Lung Function Profiles among Individuals with Nonmalignant Asbestos-related Disorders

Our plain-English summary of Lung Function Profiles among Individuals with Nonmalignant Asbestos-related Disorders, by E.K. Park, D.H. Yates, D. Wilson (Safety and Health at Work, 2014).

The study

• Authors: E.K. Park, D.H. Yates, D. Wilson
• Journal: Safety and Health at Work
• Published: 2014;5(4):234-7
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Inhalation of asbestos fibers can lead to adverse health effects on the lungs. This study describes lung function profiles among individuals with nonmalignant asbestos-related disorders (ARDs).

Methods: The study population was from the Workers' Compensation (Dust Diseases) Board of New South Wales, Sydney, Australia. Lung function measurements were conducted in males with asbestosis (n = 26), diffuse pleural thickening (DPT; n = 129), asbestosis and DPT (n = 14), pleural plaques only (n = 160) and also apparently healthy individuals with a history of asbestos exposure (n = 248). Standardized spirometric and single-breath diffusing capacity for carbon monoxide (DLCO) measurements were used.

Results: Mean age [standard deviation (SD)] was 66.7 (10.3) years for all participants. Current and ex-smokers among all participants comprised about 9.0% and 54.8%, respectively. Median pack-years (SD) of smoking for ex- and current-smokers were 22.7 (19.9). Overall 222 participants (38.6%) and 139 participants (24.2%) had forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measurements < 80% predicted, and 217 participants (37.7%) had FEV1/FVC results < 70%. A total of 249 individuals (43.8%) had DLco values < 80% predicted and only 75 (13.2%) had DLco/VA results < 80% predicted. A total of 147 participants (25.6%) had peak expiratory flow (PEF) measurements < 80% predicted. The presence of ARDs lowered the lung function measurements compared to those of healthy individuals exposed to asbestos.

Conclusion: Lung function measurement differs in individuals with different ARDs. Monitoring of lung function among asbestos-exposed populations is a simple means of facilitating earlier interventions.

In plain English

This study compared lung function test results among 577 men seen at the Workers' Compensation (Dust Diseases) Board of New South Wales in Sydney, Australia, using data from an existing study population. The men were grouped as having asbestosis (26), diffuse pleural thickening (129), both asbestosis and diffuse pleural thickening (14), or pleural plaques only (160), or as apparently healthy with a history of asbestos exposure (248). The authors reported that average FEV1, FVC and diffusing capacity (DLco), measured as percent of predicted, were significantly lower in each disease group than in the apparently healthy exposed men. For example, mean DLco was 59.6% of predicted with asbestosis, 83.6% with pleural plaques and 90.6% in the apparently healthy group. Adjusting for age, smoking pack-years and body mass index gave similar results. The authors noted that the amount of asbestos exposure was not assessed. They concluded that lung function differed between these groups and that regular lung function monitoring of asbestos-exposed people is a simple tool to support earlier interventions.

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: Comparison of lung function measurements across disease groups, using data from an existing study population (a single measurement per person; no follow-up over time is described)
• Who was studied: 577 males at the Workers' Compensation (Dust Diseases) Board of New South Wales, Sydney, Australia: asbestosis (n = 26), diffuse pleural thickening (n = 129), asbestosis and diffuse pleural thickening (n = 14), pleural plaques only (n = 160), and apparently healthy individuals formerly exposed to asbestos (n = 248). Mean age was 66.7 (SD 10.3) years. Study dates are not given.
• Exposure: A history of asbestos exposure, documented through a standardized occupational history. Fiber types, products, jobs and doses are not reported, and the authors state that exposure assessment data were not collected.
• Main results:
  • Unadjusted mean FEV1 as percent of predicted (SD): asbestosis 78.4 (14.0), diffuse pleural thickening 69.5 (16.4), asbestosis plus diffuse pleural thickening 68.6 (11.7), pleural plaques 85.9 (18.4), compared with 92.5 (17.2) in apparently healthy exposed individuals. The authors reported p less than 0.0001.
  • Unadjusted mean FVC as percent of predicted (SD): asbestosis 81.9 (15.8), diffuse pleural thickening 79.4 (16.0), asbestosis plus diffuse pleural thickening 71.4 (13.2), pleural plaques 94.7 (14.9), compared with 100.2 (14.6) in apparently healthy exposed individuals. The authors reported p less than 0.0001.
  • Unadjusted mean DLco as percent of predicted (SD): asbestosis 59.6 (14.1), diffuse pleural thickening 72.7 (16.6), asbestosis plus diffuse pleural thickening 62.2 (17.8), pleural plaques 83.6 (17.7), compared with 90.6 (18.9) in apparently healthy exposed individuals. The authors reported p less than 0.0001.
  • Among all participants, 222 (38.6%) had FEV1 below 80% of predicted and 139 (24.2%) had FVC below 80% of predicted. 249 (43.8%) had DLco below 80% of predicted.
  • After adjustment for age, smoking pack-years and body mass index, the lung function profiles were similar to the unadjusted ones. The apparently healthy exposed group had better lung function than those with asbestos-related disorders, with differences across all groups statistically significant (p less than 0.0001).
  • Adjustment lowered lung function values only in the apparently healthy group. For example, mean FEV1 percent predicted in that group was 92.5 unadjusted and 90.4 adjusted.
• The authors' conclusion: The authors concluded that lung function differed significantly in individuals with asbestos-related disorders compared with currently healthy individuals with past asbestos exposure, and that regular monitoring of lung function among asbestos-exposed populations is a simple tool to facilitate earlier interventions.
• Limitations the authors state:
  • Asbestos exposure was not assessed because the data were not collected.

Topics

Medical terms in this study, explained in our Lexicon: Diffuse Pleural Thickening, Pleural Plaques, Asbestos Exposure, Diffusing Capacity (DLCO), FEV1, FEV1/FVC Ratio.

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• Lung function and respiratory symptoms in subjects with asbestos-related disorders: a cross-sectional study — B. Hilt, J.T. Lien, et al. (1987)
• Breath analysis in asbestos-related disorders: a review of the literature and potential future applications — E.A. Chapman, P.S. Thomas, et al. (2010)
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• Lung function profiles in the chrysotile asbestos mines and mills of Quebec — M.R. Becklake, G. Fournier-Massey, et al. (1976)

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