Reduced lung function in smokers in a lung cancer screening cohort with asbestos exposure and pleural plaques

Lopatin, Sarah; Tsay, J.J.; Addrizzo-Harris, Doreen; Munger, John S.; Pass, Harvey I.; Rom, William N.

doi:10.1002/ajim.22571

Cited by 8 publications

(5 citation statements)

References 28 publications

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“…Lung cancer screening by low-dose computed tomography (LDCT) has the main purpose of reducing lung cancer mortality in subjects that have several risk factors contributing to increased risk of lung cancer [ 1 ]. Asbestos exposure is a well-known risk factor for thoracic malignancies and non-malignant respiratory diseases [ 2 – 5 ], hence, the majority of lung cancer risk models include exposure to asbestos for pre-test calculation of lung cancer risk [ 3 , 6 , 7 ]. However, there is limited reliability on reference methods for the assessment of life-time exposure from occupational and, notably, non-occupational inhalation.…”

Section: Introductionmentioning

confidence: 99%

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

et al. 2017

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BackgroundTo report the prevalence of pleural plaques in a lung cancer screening trial by low-dose computed tomography (LDCT) and to test the association with incidence of lung cancer and mortality.MethodsThe LDCT of 2303 screenees were retrospectively reviewed with the specific aim of describing the prevalence and features of pleural plaques. Self-administered questionnaire was used to assess asbestos exposure. Frequency of lung cancer, lung cancer mortality, and overall mortality were detailed according to presence of pleural findings. Statistical analyses included comparison of mean or median, contingency tables, and Cox model for calculation of hazard ratio (HR) and its 95% confidence interval (CI).ResultsAmong male screenees, 31/1570 (2%) showed pleural abnormalities, 128/1570 (8.2%) disclosed asbestos exposure, 23/31 (74.2%) subjects with pleural plaques consistently denied exposure to asbestos. There was a trend for higher frequency of lung cancer among subjects with pleural plaques (9.7% vs 4.2%). Lung cancer in subjects with pleural plaques was always diagnosed in advanced stage. Subjects with pleural plaques showed HR 5.48 (95% CI 1.61–18.70) for mortality from lung cancer.ConclusionsPleural plaques are a risk factor for lung cancer mortality that can be detected in lung cancer screening by LDCT, also in subjects that are not aware of asbestos exposure.Trial registration NCT02837809 - Retrospectively registered July 1, 2016 - Enrolment of first participant September 2005.

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Section: Introductionmentioning

confidence: 99%

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

et al. 2017

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“…A significant reduction in FVC and FEV1 volumes in subjects exposed to asbestos compared to unexposed subjects, and a significant FVC reduction in exposed 20+ years compared to subjects for a lesser duration have been previously reported [22]. In that study, the authors used duration as a surrogate for asbestos exposure, while, in our study, we did use retrospective exposure estimates and compared respiratory function tests by increasing category of time-weighted average and cumulative exposure.…”

Section: Discussionmentioning

confidence: 82%

Pulmonary Function and CT Scan Imaging at Low-Level Occupational Exposureto Asbestos

Satta

Serra

Meloni

et al. 2019

IJERPH

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Background: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. Results: Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19–0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95–5.07). Exposure was elevated among maintenance workers, compared to other jobs (p = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18–54.5). Conclusions: Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.

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“…The latter is especially clarified in the meta‐analysis of Wilken et al summarizing all available work, demonstrating a small, but statistically significant impairment in FVC, FEV 1 , and FEV 1 /VC in asbestos workers with normal chest X‐ray or Computed Tomography findings (see Figure and Table ). Recently, Lopatin et al showed that long duration at low‐level asbestos exposure is associated with further declines in pulmonary function, as others have shown for higher levels of exposure. Additional decline in FVC and FEV 1 was significantly associated with asbestos exposure, duration of exposure, and isolated pleural plaques, even in this cohort of heavy smokers.…”

Section: Commentmentioning

confidence: 86%

Commentary to the article lung function not affected by asbestos exposure in workers with normal Computed Tomography scan, by Schikowsky, Felten, et al., 2017

Baur¹,

Terracini

Belpoggi

et al. 2018

American J Industrial Med

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Reduced lung function in smokers in a lung cancer screening cohort with asbestos exposure and pleural plaques

Cited by 8 publications

References 28 publications

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality

Pulmonary Function and CT Scan Imaging at Low-Level Occupational Exposureto Asbestos

Commentary to the article lung function not affected by asbestos exposure in workers with normal Computed Tomography scan, by Schikowsky, Felten, et al., 2017

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