Earlier study on asbestos workers, ILO scores, and oxygenation more comprehensive

Our plain-English summary of Earlier study on asbestos workers, ILO scores, and oxygenation more comprehensive, by D.D. Smith (Occupational and Environmental Medicine, 2003).

The study

• Author: D.D. Smith
• Journal: Occupational and Environmental Medicine
• Published: 2003;60(8):611; author reply 611
• Type of article: Comment, Letter
• Read it: PubMed · Publisher · Free full text

In plain English

This item is a published letter to the editor followed by the original authors' reply. It is not a research study and reports no new data. The letter's author, D D Smith, argued that a 2003 paper by Y C G Lee and colleagues presented no new information and failed to cite an earlier paper by Smith and Agostoni. The Lee paper compared chest x-ray (ILO) readings with drops in blood oxygen during exercise in people with asbestosis. The letter said the earlier paper measured the oxygen gap between the lungs and arterial blood directly, rather than estimating it by pulse oximetry. It added that pulse oximetry can be affected by motion artifact and anaemia. In reply, Lee and colleagues strongly disagreed. They said that in their study of 38 subjects with asbestosis, multivariate analysis found oxygen desaturation was independently predicted by DLco, the FEV1/FVC ratio and the number of zones affected on ILO scoring. The profusion score did not remain significant in that analysis. They questioned how the earlier study chose its asbestosis group of 27 and defended pulse oximetry as a standard method.

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 with the original authors' reply; no new data
• Who was studied: No new subjects. The letters discuss two earlier studies: Lee et al's 38 subjects with asbestosis (Perth), and Smith and Agostoni's 95 asbestos exposed workers, 27 of whom were placed in an asbestosis group
• Exposure: Asbestos exposure in workers; no fiber types are named
• Main results:
  • The letter argued that Lee et al failed to cite an earlier paper on the same subject
  • The letter said the earlier paper measured P(A-a)O2 directly rather than estimating it from oxygen saturation
  • The letter said pulse oximetry estimates are prone to error from factors including motion artifact, vasoconstriction, hypotension and anaemia
  • Lee and colleagues replied that they disagreed with both points
  • The reply restated the authors' own finding: arterial oxygen desaturation was independently predicted by DLco, the FEV1/FVC ratio and the number of affected zones on ILO scoring
  • The reply said the profusion score correlated with desaturation on linear regression but did not remain significant in the multivariate analysis
  • The reply questioned the earlier study's asbestosis group of 27, which included subjects without radiological evidence of asbestosis
  • The reply said Smith and Agostoni examined only the profusion score and did not do a multivariate analysis
  • The reply defended pulse oximetry as a standard, widely used method
• The authors' conclusion: The letter's author concluded that the same information was available more comprehensively in the earlier Smith and Agostoni paper. Lee and colleagues rejected the claim that their paper presented no new information.

Related studies

• Diffusing capacity and forced vital capacity in 5,003 asbestos-exposed workers: relationships to interstitial fibrosis (ILO profusion score) and pleural thickening — A. Miller, R. Warshaw, et al. (2013)
• Retinol supplementation and mesothelioma incidence in workers earlier exposed to blue asbestos (Crocidolite) at Wittenoom, Western Australia — H.S. Alfonso, A. Reid, et al. (2010)
• Variation in the peritoneal cancer index scores between surgeons and according to when they are determined (before or after cytoreductive surgery) — D. Elias, A. Souadka, et al. (2012)
• Relation of spirometric function to radiographic interstitial fibrosis in two large workforces exposed to asbestos: an evaluation of the ILO profusion score — A. Miller, R. Lilis, et al. (1996)
• Effects of Occupational Hazards on Job Stress and Mental Health of Factory Workers and Miners: A Propensity Score Analysis — Y. Lu, Z. Zhang, et al. (2020)
• Association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners: a propensity score analysis — Y. Lu, Z. Zhang, et al. (2021)

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