Association between increased small airway obstruction and asbestos exposure in patients with asbestosis

Yang, Xiaoli; Yan, Yuwei; Xue, Changjiang; Du, Xuqin; Qiao, Ye

doi:10.1111/crj.12728

Cited by 14 publications

(14 citation statements)

References 29 publications

(42 reference statements)

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“…We observed that the mean FVC % predicted at the time of the diagnosis was nearly 80 % when DLCO had slightly declined; these results are in line with a previous study [23]. In a Chinese study, Yang et al estimated the mean FVC as being 76.7% and that of DLCO as 59.9%; their cohort consisted of 281 newly diagnosed asbestosis patients with a mean age of 65 years, which is nearly the same as the mean age of the individuals examined here.…”

Section: Discussionsupporting

confidence: 93%

Survival of patients with asbestosis can be assessed by risk-predicting models

et al. 2021

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ObjectivesOur aim was to investigate the pulmonary function test (PFT) results of patients with asbestosis and determine whether baseline PFTs and the risk-predicting models such as gender, age and physiologic (GAP) variables model and composite physiologic index (CPI) would be useful in predicting survival in these patients.MethodsDemographics and PFTs of 100 patients with asbestosis were evaluated. The survival difference between the GAP stages was determined with Kaplan-Meier survival curves with statistical significance analysed with log-rank test. The suitability of the risk-predicting models and baseline PFTs to predict the survival of patients was analysed with Cox regression.ResultsAt baseline, the mean value of diffusion capacity for carbon monoxide (DLCO) was 65%; for forced vital capacity it was 81%, with restrictive lung function being the most common impairment. The median estimated survival of the patients was 124 months, that is, 171 months in GAP stage I, 50 months in stage II and 21 months in stage III (p<0.001). CPI, DLCO% predicted, age at baseline and GAP stage were significant predictors of mortality (all p values under 0.001).ConclusionsGAP and CPI as well as baseline DLCO% predicted were significant parameters in the evaluation of the prognosis of the patients with asbestosis; they may be useful in clinical practice when considering treatment strategies of individual patients.

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Section: Discussionsupporting

confidence: 93%

Survival of patients with asbestosis can be assessed by risk-predicting models

et al. 2021

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“…These findings indicate that FeNO reflects the degree of eosinophilic inflammation of the airway rather than small airway obstruction [35,36], and that combining parameters for testing small airway function, such as MMEF, reflects small airway obstruction. However, the findings from a previously published study did not support a similar role for MMEF for the clinical diagnosis of cough variant asthma [37].…”

Section: Discussionmentioning

confidence: 83%

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

et al. 2019

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Background Cough variant asthma in children presents with a dry nonproductive cough. This study aimed to investigate the diagnostic value of fractional exhaled nitric oxide (FeNO) combined with small airway functional parameters in cough variant asthma. Material/Methods Children with asthma (n=136) were divided into a cough variant asthma (CVA) group (n=57; mean age, 8.03±2.1 years) and a non-cough variant asthma (nCVA) group (n=79; mean age, 8.61±1.7 years). In both groups, FeNO and other pulmonary function parameters were measured including forced expiratory volume in one second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF), forced expiratory flow (FEF), and maximum expiratory flow at 25%, 50%, and 75% expired volume (MEF25, MEF50, and MEF75). Receiver-operating characteristic (ROC) curve analysis compared the sensitivity and specificity between the diagnostic parameters. Results The FeNO values were significantly increased in the CVA group compared with the nCVA group (Z=6.890, p<0.001). The MMEF, MEF25, MEF50, and MEF75 values were significantly lower in the CVA group compared with the nCVA group (p=0.000, p=0.014, p=0.000, and p=0.000, respectively). The FeNO values were negatively correlated with MEF25, MEF50, and MMEF (r=−0.334, r=−0.257 and r=−0.276, respectively). FeNO was significantly more efficient diagnosing cough variant asthma comparing with pulmonary parameters (p<0.05), and was most sensitive and specific when combined with MMEF/MEF50 compared with single diagnostic parameters (p<0.05). Conclusions FeNO combined with pulmonary function parameters of MMEF/MEF50 showed increased sensitivity and specificity for the diagnosis of cough variant asthma.

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“…Of note, our previous study found that even in the presence of both emphysema and pulmonary fibrosis, spirometry and lung volumes may still be in normal range or show mild abnormalities, such as the small airway dysfunction. 32 Thus, it is possible that COPD was underestimated in patients with pneumoconiosis, especially asbestosis. 32 Additionally, we found that pneumoconiosis severity was associated with COPD prevalence.…”

Section: Discussionmentioning

confidence: 99%

“…32 Thus, it is possible that COPD was underestimated in patients with pneumoconiosis, especially asbestosis. 32 Additionally, we found that pneumoconiosis severity was associated with COPD prevalence. This finding is consistent with previous data showing that the prevalence of emphysema increases with pneumoconiosis stage-as high as 60.76% (144/237) in pneumoconiosis stage Ⅲ…”

Section: Discussionmentioning

confidence: 99%

Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China

Fan

Wang

et al. 2020

BMJ Open

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ObjectivesOccupational dust exposure may induce various lung diseases, including pneumoconiosis and chronic obstructive pulmonary disease (COPD). The features of combined COPD and pneumoconiosis have not been well described, and this may hamper the management. This study aimed to describe the prevalence and characteristics as well as the risk factors of the combined diseases.DesignA cross-sectional study.Setting and participants758 patients with pneumoconiosis were recruited at a single-medical centre. Of these, 675 patients with pneumoconiosis, including asbestosis, silicosis, coal workers’ pneumoconiosis and other pneumoconiosis, was eligible for analysis.Primary outcome measuresCOPD was diagnosed based on clinical features and/or history of exposure to risk factors and post bronchodilator forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio <0.7. Clinical data were collected from predesigned medical reports. The patients underwent both chest radiograph and high-resolution CT scans. Risk factors for combined COPD and pneumoconiosis were analysed using regression analysis.ResultsCOPD prevalence overall was 32.7% (221/675) and was the highest in silicosis (84/221) and coal workers’ pneumoconiosis (100/221). COPD prevalence increased with smoking pack-years, dust exposure duration and pneumoconiosis stage. Patients with combined diseases had lower body mass index, higher smoking index and worse pulmonary function. Risk factors for combined diseases included heavy smoking, silica or coal exposure and advanced pneumoconiosis. The interaction between dust exposure and smoking in COPD was also identified. The risk of combined COPD significantly increased with heavy smoking and silica or coal exposure (OR 5.49, 95% CI 3.04 to 9.93, p<0.001).ConclusionsCOPD is highly prevalent in patients with pneumoconiosis, especially patients with silicosis and coal workers’ pneumoconiosis. Occupational dust exposure as well as heavy smoking is associated with an increased risk of combined COPD and pneumoconiosis, which demands an effective preventive intervention.

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Association between increased small airway obstruction and asbestos exposure in patients with asbestosis

Cited by 14 publications

References 29 publications

Survival of patients with asbestosis can be assessed by risk-predicting models

Survival of patients with asbestosis can be assessed by risk-predicting models

Fractional Exhaled Nitric Oxide (FeNO) Combined with Pulmonary Function Parameters Shows Increased Sensitivity and Specificity for the Diagnosis of Cough Variant Asthma in Children

Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis: a cross-sectional study in China

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