Respiratory findings among millwright and machinery erectors: identification of health hazards from asbestos in place at work

Our plain-English summary of Respiratory findings among millwright and machinery erectors: identification of health hazards from asbestos in place at work, by A. Fischbein, J.C. Luo, M. Lacher, et al (Environmental Research, 1993).

The study

• Authors: A. Fischbein, J.C. Luo, M. Lacher, S. Rosenfeld, A. Rosenbaum, A. Miller, S.J. Solomon
• Journal: Environmental Research
• Published: 1993;61(1):25-35
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos-associated diseases are prevalent in the construction trades primarily because of the previously widespread use of asbestos-containing insulation materials. Workers in metal-related trades, employed at construction sites and power facilities, but who do not routinely handle such materials as part of their work, may also be at risk for significant asbestos exposure. In order to evaluate such risk, a clinical field survey was conducted of 110 millwright and machinery erectors from the New York metropolitan area. A high prevalence of chest roentgenologic abnormalities was found. Forty-nine (44.5%) of the examined workers had pleural abnormalities consistent with asbestos-induced effects. Eighteen workers showed evidence of unilateral pleural thickening. Duration from onset of employment was significantly longer for those with pleural abnormalities (mean 32.3 years) as compared to those with normal chest radiographs (mean 18.5 years). Thirteen workers (11.8%) had radiographic signs of interstitial lung disease. The workers with pleural abnormalities had lower mean values of restrictive and obstructive lung function parameters than those with normal pleura. Multivariate and logistic regression analyses demonstrated association between duration of employment in the millwright trade and pleural abnormalities which was independent of smoking status. These findings suggest that millwright and machinery erectors employed in work environments where there is potential for primarily indirect exposure to airborne asbestos-containing dust are at risk for adverse effects from such exposure.

In plain English

This study examined millwrights and machinery erectors for asbestos-related health effects. The readable parts of the article describe 110 workers with a mean age of 49.3 years. Of these, 37 were current smokers, 20 were former smokers and 53 had never smoked. On chest X-rays, ten millwrights showed blunting of the costophrenic angle, a corner at the base of the lung. The authors described most pleural changes along the chest wall as circumscribed thickening (plaques). Rales, a crackling sound, were heard in 11 workers, and seven of them had pleural abnormalities. Breathing tests could be done on only 76 workers, and nine showed reduced FVC. Of the 13 workers with lung-tissue (parenchymal) abnormalities on X-ray, 11 had breathing tests, and eight of these showed reduced FVC. Among workers without lung-tissue disease, mean FVC was 102.8% of predicted with normal pleura, compared with 94.0% with one-sided and 96.0% with two-sided pleural changes. In logistic regression, the authors reported that pleural abnormalities were associated with duration of employment and time since first employment but not with smoking.

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: Clinical examination of a group of workers at one point in time (cross-sectional survey). It used chest X-rays, a symptom questionnaire, a physical examination and breathing tests
• Who was studied: 110 millwright and machinery erectors. Mean age 49.3 years (SD 14.4), with eight younger than 30. There were 37 current smokers, 20 ex-smokers and 53 never smokers
• Exposure: Work as millwrights and machinery erectors, a trade the authors studied for asbestos hazards. The readable text does not name specific fiber types or measured doses
• Main results:
  • Ten millwrights showed blunting of the costophrenic angle on their chest X-rays
  • The authors reported that the great majority of workers with pleural changes along the lateral chest wall had circumscribed pleural thickening (plaques)
  • End-inspiratory rales were heard in 11 workers. Seven of these 11 had pleural abnormalities
  • Of the 76 workers who had breathing tests, nine showed a decrease in FVC
  • Of the 13 workers with parenchymal (lung-tissue) abnormalities on X-ray, 11 had breathing tests. Eight of these 11 showed a decrease in FVC
  • Mean breathing-test values did not differ significantly between the smoking groups (current smokers, ex-smokers and never smokers)
  • This comparison covered workers with pleural findings but no lung-tissue (parenchymal) disease. Mean FVC was 102.8% of predicted with normal pleura, 94.0% with unilateral changes and 96.0% with bilateral changes (p = 0.05 compared with normal)
  • In the same comparison, mean FEV/FVC was 81.1% of predicted with normal pleura and 78.9% in both the unilateral and the bilateral groups (p less than 0.05 compared with normal)
  • In regression analysis, only duration of employment showed a significant association with the restrictive breathing measure (FVC)
  • Logistic regression analyses confirmed associations between pleural abnormalities, duration of employment and time since first employment in the trade. They found no association between smoking and pleural changes
• Limitations the authors state:
  • Technical considerations meant breathing tests could be done on only 76 of the 110 workers

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: Asbestos Exposure, Pleural Thickening, Chest X-Ray, Interstitial Lung Disease, Pleura.

Related studies

• The relationship between respiratory impairment and asbestos-related pleural abnormality in an active work force — J. Bourbeau, P. Ernst, et al. (1990)
• Respiratory health of workers exposed to metal dusts and foundry fumes in a copper refinery — G. Ostiguy, C. Vaillancourt, et al. (1995)
• Cardiorespiratory responses to incremental exercise in patients with asbestos-related pleural thickening and normal or slightly abnormal lung function — A. Miller, A. Bhuptani, et al. (1993)
• Exposure to tremolite asbestos and respiratory health in Swedish dolomite workers — A.I. Seldén, N.P. Berg, et al. (2001)
• Work-related respiratory health conditions among construction workers: a systematic narrative review — E.F. Boadu, S.R. Okeke, et al. (2023)
• The relationship between respiratory impairment and asbestos-related pleural abnormality in an active work force — J.E. Cotes, B. King (1991)

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