Pulmonary functional impairment and symptoms in women in the Los Angeles Harbor area

Our plain-English summary of Pulmonary functional impairment and symptoms in women in the Los Angeles Harbor area, by K.H. Kilburn, R. Warshaw, J.C. Thornton (The American Journal of Medicine, 1985).

The study

• Authors: K.H. Kilburn, R. Warshaw, J.C. Thornton
• Journal: The American Journal of Medicine
• Published: 1985;79(1):23-8
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001218).

Abstract

Spirometric measurements of vital capacity and flow rates, thoracic gas volume, and single-breath diffusing capacity for carbon monoxide were obtained in 360 white women, 238 wives age 58 years and 122 daughters age 32 years of shipyard workers from the Long Beach area of southern California. The values for nonsmokers, exsmokers, and current smokers were compared with smoking-specific mean values, age- and height-adjusted, from a reference population in Michigan. The wives from Long Beach had significantly lower mid and terminal flows, single-breath diffusing capacity for carbon monoxide, and alveolar volume, except that single-breath diffusing capacity for carbon monoxide was not significantly lower in current smokers. Nonsmokers and ex-smokers showed significantly different values for one-second forced expiratory volume in addition to flow rates and single-breath diffusing capacity for carbon monoxide. Daughters showed significant reductions in single-breath diffusing capacity for carbon monoxide and alveolar volume, which are attributable to maldistribution of inspired gas. These data showed that a powerful factor has affected expiratory air flow and distribution of gas, resulting in altered single-breath diffusing capacity for carbon monoxide and alveolar volume in this population. The factor is additive with and resembles the effect of cigarette smoking, and it is postulated that this factor is oxidant air pollution.

In plain English

This study tested lung function in 360 white women in the Long Beach area in May 1981. They were wives and 122 daughters (age 32) of shipyard workers who had begun shipyard work at least 20 years earlier; the article gives the wives' age as both 56 and 58. They had volunteered to be checked for signs of asbestos disease. Results were compared, smoking group by smoking group, with a random sample of 574 Michigan women. Vital capacity and total lung volume did not differ from reference values in any smoking group. Wives in all three smoking groups had significantly lower mid and terminal expiratory flows. Diffusing capacity for carbon monoxide was significantly reduced in all three smoking groups of daughters but only in nonsmoking and ex-smoking wives. Lung function did not differ between the 31 wives and three daughters with X-ray signs of asbestosis and women without such signs. The authors concluded that asbestos effects on lung function were undetectable here. They postulated a cumulative factor, possibly oxidant air pollution. They could not calculate how long the women had lived in the area.

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: cross-sectional survey of volunteers, compared with a smoking-specific reference population
• Who was studied: 360 white women (wives and 122 daughters) of 336 shipyard workers in the Long Beach area, examined in May 1981. Daughters were age 32. The wives' age is given as 56 in the article's abstract and as a mean of 58 for the women in the discussion. A reference group of 574 Michigan women was studied in 1978. The study also included 77 white sons (mean age 29).
• Exposure: Household or family exposure to asbestos from husbands and fathers who worked in shipyards and had begun shipyard work 20 years or more before the survey. No fiber type is named. The authors also considered cigarette smoking and, as a postulated factor, oxidant air pollution.
• Main results:
  • Forced vital capacity and total lung volume did not differ from reference values in any smoking group. The Results section describes this as a comparison with Michigan. The Methods, however, say total lung volume was compared with a national reference population.
  • Wives in all three smoking groups had significantly reduced mid and terminal expiratory flows compared with Michigan women.
  • Terminal expiratory flow as percent of predicted was 86.6 percent in nonsmoking wives, 75.9 percent in ex-smoking wives and 70.7 percent in current-smoking wives. In daughters it was 114.4 percent in nonsmokers, 100.2 percent in ex-smokers and 90.8 percent in current smokers.
  • Diffusing capacity for carbon monoxide was significantly reduced in all three smoking groups of daughters, and in nonsmoking and ex-smoking wives. It was not significantly reduced in current-smoking wives.
  • 31 wives (11.3 percent) and three daughters (2.1 percent) had radiographic signs of asbestosis. Their pulmonary function did not differ from that of women without such signs.
  • A prior medical diagnosis of chronic bronchitis was reported by 23.5 percent of never-smoking wives and daughters, compared with 1.2 percent of nonsmokers in the Michigan cohort.
  • Among the 77 sons, only nonsmokers showed significant differences from Michigan males, and only for diffusing capacity and alveolar volume, not flow rates.
• The authors' conclusion: The authors concluded that effects of asbestos exposure on lung function were undetectable in this population. They postulated an adverse, cumulative exposure, additive to cigarette smoking, which they suggested may be oxidant air pollution.
• Limitations the authors state:
  • The authors could not calculate how long subjects had lived in the Long Beach-South Bay area. They called for a further study designed to look specifically at air pollution.
  • Only white subjects were analyzed, because of uncertainty about differences in lung function measurements between blacks and whites.

Topics

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

Medical terms in this study, explained in our Lexicon: Diffusing Capacity (DLCO).

Related studies

• Asbestosis, pulmonary symptoms and functional impairment in shipyard workers — K.H. Kilburn, R. Warshaw, et al. (1985)
• Pulmonary functional impairment from years of arc welding — K.H. Kilburn, R.H. Warshaw (1989)
• Signs of asbestosis and impaired pulmonary function in women who worked in shipyards — K.H. Kilburn, R. Warshaw, et al. (1985)
• Symptoms and pulmonary functions as measures of morbidity — M.R. Becklake (1994)
• Role of exercise testing in assessing functional respiratory impairment due to asbestos exposure — J. Howard, Z. Mohsenifar, et al. (1982)
• Exercise performance and functional impairment in asbestos-exposed workers — J. Pearle (1981)

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