Physical activity in people with asbestos related pleural disease and dust-related interstitial lung disease: An observational study

Our plain-English summary of Physical activity in people with asbestos related pleural disease and dust-related interstitial lung disease: An observational study, by M.T. Dale, Z.J. McKeough, P.A. Munoz, et al (Chronic Respiratory Disease, 2015).

The study

• Authors: M.T. Dale, Z.J. McKeough, P.A. Munoz, P. Corte, P.T. Bye, J.A. Alison
• Journal: Chronic Respiratory Disease
• Published: 2015;12(4):291-8
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This study aimed to measure the levels of physical activity (PA) in people with dust-related pleural and interstitial lung diseases and to compare these levels of PA to a healthy population. There is limited data on PA in this patient population and no previous studies have compared PA in people with dust-related respiratory diseases to a healthy control group. Participants with a diagnosis of a dust-related respiratory disease including asbestosis and asbestos related pleural disease (ARPD) and a healthy age- and gender-matched population wore the SenseWear(®) Pro3 armband for 9 days. Six-minute walk distance, Medical Outcomes Study 36-item short-form health survey and the Hospital Anxiety and Depression Scale were also measured. Fifty participants were recruited and 46 completed the study; 22 with ARPD, 10 with dust-related interstitial lung disease (ILD) and 14 healthy age-matched participants. The mean (standard deviation) steps/day were 6097 (1939) steps/day for dust-related ILD, 9150 (3392) steps/day for ARPD and 10,630 (3465) steps/day for healthy participants. Compared with the healthy participants, dust-related ILD participants were significantly less active as measured by steps/day ((mean difference 4533 steps/day (95% confidence interval (CI): 1888-7178)) and energy expenditure, ((mean difference 512 calories (95% CI: 196-827)) and spent significantly less time engaging in moderate, vigorous or very vigorous activities (i.e. >3 metabolic equivalents; mean difference 1.2 hours/day (95% CI: 0.4-2.0)). There were no differences in levels of PA between healthy participants and those with ARPD. PA was reduced in people with dust-related ILD but not those with ARPD when compared with healthy age and gender-matched individuals.

© The Author(s) 2015.

In plain English

This prospective observational study, carried out in Sydney, Australia, between February 2009 and May 2012, measured physical activity in men with non-malignant dust-related lung disease and compared them with healthy men of similar age. Of 48 men recruited, 46 were analysed: 22 with asbestos related pleural disease (ARPD, defined as diffuse pleural thickening and/or rounded atelectasis), 10 with dust-related interstitial lung disease (ILD: 6 asbestosis, 3 silicosis, 1 mixed-dust pneumoconiosis) and 14 healthy controls. Participants wore an activity armband for nine days. Mean steps per day were 6097 in the dust-related ILD group, 9150 in the ARPD group and 10630 in the healthy group. The dust-related ILD group was significantly less active than the healthy group (4533 fewer steps per day, 95% CI 1888 to 7178) and than the ARPD group. No statistically significant differences in activity were found between the ARPD and healthy groups, although the authors stated the study was not powered to detect such a difference. The authors concluded that activity was reduced in people with dust-related ILD. They noted that the small sample limits how widely the findings apply.

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: prospective observational study comparing patients with a healthy control group
• Who was studied: Men in New South Wales, Australia, studied February 2009 to May 2012. 50 were screened and 48 recruited. 46 were analysed: 22 with ARPD, 10 with dust-related ILD (6 asbestosis, 3 silicosis, 1 mixed-dust pneumoconiosis) and 14 healthy controls aged 60 to 90. Patients were recruited through the Workers' Compensation Dust Diseases Board of New South Wales and respiratory physicians. People with mesothelioma, or with pleural plaques as their only manifestation of dust exposure, were excluded.
• Exposure: Participants were grouped by diagnosed non-malignant dust-related disease: ARPD (diffuse pleural thickening and/or rounded atelectasis) or dust-related ILD (asbestosis, silicosis, mixed-dust pneumoconiosis). No fiber types, jobs or doses were reported.
• Main results:
  • Mean (SD) steps per day: 6097 (1939) in the dust-related ILD group, 9150 (3392) in the ARPD group and 10630 (3465) in the healthy group.
  • Compared with the healthy group, the dust-related ILD group had a significant decrease in all physical activity outcomes (all p less than 0.05).
  • Healthy group minus dust-related ILD group: mean difference of 4533 steps per day (95% CI 1888 to 7178).
  • Healthy group minus dust-related ILD group: mean difference in energy expenditure of 512 calories per day (95% CI 196 to 827).
  • Healthy group minus dust-related ILD group: mean difference in time spent above 3 METs (moderate, vigorous or very vigorous activity) of 1.2 hours per day (95% CI 0.4 to 2.0).
  • Compared with the ARPD group, the dust-related ILD group also had significantly lower physical activity on all outcomes (all p less than 0.05). The ARPD group minus the dust-related ILD group was a mean of 3053 steps per day (95% CI 616 to 5489).
  • No differences in physical activity measures were found between the ARPD group and the healthy control group.
  • Both the ARPD group (mean 483 m) and the dust-related ILD group (mean 462 m) had significantly lower six-minute walk distance than the healthy group (mean 584 m).
  • Compared with the ARPD group, the dust-related ILD group had lower six-minute walk distance, health-related quality of life, DLCO and KCO, and higher depression scores.
  • In the ARPD group, steps per day were significantly correlated with the SF-36 Role Physical domain. No other correlations between activity and quality-of-life measures were found.
• The authors' conclusion: The authors concluded that physical activity was reduced in people with dust-related ILD compared with people with ARPD and with healthy age- and gender-matched individuals. They called for further studies of the effects of low activity and of ways to increase it in people with dust-related ILD.
• Limitations the authors state:
  • The small sample size limits how far the findings can be generalized to all people with ARPD or dust-related ILD.
  • A post hoc calculation indicated the study was not powered to detect a difference between the ARPD group and the healthy group. No sample size was calculated in advance.
  • None of the patients were on oxygen therapy, so the findings cannot be generalized to people with severe disease on oxygen therapy.
  • The accuracy of the activity armband in people with dust-related respiratory diseases is unknown.

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: Interstitial Lung Disease, Six-Minute Walk Test, confidence interval.

Related studies

• Exercise training for asbestos-related and other dust-related respiratory diseases: a randomised controlled trial — M.T. Dale, Z.J. McKeough, et al. (2014)
• Functional exercise capacity and health-related quality of life in people with asbestos related pleural disease: an observational study — M.T. Dale, Z.J. McKeough, et al. (2013)
• Exercise training to improve exercise capacity and quality of life in people with non-malignant dust-related respiratory diseases — M.T. Dale, Z.J. McKeough, et al. (2015)
• Factors influencing exercise performance in thoracic cancer — R. England, M. Maddocks, et al. (2012)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)
• Effect of induction chemotherapy on lung function and exercise capacity in patients affected by malignant pleural mesothelioma — G. Marulli, F. Rea, et al. (2010)

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