Re: "US prevalence of occupational pleural thickening: a look at chest x-rays from the first National Health and Nutrition Examination Survey"

Our plain-English summary of Re: "US prevalence of occupational pleural thickening: a look at chest x-rays from the first National Health and Nutrition Examination Survey", by W.C. Cooper (American Journal of Epidemiology, 1989).

The study

• Author: W.C. Cooper
• Journal: American Journal of Epidemiology
• Published: 1989;129(1):229-30
• Type of article: Letter
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M nos. 000061, 000148).

In plain English

This was a letter to the editor with no new data. The author criticized a 1987 paper by Rogan and colleagues estimating US prevalence of occupational pleural thickening from chest x-rays in the first National Health and Nutrition Examination Survey. The author argued that the title was misleading because the paper had not shown the pleural changes were occupational. The author questioned the step from readings of "pleural abnormality consistent with pneumoconiosis" in 59 films to about 8 million people with asbestos exposure in the mid-1970s. The author said the paper did not address how the original 6,758 people were selected. The author noted that fat deposits and muscle shadows cannot always be ruled out on single films, and that the paper did not say whether changes were one- or two-sided, localized or diffuse, or calcified. The author concluded that the paper would have been useful had it only reported the prevalence of pleural abnormalities in a fairly large sample, if representative, with more detail on the abnormalities. The author called for studies linking x-ray findings with pathology and fiber analyses.

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 (critical commentary on a published paper); no new data
• Who was studied: No population was studied. The letter comments on Rogan et al., American Journal of Epidemiology 1987, which used chest films from the first National Health and Nutrition Examination Survey (an original population of 6,758 persons, with 1,166 films reviewed by the panel, as described in the letter)
• Exposure: Asbestos exposure, as estimated in the criticized paper from x-ray readings of pleural abnormality
• Main results:
  • The author argued that the criticized paper's title was misleading because it had not established that the pleural thickening was occupational
  • The author questioned the step from readings of "pleural abnormality consistent with pneumoconiosis" in 59 films to the conclusion of approximately 8 million people with asbestos exposure in the mid-1970s
  • The author stated that the criticized paper did not address how the original population of 6,758 persons was selected
  • The author noted that fat deposits and muscle shadows cannot always be ruled out by single films
  • The author stated that the criticized paper gave no information on whether changes were unilateral or bilateral, circumscribed or diffuse, or calcified
  • The author stated that radiologists are not expected to make decisions about causes
  • The author said the criticized paper's conclusion that one person with radiographic abnormalities represents six people with occupational exposure rested on a number of assumptions
• The authors' conclusion: The author concluded that the paper would have been a useful contribution if it had been limited to reporting the prevalence of pleural abnormalities in a fairly large sample (if representative) and had given more detail on their type, location, thickness and calcification. The author also concluded that studies correlating radiographic findings with pathologic findings and fiber analyses are needed

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Pleural Thickening, Chest X-Ray.

Related studies

• US prevalence of occupational pleural thickening. A look at chest X-rays from the first National Health and Nutrition Examination Survey — W.J. Rogan, B.C. Gladen, et al. (1987)
• Relationship of mortality, occupation, and pulmonary diffusing capacity to pleural thickening in the First National Health and Nutrition Examination Survey — D.P. Loomis, G.W. Collman, et al. (1989)
• X-ray evidence of increased asbestos exposure in the US population from NHANES I and NHANES II, 1973-1978. National Health Examination Survey — W.J. Rogan, N.B. Ragan, et al. (2000)
• Assessment of physicians' proficiency in reading chest radiographs for pneumoconiosis, based on a 60-film examination set with two factors constituting eight indices — T. Tamura, Y. Kusaka, et al. (2018)
• A survey of pleural thickening: its relation to asbestos exposure and previous pleural disease — (1972)
• Development, radiological zone patterns, and importance of diffuse pleural thickening in relation to occupational exposure to asbestos — H. Bohlig, A. Calavrezos (1987)

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