Changes on radiographs of wives of workers exposed to asbestos

Our plain-English summary of Changes on radiographs of wives of workers exposed to asbestos, by L. Sider, E.A. Holland, T.M. Davis, et al (Radiology, 1987).

The study

• Authors: L. Sider, E.A. Holland, T.M. Davis, D.W. Cugell
• Journal: Radiology
• Published: 1987;164(3):723-6
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000356).

Abstract

Between January and March 1986, 117 wives of insulation workers exposed to asbestos were screened by means of chest radiography, pulmonary function testing, and a detailed questionnaire. The final study group included 93 women over 40 years of age. Eighteen of these (19.4%) demonstrated pleural changes consistent with asbestos exposure, including pleural plaque (88.9%), diaphragm plaque (27.8%), pleural calcification (16.6%), and diffuse pleural thickening (5.5%). In statistical correlation between the groups with normal and abnormal radiographs, the only factor that proved significant was the year of first exposure (the duration of the latent period). Finally, radiographs of the husbands were compared for 17 of the 18 wives with radiographic abnormalities. Fourteen of the husbands (82%) demonstrated more severe radiographic changes than their wives.

In plain English

Between January and March 1986, 117 wives of insulation workers were screened at a Chicago hospital with chest X-rays, breathing tests and a questionnaire. Virtually all said their exposure came mainly from shaking and washing their husbands' clothes; none had worked with asbestos. None of the 24 women under 40, all exposed for less than 8 years, had X-ray abnormalities, and they were excluded. Of the remaining 93, 18 (19.4%) had pleural changes consistent with asbestos exposure, mostly plaques. The X-rays showed no evidence of parenchymal (lung-tissue) opacities or chest cancer. Among exposure factors, only year of first exposure differed significantly: on average 1952 for women with abnormal X-rays versus 1958 for the others. Total years of exposure, number of exposed family members and age did not. Women with normal X-rays had smoked significantly more. Women with abnormal X-rays had significantly lower average FEV1 and FVC, though both stayed within the normal range; FEF(75-25) did not differ significantly. In 14 of 17 couples compared, the husband had more severe pleural changes. The authors concluded that chest radiography is a valuable tool.

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 screening study (voluntary screening program with chest radiographs, pulmonary function tests and a questionnaire)
• Who was studied: 117 wives of insulation workers screened from January to March 1986 at Northwestern Memorial Hospital, Chicago, through the local pipe coverers' union. The 24 women under 40 were excluded, leaving 93 women over 40 (75 with normal and 18 with abnormal radiographs).
• Exposure: Household exposure to asbestos from husbands (and in some cases fathers, brothers or sons) who were insulation workers (pipe coverers and asbestos removers), mainly through shaking and washing the workers' clothes. The women were not asbestos workers themselves. The fiber type is not stated.
• Main results:
  • None of the 24 women under 40 years of age had radiographic abnormalities, and each had been exposed for less than 8 years.
  • Of the 93 women over 40, 18 (19.4%) had radiographic abnormalities consistent with asbestos exposure, as defined by the ILO classification.
  • Among the 18 women with abnormalities, most had circumscribed plaques on the chest wall (88.9%).
  • Among the 18 women with abnormalities, plaques on the diaphragm were seen in six cases (33.3%). In two cases (11.1%) these were the only evidence of asbestos exposure.
  • Among the 18 women with abnormalities, calcification of plaques was seen in three cases (16.7%).
  • Among the 18 women with abnormalities, diffuse pleural thickening was present in one case (5.5%).
  • The radiographs showed only pleural changes, with no evidence of parenchymal opacities or thoracic malignancy.
  • Among the exposure factors, only the year of first exposure was statistically significant. The mean year of first exposure was 1952 for the 18 women with abnormal radiographs and 1958 for the 75 with normal radiographs (P less than .037).
  • Differences between the groups in total years of exposure (P less than .72), number of family contacts (P less than .89) and age (P less than .282) were not statistically significant.
  • Women with normal radiographs had a statistically greater smoking history than those with plaque formation (P less than .024). Mean pack-years were 36.66 in the normal group and 18.37 in the abnormal group.
  • Women with abnormal radiographs had statistically lower mean FEV1 (P less than .028) and FVC (P less than .011) than women with normal radiographs, but both mean values remained within the normal range.
  • FEF(75-25) did not differ significantly between the groups (P less than .456 in Table 2).
  • Radiographs of 17 of the 18 women with abnormal findings were compared with their husbands' radiographs. In 14 cases the husband had more severe pleural involvement, and six of these men also had parenchymal abnormalities. Three husbands had normal radiographs; their wives had only mild abnormalities.
  • The mean latency period was 32.8 years for the women and 23.8 years for the workers.
• The authors' conclusion: The authors concluded that pleural plaque appeared most dependent on the time since first household exposure, that the latency period appeared longer than with occupational exposure, and that, although data on household exposure risk are far from complete, chest radiography is a valuable tool.
• Limitations the authors state:
  • The lack of parenchymal opacities may reflect the smaller study population or a different type of exposure among pipe coverers.
  • The pulmonary function data were not corrected for smoking history.
  • Additional household contacts (a brother, a father, and a father and son) of the three women with more severe changes than their husbands did not take part in the study.
  • The authors described the functional (breathing-test) findings as somewhat difficult to interpret.

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: Insulator, Asbestos Exposure, Pleural Plaques, Diaphragm, Pleural Calcification, Diffuse Pleural Thickening.

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