The follow-up study of skin reactivity to recall antigens and E- and EAC-RFC profiles in blood in asbestos workers

Our plain-English summary of The follow-up study of skin reactivity to recall antigens and E- and EAC-RFC profiles in blood in asbestos workers, by A. Lange, G. Skibiński, D. Garncarek (Immunobiology, 1980).

The study

• Authors: A. Lange, G. Skibiński, D. Garncarek
• Journal: Immunobiology
• Published: 1980;157(1):1-11
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We have determined cutaneous DTH reactions to SK-SD and PPD and peripheral blood lymphocyte profiles in a group of asbestos workers in two consecutive surveys. It was found that asbestosis and, to a lesser extent, the presence of ANA are significantly correlated with the lack of response to the above antigens. 83% of asbestos workers when tested at a 4 year interval fell into the same two categories of responsiveness (lack of response or response at least to one antigen). The asbestosis cases had lower total lymphocyte count as well as proportions and absolute number of E-RFC as compared to asbestos workers without asbestosis and/or ANA. Furthermore, the latter group showed the lower percentages and absolute number of E-RFC than the matched controls. The presence of ANA is also correlated with lower proportions of E-RFC. However, this is related at least in part to asbestosis.

In plain English

The authors studied workers at an asbestos textile factory in a small rural town in Poland, where chrysotile had been used exclusively since 1953. Skin tests with two recall antigens (tuberculin, called PPD, and streptokinase-streptodornase, called SK-SD) were done on 321 workers in 1972-1973 and repeated on 217 of them four years later. Blood lymphocytes, including a cell type called E-RFC, were counted in some workers and compared with 28 light-industry workers. Eight of 17 workers with asbestosis responded to neither antigen, against 36 of 205 workers without asbestosis. Workers who responded to neither antigen more often had antinuclear antibodies (ANA): 28% versus 11% in the first survey. In the second survey this difference lost statistical significance once asbestosis cases were left out. Of 217 workers tested twice, 180 fell into the same response category both times. Workers without asbestosis or ANA had lower E-RFC levels than the comparison workers. Those with asbestosis had lower lymphocyte and E-RFC counts than other asbestos workers. The authors concluded that lack of skin response was a persistent abnormality correlated with lung fibrosis and, to a lesser extent, with ANA.

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: Follow-up study with two surveys of the same workforce four years apart (skin testing and blood lymphocyte counts), with comparisons within the asbestos workers and against an outside comparison group
• Who was studied: Workers at an asbestos textile factory in a small rural town in Poland. 321 were examined in 1972-1973 and 217 were re-examined in 1976-1977. Lymphocyte rosette studies were done on 106 workers in 1975 and repeated in 1976-1977, when only 19 were re-examined and the rest were tested for the first time. The comparison group was 28 apparently healthy light-industry factory workers. Asbestosis was diagnosed on chest X-ray using the ILO/UC 1971 classification: 20 workers had moderate or severe asbestosis and one had only minimal abnormality.
• Exposure: Work in an asbestos textile factory where only chrysotile had been used since 1953
• Main results:
  • Among workers with asbestosis, 8 of 17 responded to neither SK-SD nor PPD, compared with 36 of 205 workers without asbestosis (referred to as 'controls' in this sentence; Table 1 labels them as asbestosis absent). The difference was statistically significant (chi-square 5.68, p less than 0.02).
  • First survey: ANA were found in 28% of workers who responded to neither antigen versus 11% of workers responding to at least one (p less than 0.01). With asbestosis cases excluded, the figures were 25% versus 10% (p less than 0.01).
  • Second survey: ANA were found in 31% of non-responders versus 10% of responders (p less than 0.01).
  • Second survey: when asbestosis cases were excluded, the ANA difference was 19% versus 9% and was not statistically significant (chi-square 2.04, p greater than 0.1).
  • Of 217 workers tested in both surveys, 180 fell into the same responsiveness category. 24 were unresponsive to both antigens on both occasions; in this group 21% had asbestosis and 42% had ANA.
  • Over the four-year interval, 5 of 24 workers who did not respond in both surveys developed asbestosis and/or ANA, compared with 8 of 193 who responded in at least one survey (chi-square 6.05, p less than 0.02). The '5' is printed as 'intervalS' in the scanned text; the discussion confirms it (two cases preceding asbestosis and three preceding ANA).
  • The 57 asbestos workers without asbestosis and without ANA had lower E-RFC than the 28 comparison workers: 48% (SD 9) versus 68% (SD 7), p less than 0.001. Absolute E-RFC counts were also lower in this group (1253 versus 1927 per cubic mm, p less than 0.001).
  • Among the asbestos workers, those with asbestosis had significantly lower total lymphocyte and E-RFC counts than those without asbestosis. In the first survey, total lymphocytes were 2243 versus 2703 per cubic mm (p less than 0.05) and E-RFC counts were 868 versus 1221 per cubic mm (p less than 0.01).
  • ANA-positive workers had a lower percentage, but not a lower absolute number, of E-RFC than ANA-negative workers. With asbestosis cases excluded, the difference in percentage was statistically significant only in the first survey.
  • No significant correlation was found between cigarette smoking and abnormal skin-test response.
• The authors' conclusion: The authors concluded that lack of response to the recall antigens is a persistent abnormality, significantly correlated with lung fibrosis and to a lesser extent with ANA in asbestos workers. They also considered it likely that the lower E-RFC levels are related to lung fibrosing processes even when asbestosis is not seen on X-ray.
• Limitations the authors state:
  • Only one lung cancer had been diagnosed. The authors attributed this to the long latency of asbestos cancer, noting that only 21% of the workers had been employed longer than 20 years.

Topics

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

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