Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age

Abstract

Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos. Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema <25%, moderate: between 25 and 50% and severe: >50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure. Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02–1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure. Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.

Disease progression in patients with usual interstitial pneumonia and probable UIP patterns on computed tomography with various underlying etiologies: a retrospective cohort study

“…Similarly, in secondary ILDs, studies have reported older age in ILDs associated with CTD compared to CTD without ILD ( 37 , 38 ), as well as in chronic HP compared to acute HP ( 39 ). In a recent study by Laurent et al ( 40 ), a significant positive correlation was found between definite or possible UIP patterns and age in individuals exposed to asbestos. However, previous studies have yielded inconsistent findings regarding age differences between patients with UIP and NSIP ( 30 , 41 ).…”

“…Despite the heterogeneities, the clinical and laboratory data of patients with UIP from various causes display remarkable similarities, shedding light on the shared underlying mechanisms (37,38), as well as in chronic HP compared to acute HP (39). In a recent study by Laurent et al (40), a significant positive correlation was found between definite or possible UIP patterns and age in individuals exposed to asbestos. However, previous studies have yielded inconsistent findings regarding age differences between patients with UIP and NSIP (30, 41).…”

Frequency of Asbestos Exposure and Histological Subtype of Ovarian Carcinoma

“…Information on other asbestosrelated diseases such as plaques, pleurisy, or fibrosis have not been collected. However, while these signs may provide arguments for past exposure, they are rare, even among highly exposed subjects [43,44]. Finally, reliable environmental and geographic information on asbestos (from the natural environment or asbestos processing facilities) are not available in France, and could therefore not be assessed in the present study.…”

Occupational Medicine and Prevention of Chronic and Infectious Diseases

“…The role of asbestos in the development of lung cancer and pleural mesothelioma has been clearly demonstrated, even if one fifth of mesothelioma is not explained by an exposure to asbestos. The study by Laurent et al [ 10 ] was carried out on 2157 former workers previously professionally exposed to asbestos who underwent chest CT scans and pulmonary function tests in order to assess asbestos exposure and calculate a cumulative asbestos exposure index (CEI) for each subject. The aim was to evaluate the link between interstitial lung anomalies, asbestos exposure, and age in a population of retired workers previously occupationally exposed.…”