Association between asbestos-related pleural plaques and resting hyperventilation.

A systematic review of the association between pleural plaques and changes in lung function

“…García-Closas and Christiani 28 observed a non-statistically significant increase in the proportion classified as having restrictive disease (defined as FVC <80% predicted and FEV 1 /FVC >75%), from 3.9% in the group with no pleural plaques to 7.8% in the pleural plaques group. In the study by Dujić et al , 27 the estimated relative risk for restrictive disease (defined as FVC <80%pred and FEV 1 /FVC ≥70%) in the group with pleural plaques, compared with the group with no pleural plaques, was 2.6 (95% CI 1.7 to 3.9); the results in terms of mean difference in %pred FVC between groups in this study were notably larger than other studies in figure 1 . The risk of obstructive disease in these studies were not different between those with plaques compared with those without pleural plaques, where obstructive disease was defined as FEV 1 <80%pred and either FEV 1 /FVC<70% 27 or FEV 1 /FVC≤75%.…”

“…In the study by Dujić et al , 27 the estimated relative risk for restrictive disease (defined as FVC <80%pred and FEV 1 /FVC ≥70%) in the group with pleural plaques, compared with the group with no pleural plaques, was 2.6 (95% CI 1.7 to 3.9); the results in terms of mean difference in %pred FVC between groups in this study were notably larger than other studies in figure 1 . The risk of obstructive disease in these studies were not different between those with plaques compared with those without pleural plaques, where obstructive disease was defined as FEV 1 <80%pred and either FEV 1 /FVC<70% 27 or FEV 1 /FVC≤75%. 28 However, the increase in the proportion of individuals with mixed-pattern disease (FVC and FEV 1 <80%pred, and 60%<FEV 1 /FVC<75%), from 1.3% in the no plaques group to 6.5% in the plaques group, was significant in the study by García-Closas and Christiani.…”

“…Among the studies identified for the meta-analyses, specific limitations pertaining to participant selection, data collection and analysis were noted as follows: Recruitment through clinic setting, or other attributes of recruitment, that may have led to overselection of symptomatic individuals; 21 24 28 32 Only one X-ray or HRCT reader or different readers in different locations (without validation sample), or lack of details about X-ray or HRCT reading protocol; 21 23 24 30–33 39 40 Lack of blinding (or lack of reporting of blinding) of X-ray or HRCT readers to asbestos exposure or medical history; 21 23 24 29 30 33 34 36 37 39 Inadequate consideration of smoking as a potential confounder. 21 22 27 31 32 40 …”

Systematic review of pleural plaques and lung function

“…In each of these studies, restriction and obstruction were defined by measurements of FVC, FEV 1 , FEV and/or FEV 1 /FVC. Of four higher quality studies, three reported a significant increase in restriction among populations with pleural plaques and one reported an increase in mixed restriction/obstruction ( Dujic et al, 1993 ; Garcia-Closas & Christiani, 1995 ; Larson et al, 2012 ; Oliver et al, 1988 ). One lower quality study did not report any associations ( Kennedy et al, 1991 ).…”

“…One way to remove some of the uncertainty surrounding the question of whether there is a true, clinically significant functional decline in a group is through categorical analysis of restrictive and obstructive effects. Several of the available studies ( Dujic et al, 1993 ; Garcia-Closas & Christiani, 1995 ; Kennedy et al, 1991 ; Oliver et al, 1988 ) categorized each study participant as having either obstructive, restrictive or mixed effects based on individual lung function test results. The authors then compared the prevalence of such conditions between groups (e.g.…”