Diagnosis and Initial Management of Nonmalignant Diseases Related to Asbestos

Apfelbaum, Jeffrey L.; Roberson, David W.; Caplan, Robert A.; Barker, Steven J.; Connis, Richard T.; Cowles, Charles E.; Richemond, Albert L. de; Ehrenwerth, Jan; Nickinovich, David G.; Pritchard, Donna; Wolf, Gerald

doi:10.1164/rccm.200310-1436st

Cited by 401 publications

(120 citation statements)

References 140 publications

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“…For example, a participant who expressed a belief that medications do more harm than good had encouraged his brother, who has ARD, to stop taking some of his medication: “get rid of some of those pills” (Family). Although the potential consequences for this particular person are unknown, medication generally is an important component of ARD management (American Thoracic Society, 2004). …”

Section: Discussionmentioning

confidence: 99%

A Typology of Communication Dynamics in Families Living a Slow-Motion Technological Disaster

Orom

Cline

Hernandez

et al. 2012

Journal of Family Issues

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With increasing numbers of communities harmed by exposures to toxic substances, greater understanding of the psychosocial consequences of these technological disasters is needed. One community living the consequences of a slow-motion technological disaster is Libby, Montana, where, for nearly 70 years, amphibole asbestos-contaminated vermiculite was mined and processed. Former mine employees and Libby area residents continue to cope with the health consequences of occupational and environmental asbestos exposure and with the psychosocial challenges accompanying chronic and often fatal asbestos-related diseases (ARD). Nine focus groups were conducted with Libby area residents. Transcripts were analyzed to explore patterns of family communication about ARD. The following five patterns emerged: Open/Supportive, Silent/Supportive, Open/Conflictual, Silent/Conflictual, and Silent/Denial. Open/Supportive communication included encouragement to be screened for ARD, information about ARD and related disaster topics, and emotional support for people with ARD. In contrast, communication patterns characterized by silence or conflict have the potential to hinder health-promoting communication and increase psychological distress.

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Section: Discussionmentioning

confidence: 99%

A Typology of Communication Dynamics in Families Living a Slow-Motion Technological Disaster

Orom

Cline

Hernandez

et al. 2012

Journal of Family Issues

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“…The reading results of the MDCTs were grouped in any changes (parenchymal or pleural), asbestosis with or without pleural lesions and pleural thickening (plaques) with or without asbestosis, including parietal and visceral changes (Table 1) [10,40]. …”

Section: Methodsmentioning

confidence: 99%

Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT

Eisenhawer

Felten

Tamm

et al. 2014

Journal of Occupational Medicine and Toxicology

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BackgroundTo determine the prevalence of asbestos-related changes on chest X-ray (CXR) and low-dose multidetector-row CT (MDCT) of the thorax in a cohort of formerly asbestos-exposed power industry workers and to assess the importance of common risk factors associated with specific radiological changes.MethodsTo assess the influence of selected risk factors (age, time since first exposure, exposure duration, cumulative exposure and pack years) on typical asbestos-related radiographic changes, we employed multiple logistic regression and receiver operating characteristic (ROC) analysis.ResultsOn CXR, pleural changes and asbestosis were strongly associated with age, years since first exposure and exposure duration. The MDCT results showed an association between asbestosis and age and between plaques and exposure duration, years since first exposure and cumulative exposure. Parenchymal changes on CXR and MDCT, and diffuse pleural thickening on CXR were both associated with smoking. Using a cut-off of 55 years for age, 17 years for exposure duration and 28 years for latency, benign radiological changes in the cohort with CXR could be predicted with a sensitivity of 82.0% for all of the three variables and a specificity of 47.4%, 39.0% and 40.6%, respectively.ConclusionsParticipants aged 55 years and older and those with an asbestos exposure of at least 17 years or 28 years since first exposure should be seen as having an increased risk of abnormal radiological findings. For implementing a more focused approach the routine use of low-dose MDCT rather than CXR at least for initial examinations would be justified.

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“…Asbestos-related pleural diseases include malignant pleural mesothelioma, benign asbestos pleural effusion (BAPE), and diffuse pleural thickening (DPT) [1]. DPT often develops after the onset of BAPE [2,3]; however, some patients develop DPT in the absence of BAPE.…”

Section: Introductionmentioning

confidence: 99%

Asbestos-Related Diffuse Pleural Thickening

Fujimoto

Kato²,

Usami³

et al. 2014

Respiration

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Background: The clinical features of asbestos-related diffuse pleural thickening (DPT) remain unclear. Objectives: To clarify the association between radiological findings of DPT and respiratory function. Methods: Medical data from patients with asbestos-related DPT were collected, including their history of occupational or neighborhood asbestos exposure, initial symptoms, modified Medical Research Council dyspnea grade, smoking history, radiological findings, and respiratory function test results. Results: There were 106 DPT patients between 2005 and 2010 [i.e. 103 men (97.2%) and 3 women (2.8%)]. The median age at diagnosis was 69 years (range 46-88). Patient occupations related to asbestos exposure included: asbestos product manufacturing (n = 17); the shipbuilding industry (n = 14); the construction industry (n = 13); heat insulation work (n = 12); plumbing, asbestos spraying, and electrical work (n = 7 each), and transportation and demolition work (n = 4 each). The median duration of asbestos exposure was 25 years (range 2-54), and the median latency period before the onset of DPT was 46 years (range 25-66). Involvement of the costophrenic angle (CPA) was also negatively correlated with the percent vital capacity (%VC; r = -0.448, p < 0.01). Pleural thickness and the craniocaudal and horizontal extension of pleural thickening, as determined by chest computed tomography (CT), were also negatively correlated with %VC (r = -0.226, p < 0.05; r = -0.409, p < 0.01, and r = -0.408, p < 0.01, respectively). Conclusions: DPT develops after a long latency period following occupational asbestos exposure and causes marked respiratory dysfunction. The extension of DPT should be evaluated by chest CT, and chest X-ray would be important for the evaluation of the involvement of the CPA.

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Diagnosis and Initial Management of Nonmalignant Diseases Related to Asbestos

Cited by 401 publications

References 140 publications

A Typology of Communication Dynamics in Families Living a Slow-Motion Technological Disaster

A Typology of Communication Dynamics in Families Living a Slow-Motion Technological Disaster

Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT

Asbestos-Related Diffuse Pleural Thickening

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