The increasing importance of asbestos-related pleural disease

Our plain-English summary of The increasing importance of asbestos-related pleural disease, by L. Rosenstock, L.D. Hudson (Annals of the New York Academy of Sciences, 1991).

The study

• Authors: L. Rosenstock, L.D. Hudson
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:296-300
• 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. 004936).

In plain English

This short article was partly a brief review of non-cancer pleural disease caused by asbestos and partly a summary of the authors' own earlier cross-sectional study of plumbers and pipefitters. That study included 681 men with a mean age of 42 years and a mean of 17 years in their trade. Of these, 200 (29%) had chest X-ray findings consistent with asbestos-induced pleural thickening: 74 had only plaques (discrete thickening), 103 had only diffuse thickening and 23 had both. Isolated pleural thickening was seen in 12 (5%) of men with less than 10 years in the trade and 71 (56%) of those with 30 or more years. Men with pleural thickening had lower lung function (forced vital capacity) than men without: 89% versus 97% of predicted, on average. Bilateral diffuse thickening was linked to a larger drop than plaques. After accounting for age, smoking showed no relation to pleural thickening. The authors concluded that pleural thickening is itself clinically significant. They noted that lung scarring not visible on X-ray could also explain the results.

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: Brief review of nonmalignant asbestos-related pleural disease, combined with a summary of the authors' own previously published cross-sectional prevalence study
• Who was studied: 681 men in a cohort of plumbers and pipefitters, mean age 42 years, mean 17 years in their trade. The article does not say where or when they were studied.
• Exposure: Asbestos exposure through work as plumbers and pipefitters, measured by years in the trade. No fiber type is named.
• Main results:
  • 200 of 681 men (29%) had X-ray findings consistent with asbestos-induced pleural thickening
  • Among the 200 with pleural thickening, 74 (37%) had only plaques, 103 (52%) had only diffuse thickening, and 23 (11%) had both
  • Isolated pleural thickening was found in 12 (5%) of men with less than 10 years in the trade, compared with 71 (56%) of those with 30 or more years
  • Men with pleural thickening had a lower mean percent of predicted forced vital capacity than men without: 89% versus 97%
  • At any given degree of lung scarring (ILO profusion grades 0/- to 1/0), men with pleural thickening had lower mean percent predicted FVC
  • Bilateral diffuse pleural disease was associated with a greater decrease in FVC than discrete plaques in each ILO profusion grade
  • Even isolated plaques were associated with a significant decrease in lung function among men who also had minimal fibrosis (ILO grade 1/0)
  • After stratifying by age, cigarette smoking was found to have no relation to the development of pleural thickening
• The authors' conclusion: The authors concluded that their findings add evidence that pleural thickening by itself is of clinical significance and may be associated with decreased lung function
• Limitations the authors state:
  • The studies do not show how pleural disease affects lung mechanics. A greater degree of lung scarring that is not visible on X-ray could also explain the results.
  • The authors note it is difficult to tell discrete plaques from diffuse thickening on conventional X-rays

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-Related Pleural Disease.

Related studies

• Asbestos-related disease in plumbers and pipefitters employed in building construction — N.L. Sprince, L.C. Oliver, et al. (1985)
• The role of polymorphisms in glutathione-related genes in asbestos-related diseases — A. Franko, K. Goricar, et al. (2021)
• Relative importance of cigarette smoking in occupational lung disease — P.C. Elmes (1981)
• Is living close to ophiolites related to asbestos related diseases? Cross-sectional study — I. Döngel, M. Bayram, et al. (2013)
• The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking — A. Reid, N.H. de Klerk, et al. (2006)
• Asbestos related diseases from environmental exposure to crocidolite in Da-yao, China. I. Review of exposure and epidemiological data — S. Luo, X. Liu, et al. (2003)

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