Pleural plaque related to asbestos mining in Taiwan

Our plain-English summary of Pleural plaque related to asbestos mining in Taiwan, by H.Y. Yang, J.D. Wang, P.C. Chen, et al (Journal of the Formosan Medical Association = Taiwan Yi Zhi, 2010).

The study

• Authors: H.Y. Yang, J.D. Wang, P.C. Chen, J.J. Lee
• Journal: Journal of the Formosan Medical Association = Taiwan Yi Zhi
• Published: 2010;109(12):928-33
• Type of article: Case report
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 78-year-old woman complained of twisting-like pain in her left lower chest. During physical examination, friction rubbing was noted in both lungs. Chest radiography showed extensive bilateral pleural calcification. High-resolution computed tomography confirmed the presence of bilateral calcified pleural plaques. The patient had worked at a Japanese asbestos factory in Taiwan for 1 year when she was 16 years old. Her job involved picking out asbestos fibers from crushed asbestos minerals, but no protective equipment was used at that time. This is believed to be the first reported case of asbestos-related disease in Taiwan that resulted from asbestos mining. We also summarize the history of domestic asbestos mining, importation of asbestos, and trends in asbestos use in Taiwan.

Copyright © 2010 Formosan Medical Association & Elsevier. Published by Elsevier B.V. All rights reserved.

In plain English

This was a case report from Taiwan, combined with the authors' review of the history of asbestos mining and use there. It described a 78-year-old woman examined in January 2006 after 3 months of left lower chest pain. She had never smoked. In 1944, at age 16, she had worked for 1 year in a Japanese asbestos manufactory, picking asbestos fibers out of crushed asbestos minerals without protective equipment. The fiber type she handled was not stated. A chest X-ray and high-resolution CT scan showed multiple calcified pleural plaques on both sides, with no change in the lung tissue. Her lung function tests were normal. The authors concluded that her pain was pleurisy caused by irritation from a large calcified plaque. The pain eased with treatment, and an X-ray a year later showed no further progression. The authors believed this was the first reported case in Taiwan of asbestos-related disease resulting from asbestos mining. They recommended that the community around the Fongtian mining areas be carefully monitored for asbestos-related diseases over the next 20 years.

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: Case report (one patient), with a summary of the history of asbestos mining, imports and use in Taiwan
• Who was studied: One 78-year-old woman in Taiwan, examined in January 2006 after 3 months of chest pain. She had no history of cigarette smoking, chest trauma or pulmonary tuberculosis.
• Exposure: In 1944, at age 16, she worked for 1 year in a Japanese asbestos manufactory picking out asbestos fibers from crushed asbestos minerals, with no protective equipment. The fiber type she handled is not stated. The article says Fongtian, the only asbestos mining area in Taiwan, produced actinolite, tremolite and chrysotile, but it does not explicitly say she worked there.
• Main results:
  • Chest radiography in this patient showed multiple bilateral calcified pleural plaques.
  • High-resolution CT in this patient showed multiple dense calcified plaques and thickened pleura in both lung fields, without change in the lung tissue (parenchyma).
  • This patient's lung function was normal: forced vital capacity 1.92 L (118.3% of predicted) and forced expiratory volume in 1 second 1.62 L (126.6% of predicted).
  • After ruling out other causes, the authors attributed this patient's left lower chest pain to pleurisy resulting from irritation by a large calcified pleural plaque.
  • This patient's symptoms gradually subsided with prescribed anti-inflammatory drugs, and follow-up chest radiography 1 year later showed no further progression.
  • The time since this patient's exposure (latency) was more than 60 years.
• The authors' conclusion: The authors believed this to be the first reported case of asbestos-related disease in Taiwan resulting from asbestos mining. They recommended that the community around the Fongtian mining areas be carefully monitored for asbestos-related diseases over the next 20 years.
• Limitations the authors state:
  • Because of the patient's frailty, diagnostic fiberoptic bronchoscopy and bronchoalveolar lavage were not performed.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Bilateral, Pleural Calcification, Asbestos.

Related studies

• Upcoming epidemic of asbestos-related malignant pleural mesothelioma in Taiwan: A prediction of incidence in the next 30 years — R.T. Lin, Y.Y. Chang, et al. (2019)
• Asbestos-related pleural diseases: dimensional criteria are not appropriate to differentiate diffuse pleural thickening from pleural plaques — J. Ameille, M. Matrat, et al. (2004)
• Absence of left-sided predominance in asbestos-related pleural plaques: a CT study — J.C. Gallego (1998)
• Pleural plaques in asbestos-exposed workers: reproducibility of a new high-resolution CT visual semiquantitative measurement method — G.S. Meirelles, J.I. Kavakama, et al. (2006)
• Present status of asbestos mining and related health problems in India--a survey — A.L. Ramanathan, V. Subramanian (2001)
• Asbestos-related cancer risk in patients with asbestosis or pleural plaques — J. Ameille, P. Brochard, et al. (2011)

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