Pleural determinants of restrictive lung function and respiratory symptoms in an asbestos-exposed population

Our plain-English summary of Pleural determinants of restrictive lung function and respiratory symptoms in an asbestos-exposed population, by P.H. Wright (Chest, 1993).

The study

• Author: P.H. Wright
• Journal: Chest
• Published: 1993;104(4):1314-5
• Type of article: Comment, Letter
• Read it: PubMed · Publisher

In plain English

In a letter to the editor with no new data, the author responded to a 1992 Chest article by Broderick and colleagues. That article cited a 1980 paper co-written by the author as support for the view that reduced diffusing capacity in people with pleural disease but normal-looking lungs on x-ray suggests underlying lung disease. The author wrote that the paper reported the finding but not that conclusion. The patients' transfer coefficient values fell within published limits for healthy people, which relate the coefficient to lung volume, so the results could all have been due to pleural restriction of lung expansion. Their earlier work, the author stated, showed CT can show normal lungs in such cases. This evidence, the author stated, led the United Kingdom to prescribe diffuse bilateral asbestos-induced pleural thickening as an industrial disease separate from asbestosis. In a reply, David A. Schwartz agreed that asbestos-induced pleural fibrosis is independently associated with restrictive lung function. The reply cited its authors' earlier finding of high-resolution CT abnormalities consistent with asbestosis in over 50 percent of individuals with pleural disease and normal-appearing parenchyma on chest x-ray, and called the process likely multifactorial.

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 (correspondence) commenting on a published article, followed by a reply; no new study data
• Who was studied: No study population. The letter refers to patients in the author's earlier 1980 paper on respiratory function after asbestos pleurisy; no numbers are given
• Exposure: Asbestos-induced pleural thickening; no fiber types, jobs or doses are named
• Main results:
  • The author stated that the cited 1980 paper reported reduced diffusing capacity in patients with pleural disease but did not conclude that this indicated parenchymal disease
  • The author noted that impaired chest expansion reduces the transfer factor but raises the transfer coefficient
  • The author stated that the 1980 patients' transfer coefficient results fell within limits for healthy subjects published by Lipscomb and colleagues, which describe the coefficient in relation to lung volume
  • The author stated that their earlier work showed computed tomography can show normal lungs in cases with abnormalities explicable by pleural thickening
  • The author stated that this evidence, confirmed by others, led to diffuse bilateral asbestos-induced pleural thickening being prescribed as an industrial disease in the United Kingdom separate from asbestosis
  • The author argued that if such cases were diagnosed as asbestosis, most patients diagnosed and compensated that way would not have asbestosis
  • In the reply, Schwartz agreed that asbestos-induced pleural fibrosis is independently associated with restrictive lung function
  • The reply cited the reply authors' previous finding that over 50 percent of individuals with pleural disease and normal-appearing parenchyma on chest x-ray had high-resolution CT abnormalities consistent with asbestosis
• The authors' conclusion: The author concluded that the 1980 results did not require parenchymal disease as an explanation and could all have been due to pleural restriction of lung expansion

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: Restrictive Lung Disease.

Related studies

• Pleural determinants of restrictive lung function and respiratory symptoms in an asbestos-exposed population — A. Broderick, L.J. Fuortes, et al. (1992)
• Determinants of restrictive lung function in asbestos-induced pleural fibrosis — D.A. Schwartz, J.R. Galvin, et al. (1990)
• Determinants of restrictive lung function in asbestos-induced pleural fibrosis — C.J. Bergin (1991)
• Metsovo lung: pleural calcification and restrictive lung function in northwestern Greece. Environmental exposure to mineral fiber as etiology — S.H. Constantopoulos, J.A. Goudevenos, et al. (1985)
• Restrictive lung function and asbestos-induced pleural fibrosis. A quantitative approach — D.A. Schwartz, J.R. Galvin, et al. (1993)
• Determinants of respiratory symptoms in insulation workers exposed to asbestos and synthetic mineral fibres — P. Ernst, S. Shapiro, et al. (1987)

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