Changing patterns in asbestos-induced lung disease

Our plain-English summary of Changing patterns in asbestos-induced lung disease, by P. De Vuyst, P.A. Gevenois, A. Van Muylem, et al (Chest, 2004).

The study

• Authors: P. De Vuyst, P.A. Gevenois, A. Van Muylem, J.C. Yernault
• Journal: Chest
• Published: 2004;126(3):999
• Type of article: Letter, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor reporting no new data. The authors, from Erasme Hospital in Brussels, Belgium, commented on an earlier article by Ohar and colleagues. That article studied 3,327 asbestos-exposed workers and concluded that asbestos-related disease today shows low chest X-ray (ILO) scores and normal or obstructive lung function. The letter's authors questioned that study's methods. They argued that thin-section CT scans have been shown to outperform X-rays in patients with chronic diffuse infiltrative lung disease, that the X-rays were read by one reader instead of several, and that workers with high ILO scores were older and smoked more, factors that themselves affect X-rays. They also argued that the lung function cut-offs ignored normal ageing and might have misclassified people. The authors stated that severe asbestosis is now rarely seen and that most asbestos-related lesions are pleural plaques and diffuse pleural thickening. They added that the earlier study showed no evidence that asbestosis or diffuse pleural thickening could lead to an obstructive defect, which they said usually comes from longstanding smoking.

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 to the editor commenting on another published study (Ohar et al, Chest, February 2004); no original data
• Who was studied: No population of the letter's own. It discusses the 3,327 asbestos-exposed workers studied by Ohar et al. The letter's authors are at Erasme Hospital, Brussels, Belgium.
• Exposure: Asbestos exposure of the workers in the Ohar et al study. The letter gives no fiber types, products, jobs or doses.
• Main results:
  • The authors stated that thin-section CT scanning has been extensively demonstrated to be superior to radiography in patients with chronic diffuse infiltrative lung disease. They argued that small opacities should therefore be considered more carefully as a reflection of asbestos-related disease unless CT had been performed.
  • The authors noted that in the Ohar et al study the radiographs were assessed by one reader only rather than several independent readers, as recommended
  • The authors noted that in the Ohar et al study the subjects with high ILO scores were older and smoked more. They stated that both factors influence small irregular opacities even in people not exposed to asbestos.
  • The authors argued that the restrictive defect should be defined by a total lung capacity below normal values, not by FVC as Ohar et al did
  • The authors argued that the obstruction criterion used did not account for the normal decline of the FEV1/FVC ratio with age. They stated the lower limit of normal is very close to 65% at age 65.
  • The authors suggested these limitations might have led to misclassification of individuals into lung function categories
  • The authors stated that severe asbestosis is now rarely observed and that most asbestos-related lesions are pleural plaques and diffuse pleural thickening
  • The authors stated that asbestosis and diffuse pleural thickening, if extensive, can be associated with a restrictive defect
• The authors' conclusion: The authors concluded that the Ohar et al study does not show any evidence that asbestosis or diffuse pleural thickening could lead to an obstructive defect. In the authors' view, such a defect is usually caused by longstanding smoking.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Related studies

• Changing patterns in asbestos-induced lung disease — J. Ohar, D.A. Sterling, et al. (2004)
• Failure to prove asbestos exposure produces obstructive lung disease — D.D. Smith (2004)
• Aquaporins in lung health and disease: Emerging roles, regulation, and clinical implications — E. Yadav, N. Yadav, et al. (2020)
• Dendritic Cells in Human Lung Disease: Recent Advances — J.W. Upham, Y. Xi (2017)
• Asbestos-related pleural plaques and lung function — L.C. Oliver, E.A. Eisen, et al. (1988)
• Airways obstruction among older construction and trade workers at Department of Energy nuclear sites — J.M. Dement, L. Welch, et al. (2010)

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