Radiology of asbestosis

Our plain-English summary of Radiology of asbestosis, by A. Solomon (Environmental Research, 1970).

The study

• Author: A. Solomon
• Journal: Environmental Research
• Published: 1970;3(4):320-9
• Cited by: 13 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. 001415).

Summary of the article

This article described the chest X-ray appearances of asbestosis in South African asbestos miners. The author reviewed the X-rays of 43 deceased asbestos workers whose chests had been X-rayed during their working lifetime. Most films were frontal chest radiographs. All the men had worked in crocidolite or amosite mines, and, as far as was known, in no other form of mining. Cases with complicating factors such as tuberculosis or neoplasms were excluded, so the review concerned uncomplicated asbestosis. The ore-bearing rock was noted to contain up to 40% free silica and substantial iron minerals. Findings included costophrenic blunting, noncalcified plaques along the lateral chest wall, calcified plaques, and fine, nodular, coarse and massive lung fibrosis. Serial X-rays of a father and son over 7 and 10 years showed early pleural calcification patterns that stayed unchanged apart from becoming denser. Massive fibrotic lesions of 2 to 10 cm were seen in six cases, without cavitation or calcification. No hilar lymph gland calcification or enlargement was seen, and no difference in lung patterns was attributed to amosite versus crocidolite. The author concluded that exposure, lung fibrosis and peripheral soft-tissue plaques together make the radiological diagnosis almost conclusive. Combined pleural and lung lesions were common. In South Africa, massive fibrosis was more common in asbestosis than in gold and coal workers' pneumoconioses, and basal massive fibrosis with pleural changes was almost diagnostic of asbestosis.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article described the chest X-ray appearances of asbestosis. The author reviewed X-rays taken during the working lives of 43 deceased asbestos workers who had all worked in crocidolite or amosite mines in South Africa. Cases with complicating conditions such as tuberculosis or tumours were excluded. Much of the article also discussed earlier published work by other researchers. Massive fibrotic lesions were seen in six of the reviewed cases, measuring 2 to 10 cm, and nodular fibrosis was also present in four of these six. No hilar calcification or enlarged glands were seen in any of the X-rays. The author found no significant difference in lung patterns that could be attributed to amosite versus crocidolite exposure. A shaggy heart outline was not a noticeable feature. The X-ray patterns did not always match the lung changes found after death. The author suggested that the high silica and iron content of South African mined asbestos rock may partly explain why these X-ray changes differed from an earlier description. The author concluded that combined pleural and lung lesions occur commonly in asbestosis and should alert the clinician to the diagnosis.

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: Descriptive review of chest radiographs from deceased asbestos workers with uncomplicated asbestosis, combined with discussion of published literature
• Who was studied: 43 deceased asbestos workers (miners) in South Africa who had chest X-rays taken during their working lifetime; most films were frontal chest radiographs
• Exposure: Work in crocidolite or amosite mines
• Main results:
  • Massive fibrotic lesions were seen in six of the reviewed cases
  • The areas of opacification from massive fibrosis ranged from 2 to 10 cm
  • Nodular fibrosis was also present in four of the six cases with progressive massive fibrosis
  • No hilar calcification or adenopathy was seen in any of the X-rays reviewed
  • No significant difference in lung patterns on X-ray could be attributed to amosite versus crocidolite exposure
  • A shaggy cardiac outline was not a noticeable feature in the X-rays reviewed
  • The X-ray patterns did not always correlate with post-mortem lung changes
• The authors' conclusion: The author concluded that combined pleural and parenchymal (lung) lesions occur commonly in asbestosis and should alert the clinician to the diagnosis
• Limitations the authors state:
  • The author suggested that the high silica and iron content of South African mined asbestos rock may be a reason the X-ray changes differed from an earlier published description
  • The author noted that surveys not using both higher kilovoltage and oblique views would be expected to find fewer plaques (most films reviewed were frontal)

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: Chest X-Ray, Crocidolite, Amosite, Neoplasm, Fibrosis, Pleural Calcification, Cavitation.

Related studies

• Radiological features of diffuse mesothelioma — A. Solomon (1970)
• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• Lymphocytic alveolitis and pleural calcifications in nonoccupational asbestos exposure. Protection against neoplasia? — S.H. Constantopoulos, Y.A. Dalavanga, et al. (1992)
• Clinical presentation of asbestosis with intractable pleural pain in the adult child of a taconite miner and radiographic demonstration of the probable pathology causing the pain — M.R. Harbut, C. Endress, et al. (2009)
• Asbestosis in South African asbestos miners — G.K. Sluis-Cremer (1970)
• Parenchymal and pleural fibrosis in construction workers — P. Oksa, H. Koskinen, et al. (1992)

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