Pleural plaques by inhalation of asbestos fibers

Our plain-English summary of Pleural plaques by inhalation of asbestos fibers, by D. Delgado, O. Ramírez, N. Sultan, et al (Revista Brasileira de Medicina Do Trabalho, 2020).

The study

• Authors: D. Delgado, O. Ramírez, N. Sultan, P. Miranda, A. Delgado
• Journal: Revista Brasileira de Medicina Do Trabalho
• Published: 2020;18(2):241-245
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Asbestos fiber pleural plaque is characterized by lesions composed of fibrous tissue that are located in the parietal pleura. They usually appear in up to 3 to 58% of workers who were exposed to asbestos fiber, and 0.5 to 8% in the general population. The objective of this article is to present a case report of a patient whose chest x-ray showed pleural changes associated with exposure to asbestos fibers.

Case Report: A 49-year-old male patient, construction worker with a history of exposure to asbestos fibers, underwent a chest x-ray performed according to International Labor Organization (ILO) standards, which revealed focal pleural changes. Subsequently, the presence of pleural plaques was confirmed by computed tomography (CT) scan of the chest.

Discussion: Chest x-ray with ILO technique is the basic instrument for the identification of diseases related to asbestos fiber exposure. The study should be completed with a CT scan of the chest, whose sensitivity is greater, allowing early detection of pleural abnormalities. It is essential to obtain a detailed occupational history, since it is the most reliable and practical method to measure asbestos fiber exposure.

In plain English

This case report described one patient in Chile: a 49-year-old male construction worker without symptoms who had been exposed to asbestos fibers. He was examined in a Chilean preventive health program for people who had worked where asbestos can be found, or handled asbestos materials, but are no longer exposed. The article did not name the type of asbestos fiber or say how long he was exposed. A chest X-ray taken to International Labor Organization (ILO) standards showed focal changes in the pleura, the lining around the lungs, including at the level of the diaphragm. A chest CT scan then confirmed calcified pleural plaques, and the figure captions describe at least two of them on the right side of the chest wall. The authors concluded that an ILO chest X-ray is the basic tool for detecting asbestos-related disease and should be followed by a chest CT scan, which is more sensitive. They also concluded that a detailed work history is essential for measuring asbestos exposure. As a single case, it cannot show how often pleural plaques occur.

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 (a single patient)
• Who was studied: One 49-year-old male construction worker without symptoms, examined in a preventive health program under Chilean occupational law (Law 16,744). The date of the examination is not given.
• Exposure: A history of past occupational exposure to asbestos fibers as a construction worker, with no current exposure. The fiber type, products and duration of exposure are not specified.
• Main results:
  • The patient's chest X-ray, taken to ILO standards, showed focal pleural changes. They arose from the inner surface of the ribs and extended along the adjacent intercostal muscles and at the level of the diaphragm.
  • A chest CT scan of the patient confirmed calcified pleural plaques.
  • One CT image of the patient showed at least two pleural plaques with internal calcification on the front-side (anterolateral) wall of the right side of the chest.
  • Another CT image of the patient showed at least three calcified pleural plaques. The figure caption states that a location on the diaphragm is considered almost a defining sign of the disease.
• The authors' conclusion: The authors concluded that an ILO chest X-ray is the basic tool for identifying asbestos-related disease. They added that it should be completed with a chest CT scan, because CT is more sensitive and allows early detection of pleural abnormalities, and that a detailed occupational history is essential for measuring asbestos exposure.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Parietal Pleura, Chest X-Ray, CT Scan, Occupational History.

Related studies

• Detection of pleural plaques in workers exposed to inhalation of natural fluoro-edenite fibres — V. Rapisarda, C. Ledda, et al. (2015)
• Pleural plaques: a signpost of asbestos dust inhalation — E.N. Sargent, G. Jacobson, et al. (1977)
• Chronic inhalation toxicity of size-separated glass fibers in Fischer 344 rats — T.W. Hesterberg, W.C. Miiller, et al. (1993)
• Studies on the chronic toxicity (inhalation) of four types of refractory ceramic fiber in male Fischer 344 rats — R.W. Mast, E.E. McConnell, et al. (1995)
• Thirteen-week study of toxicity of fiber-like multi-walled carbon nanotubes with whole-body inhalation exposure in rats — T. Kasai, Y. Umeda, et al. (2015)
• Fiber localization and its relationship to lung reaction in rats after chronic inhalation of chrysotile asbestos — K.E. Pinkerton, P.C. Pratt, et al. (1984)

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