Signs of asbestosis and impaired pulmonary function in women who worked in shipyards

Our plain-English summary of Signs of asbestosis and impaired pulmonary function in women who worked in shipyards, by K.H. Kilburn, R. Warshaw, J.C. Thornton (American Journal of Industrial Medicine, 1985).

The study

• Authors: K.H. Kilburn, R. Warshaw, J.C. Thornton
• Journal: American Journal of Industrial Medicine
• Published: 1985;8(6):545-52
• Cited by: 1 article, 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. 001215).

Abstract

Fifteen of 71 women (21.1%) who had worked in shipyards before May, 1961 had radiographic signs of asbestos disease. There were irregular opacities in the lung parenchyma in seven and pleural disease in eight, two of whom had pleural calcifications. The 71 women who volunteered to be studied had a mean age of 61.5 years. Chronic bronchitis was diagnosed in 21%, 71% had dyspnea on climbing two flights of stairs, and 42% had wheezing. These prevalences were 50% higher than in wives of shipyard workers. In 50 white women, mean values for expiratory flow rates, log (FEF25-75) and log (FEF75-85), were decreased for non-, ex- and current smokers as compared to normal nonsmokers. Ex-smokers and current smokers showed the greater effects. Diffusing capacity (DLCOsb) and alveolar volume (ALV) were also reduced in all three smoking categories. Comparison to a reference population without asbestos exposure showed that for current, ex- and nonsmoking subgroups, there were significant reductions in log (FEF25-75), DLCOsb, and ALV for nonsmokers, reductions in FEV1, log (FEV25-75), and log (FEF75-85) in ex-smokers, and reduced ALV in current smokers. These decreases may reflect a locality effect. Further studies are recommended.

In plain English

This study examined women in the Los Angeles area who had worked in shipyards, many during World War II. They volunteered in 1981 for health examinations along with shipyard workers' families. The examinations included a questionnaire, a chest examination, chest X-rays read by three physicians, and breathing tests. Of 71 women who were 20 or more years from their first shipyard job (mean age 61.5 years), 15 (21.1%) had X-ray signs of asbestos disease. Eight had pleural changes only, and seven had irregular opacities in the lung tissue. Among women 58 or older, 33% had such signs. Chronic bronchitis was found in 20.8%, breathlessness on climbing two flights of stairs in 71.8%, and wheezing in 42%. These rates were higher than among wives of shipyard workers. The authors compared 50 white women with Michigan women of the same smoking status, and some breathing measures were significantly reduced in every smoking group. The authors said this pattern was not the one attributed to asbestosis and suggested a locality effect, presumably air pollution. They noted that the volunteer group may have been biased and called for further studies.

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 health examination of volunteers: questionnaire, physical chest examination, chest radiographs classified by ILO 1980 criteria by three readers, and pulmonary function tests compared with reference populations
• Who was studied: 83 women shipyard workers among 1,017 volunteer shipyard workers and family members examined at Long Beach, California, in May 1981. All had started shipyard work before 1961. After removing 12 daughters who were fewer than 20 years from first shipyard employment, 71 women (mean age 61.5) were analyzed for asbestosis and symptoms. 50 white women with complete data were analyzed for pulmonary function.
• Exposure: Asbestos exposure from shipyard work. Women worked as welders and insulators during World War II, and some at other jobs later. The authors describe relatively heavy exposure lasting one to four years during wartime shipbuilding, plus household contact for those married to shipyard workers. Fiber types are not specified.
• Main results:
  • 15 of the 71 women who were 20 or more years from initial shipyard exposure (21.1%) had radiographic signs of asbestosis
  • Of these 15 women, eight had pleural changes only and seven had parenchymal irregular opacities with a profusion of 1/0 or greater
  • 33% of the women shipyard workers aged 58 years or older had signs of asbestos disease
  • Among the 71 women shipyard workers, 15 (20.8%) had chronic bronchitis and 51 (71.8%) reported dyspnea on climbing two flights of stairs
  • 30 (42%) of the women shipyard workers had noticed wheezing
  • Among wives of shipyard workers, cough was found in 25%, chronic bronchitis in 12.9% and dyspnea on two flights of stairs in 43.6%, lower than in the women workers
  • The authors compared the 21.1% asbestosis prevalence in women workers with 11.3% for wives and 64.2% for male shipyard workers from the same population sample
  • In white nonsmoking women workers compared with Michigan nonsmoking women, diffusing capacity (p less than 0.01), alveolar volume (p less than 0.002) and log FEF25-75 (p less than 0.01) were significantly reduced
  • In white ex-smoking women workers, FEV1, log FEF25-75 and log FEF75-85 were significantly reduced compared with Michigan ex-smoking women. Diffusing capacity, alveolar volume and thoracic gas volume were not significantly reduced.
  • In white current smokers, log FEF25-75 (p less than 0.0006), log FEF75-85 (p less than 0.001) and alveolar volume (p less than 0.02) were significantly reduced compared with Michigan current smokers
• The authors' conclusion: The authors concluded that women who had worked in shipyards and volunteered for examination showed a substantial level of asbestosis on chest radiographs. They stated that the pattern of lung function reductions was not the one attributed to asbestosis and appeared consistent with a locality effect, presumably ambient air pollution. They recommended further studies.
• Limitations the authors state:
  • The study group was made up of volunteers, and the authors state that bias may have affected it
  • Black women were excluded from the pulmonary function analysis because no smoking-specific reference population existed for them
  • The authors state that population-based studies of women shipyard workers in this and other regions are needed before the findings can be generalized
  • The authors note that breast shadows make irregular opacities on chest radiographs harder to interpret in women

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: Parenchyma, Pleural Calcification, Dyspnea, Diffusing Capacity (DLCO), Asbestos Exposure, FEV1.

Related studies

• Pulmonary functional impairment and symptoms in women in the Los Angeles Harbor area — K.H. Kilburn, R. Warshaw, et al. (1985)
• Asbestosis, pulmonary symptoms and functional impairment in shipyard workers — K.H. Kilburn, R. Warshaw, et al. (1985)
• Pulmonary function of nonsmoking female asbestos workers without radiographic signs of asbestosis — X.R. Wang, E. Yano, et al. (1998)
• Asbestos-induced pleural fibrosis and impaired lung function — D.A. Schwartz, L.J. Fuortes, et al. (1990)
• Pulmonary function in asbestosis and asbestos-related pleural disease — A. Miller (1993)
• Abnormal pulmonary function associated with diaphragmatic pleural plaques due to exposure to asbestos — K.H. Kilburn, R.H. Warshaw (1990)

Browse more research in American Journal of Industrial Medicine, or return to medical research.