Lung diffusing capacity relates better to short‐term progression on HRCT abnormalities than spirometry in mild asbestosis

Nogueira, Cristiano Rabelo; Nápolis, Lara Maris; Bagatin, Ericson; Filho, Mário Terra; Müller, Néstor L.; Silva, C. Isabela S.; Rodrigues, Reynaldo Tavares; Neder, J. Alberto; Nery, Luíz Eduardo

doi:10.1002/ajim.20922

Cited by 19 publications

(13 citation statements)

References 41 publications

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“…40 Another found a relationship between pleural plaque and risk for incident mesothelioma. 41 Pulmonary parenchymal findings on HRCT were associated with reduced lung function, [42][43][44] pulmonary inflammation, 45 all-cause mortality 46 (extent of pleural plaque was also associated), and pneumonia mortality. 47 A systematic review and meta-analysis documented relationships between asbestos-related radiographic findings and lung function changes.…”

Section: Additional Issues Addressed By Recent Articles Asbestosmentioning

confidence: 99%

Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

Weissman

2015

Semin Respir Crit Care Med

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This review provides an update on literature published over the past 5 years that is relevant to using chest computed tomography (CT) as a tool for preventing occupational respiratory disease. An important area of investigation has been in the use of low-dose CT (LDCT) to screen asbestos-exposed populations for lung cancer. Two recent systematic reviews have reached conclusions in support of screening. Based on the limited evidence that is currently available, the Finnish Institute of Occupational Health has recommended LDCT screening in asbestos-exposed individuals if their personal combination of risk factors yields a risk for lung cancer equal to that needed for entry into the National Lung Screening Trial. It has also recommended further research, such as to document the optimal frequency of screening and the effectiveness of screening. Recent literature continues to support high-resolution CT (HRCT) as being more sensitive than chest radiography in detecting pneumoconiosis. However, there are insufficient data to determine the effectiveness of HRCT screening in improving individual outcomes if used in screening for pneumoconiosis and its routine use for this purpose cannot be recommended. However, if HRCT is used to evaluate populations, recent literature shows that the International Classification of HRCT for Occupational and Environmental Respiratory Diseases provides an important tool for reproducible evaluation and recording of findings. HRCT is an important tool for individual patient management and recent literature has documented that chest HRCT findings are significantly associated with outcomes such as pulmonary function and mortality.

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Section: Additional Issues Addressed By Recent Articles Asbestosmentioning

confidence: 99%

Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

Weissman

2015

Semin Respir Crit Care Med

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“…Pleural plaques indicate prior exposure [40]. Physiologic testing correlates with radiographic abnormalities, and diffusion capacity is more sensitive at detecting progressive disease [41]. The diagnostic assessment is further reviewed below.…”

Section: Asbestosismentioning

confidence: 99%

Asbestosis and environmental causes of usual interstitial pneumonia

Gulati

Redlich²

2015

Current Opinion in Pulmonary Medicine

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Purpose of review Recent epidemiologic investigations suggest that occupational and environmental exposures contribute to the overall burden of idiopathic pulmonary fibrosis (IPF). This article explores the epidemiologic and clinical challenges to establishing exposure associations, the current literature regarding exposure disease relationships and the diagnostic work-up of IPF and asbestosis patients. Recent findings IPF patients demonstrate a histopathologic pattern of usual interstitial pneumonia. In the absence of a known cause or association, a usual interstitial pneumonia pattern leads to an IPF diagnosis, which is a progressive and often terminal fibrotic lung disease. It has long been recognized that asbestos exposure can cause pathologic and radiographic changes indistinguishable from IPF. Several epidemiologic studies, primarily case control in design, have found that a number of other exposures that can increase risk of developing IPF include cigarette smoke, wood dust, metal dust, sand/silica and agricultural exposures. Lung mineralogic analyses have provided additional support to causal associations. Genetic variation may explain differences in disease susceptibility among the population. Summary An accumulating body of literature suggests that occupational and environmental exposure can contribute to the development of IPF. The impact of exposure on the pathogenesis and clinical course of disease requires further study.

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“…Although spirometry test is the "gold standard" for examining lung function, diffusing capacity is widely used as a supplement in clinical medicine. It has been used in population based and in occupational epidemiological studies (Nogueira et al 2011, Welle et al 1999).…”

Section: Pulmonary Obstructionmentioning

confidence: 99%

Characterisation of occupational exposure to air contaminants in a nitrate fertiliser production plant

et al. 2012

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The aim of this study was to characterise personal exposures to dust, acid vapours, and gases among workers in a Norwegian nitrate fertiliser production plant, as part of an ongoing epidemiological study. In total, 178 inhalable and 179 thoracic aerosol mass fraction samples were collected from randomly chosen workers (N = 141) from three compound fertiliser departments (A, B and C), a calcium nitrate fertiliser production department, nitric acid- and ammonia-production departments, and a shipping department. The overall median inhalable and thoracic aerosol mass concentrations were generally low (1.1 mg m(-3) (min-max: <0.93-45) and 0.21 mg m(-3) (min-max: <0.085-11), respectively). Workers at the compound fertiliser departments B and C had significantly higher inhalable aerosol mass air concentrations compared to the other departments (p < 0.05), except for compound fertiliser department A; however, the difference between the compound fertiliser department C and calcium nitrate department was slightly above the significant level. Workers at the compound fertiliser department A had significantly higher thoracic aerosol mass air concentrations compared to the other departments (p < 0.05), except for compound fertiliser departments B and C. The results indicate that the extrathoracic aerosol fraction of the aerosol compared to the thoracic fraction dominated in most departments. Measurement of the main constituents Ca, K, Mg, and P in the water-soluble and water-insoluble aerosol mass fractions showed that the air concentrations of these elements were low. There is, however, a shift towards more water-soluble species as the production goes from raw material with phosphate rock towards the final product of fertilisers. Overall, the arithmetic mean of water-soluble Ca in the thoracic mass fraction was 51% (min-max: 1-100). A total of 169 personal samples were analysed for HNO(3) vapour and HF. The highest median concentration of HNO(3) (0.63 mg m(-3)) was in the compound fertiliser departments B, and all measurements but four of the HF concentrations were below the LOD of 190 μg m(-3). Exposures to NH(3), CO and NO(2) were measured using direct-reading electrochemical sensors and the time weighted overall averages were all below the LODs of the respective sensors, NH(3) 2 ppm; CO 2 ppm; and NO(2) 0.2 ppm, but some short-term peaks were detected. Even though our results indicate that the workers may experience peak exposure episodes when performing job tasks such as cleaning or maintenance work, the overall air concentrations are well below what is considered to cause known health risks.

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Lung diffusing capacity relates better to short‐term progression on HRCT abnormalities than spirometry in mild asbestosis

Cited by 19 publications

References 41 publications

Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

Role of Chest Computed Tomography in Prevention of Occupational Respiratory Disease: Review of Recent Literature

Asbestosis and environmental causes of usual interstitial pneumonia

Characterisation of occupational exposure to air contaminants in a nitrate fertiliser production plant

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