of Atherosclerotic and pleural calcifications are related among asbestos-exposed workers, by T. Vehmas, A. Hiltunen, L. Kivisaari, et al (European Journal of Cardiovascular Prevention and Rehabilitation, 2008).

The study

• Authors: T. Vehmas, A. Hiltunen, L. Kivisaari, P. Leino-Arjas
• Journal: European Journal of Cardiovascular Prevention and Rehabilitation
• Published: 2008;15(5):599-601
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Methods: We studied the relationship between calcified chest atherosclerosis and pleural plaques among 505 construction workers with computed tomography. The extent and thickness of pleural plaques and the score of visceral pleural thickening were estimated, as was calcification of both pleural disease and chest atherosclerosis.

Results: Adjusted for age, BMI, smoking, and asbestos exposure, pleural calcification was associated with calcification in coronary arteries (P<0.001) and in the aorta (P<0.001).

Conclusion: These associations may be due to susceptibility factors common to both conditions. Calcification in pleural plaques may be a hint of atherosclerosis at least among asbestos-exposed people.

In plain English

The authors studied whether calcium deposits in pleural plaques (thickened patches on the lung lining, usually linked to asbestos) were related to calcium deposits in chest arteries, a sign of atherosclerosis. They retrospectively analysed lung cancer screening CT scans of 505 male Finnish construction workers aged 39 to 81. The workers were drawn from earlier studies of workers with occupational chest disease and had on average 26 years of asbestos exposure. Radiologists blinded to clinical data scored the pleural changes and the calcification in the coronary arteries, the aorta and the arteries leaving the aortic arch. The analyses adjusted for age, smoking, years of asbestos exposure and body mass index. Pleural plaque calcification was associated with coronary calcification (B = 0.414, 95% CI 0.186 to 0.642, P < 0.001) and with aortic calcification (B = 0.413, 95% CI 0.181 to 0.645, P < 0.001), but not significantly with calcification in arteries leaving the aortic arch. Plaque thickness, plaque extent and visceral fibrosis showed no significant associations. Adding C-reactive protein, an inflammation marker, did not remove the associations. The authors suggested a shared individual susceptibility to calcification.

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: Retrospective analysis of chest CT scans and clinical data from an earlier CT lung cancer screening, using ordinal regression
• Who was studied: 505 male construction workers in Finland, aged 39 to 81 years (mean 63), selected from previous studies on workers with occupational chest disease and screened with CT for lung cancer. Women were excluded because of a major imbalance in the sex ratio. 180 had one or more previously diagnosed cardiovascular diseases. The years of examination are not stated.
• Exposure: Asbestos exposure in construction work, measured as duration: mean 26 years (range 2 to 48 years). Fiber types are not specified.
• Main results:
  • Adjusted for age, smoking pack-years, years of asbestos exposure and body mass index, the pleural plaque calcification score was associated with the coronary artery calcification score (B = 0.414, 95% confidence interval 0.186 to 0.642, P < 0.001).
  • With the same adjustment, the pleural plaque calcification score was associated with the aortic calcification score (B = 0.413, 95% confidence interval 0.181 to 0.645, P < 0.001).
  • Pleural calcification was not significantly associated with calcification in the arteries originating from the aortic arch (B = 0.203, 95% confidence interval -0.037 to 0.443, P = 0.098).
  • Plaque thickness, plaque extent and visceral pleural fibrosis were not significantly associated with artery calcification in the models. For example, plaque thickness and the aortic score gave B = -0.415, 95% confidence interval -0.859 to 0.029, P = 0.067.
  • Adding serum C-reactive protein (CRP) to the models did not eliminate the associations.
  • There was a slight relation between serum CRP and pleural calcification (B = 0.648, 95% CI: 0.035 to 1.261, P = 0.038).
• The authors' conclusion: The authors concluded that asbestos exposure did not seem to explain the association. They suggested that an individual susceptibility factor may link a tendency to calcification in both the pleura and the arteries, possibly through a common inflammatory cause. In their view, calcified plaques found incidentally should raise the suspicion of atherosclerosis, at least among asbestos-exposed people.
• Limitations the authors state:
  • The authors stated that the finding should be verified in other populations with different exposure patterns.
  • The authors stated that it remains to be studied whether these pleural findings are associated with increased cardiovascular illness or death.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Calcification, Pleural Plaques, Pleural Thickening, Asbestos Exposure.

Related studies

• The occurrence of pleural calcification among asbestos insulation workers — I.J. Selikoff (1965)
• Pleural calcifications — E. Marchiori, B. Hochhegger, et al. (2018)
• Visually scored calcifications in thoracic arteries predict death: follow-up study after lung cancer CT screening — T. Vehmas (2012)
• Tremolite whitewashing and pleural calcifications — S.H. Constantopoulos, N.A. Saratzis, et al. (1987)
• CT demonstration of interlobar fissure calcification due to asbestos exposure — S.D. Rockoff (1987)
• Pleural calcification in pancreatitis demonstrated by computed tomography — G.M. Bydder, L. Kreel (1981)

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