Authors' response: A systematic review of the association between pleural plaques and changes in lung function

Our plain-English summary of Authors' response: A systematic review of the association between pleural plaques and changes in lung function, by L. Kopylev, K.Y. Christensen, J.W. Brown, et al (Occupational and Environmental Medicine, 2015).

The study

• Authors: L. Kopylev, K.Y. Christensen, J.W. Brown, G.S. Cooper
• Journal: Occupational and Environmental Medicine
• Published: 2015;72(9):685-6
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

In plain English

This is a short letter, not a new study. The authors, from the US Environmental Protection Agency, replied to criticism by Goodman and colleagues of the authors' earlier systematic review and meta-analysis of pleural plaques and lung function. They restated that their review found statistically significant 2–4% decrements in lung function in asbestos-exposed people with pleural plaques compared with asbestos-exposed people without abnormalities. They noted that a separate review by Kerper and colleagues reported 3–5% decrements. They wrote that the decrements were similar or larger when only studies without identified limitations were analysed. They also wrote that analyses limited to HRCT studies that excluded early signs of parenchymal changes showed the decrements could not be attributed to undetected asbestos-related disease. The authors concluded that their analysis did not support the suggestion that the results were due to study limitations, undetected disease, a biased analysis or excluded studies. They added that small but significant permanent changes in group mean lung function can indicate functional impairment at the population level.

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 (authors' response to a published comment) defending the authors' earlier systematic review and meta-analysis; no new data
• Who was studied: In the authors' earlier review: studies comparing asbestos-exposed people with pleural plaques against an internal comparison group of asbestos-exposed people without abnormalities. The letter does not give the number of studies or participants.
• Exposure: Asbestos exposure (fiber types not named in the letter); pleural plaques compared with no abnormalities
• Main results:
  • The authors' earlier review found statistically significant 2–4% decrements in lung function in asbestos-exposed people with pleural plaques, compared with asbestos-exposed people without abnormalities.
  • A separate review by Kerper et al (another research group) reported 3–5% decrements. The authors wrote that the conclusions of the two reviews about the size of the effect were well aligned.
  • In the authors' sensitivity analyses, the lung function decrements linked to pleural plaques were similar or larger in the meta-analysis of studies without identified limitations than in the meta-analysis of all studies.
  • The authors stated that analyses limited to HRCT studies that excluded early signs of parenchymal changes showed the decrements could not be attributed to undetected asbestos-related disease.
  • The authors wrote that the results of the five studies excluded from their review followed a pattern consistent with the included studies, and that these were not 'null' studies.
  • The authors stated that differences from Kerper et al's set of studies came from one foreign-language paper, one study published after their cut-off date, and the authors' more restrictive inclusion criteria, such as excluding studies that included people with asbestosis.
• The authors' conclusion: The authors concluded that their analysis does not support the suggestion that the results are due to methodological limitations of the studies, undetected asbestos-related disease, a biased analysis, or the exclusion of studies. They also wrote that small but significant permanent changes in group mean lung function can indicate functional impairment at the population level.

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: Systematic Review, Pleural Plaques.

Related studies

• A systematic review of the association between pleural plaques and changes in lung function — L. Kopylev, K.Y. Christensen, et al. (2015)
• Comment on "A systematic review of the association between pleural plaques and changes in lung function" by Kopylev et al (2014) — J.E. Goodman, L.E. Kerper, et al. (2015)
• 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)
• Systematic review of pleural plaques and lung function — L.E. Kerper, H.N. Lynch, et al. (2015)
• Radiological changes in asbestos cement workers — K. Jakobsson, U. Strömberg, et al. (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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