Ultra low dose CT screen‐detected non‐malignant incidental findings in the Western Australian Asbestos Review Programme

Murray, Conor; Wong, P.M.; Teh, Joelin; Klerk, Nicholas de; Rosenow, Tim; Alfonso, Helman; Reid, Alison; Franklin, Peter; Musk, Arthur W.; Brims, Fraser

doi:10.1111/resp.12826

Cited by 15 publications

(11 citation statements)

References 29 publications

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“…Both ultra‐low‐dose computed tomography (LDCT) and dynamic contrast‐enhanced MRI (DCE‐MRI) were evaluated in the past year. Murray et al . evaluated the use of LDCT on asbestos‐exposed population screening.…”

Section: Lung Cancermentioning

confidence: 99%

Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology

et al. 2017

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Section: Lung Cancermentioning

confidence: 99%

Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology

et al. 2017

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“…Standard CT has been noted to detect ILD (or ILA) with similar sensitivity and specificity compared to (the “gold standard”) high‐resolution CT 20 and contemporary data comparing LDCT and standard‐ or HR‐CT is sparse. Nevertheless, the detection of ILA by LDCT is associated with a reduction in physiological measures of lung function (forced vital capacity [FVC] and diffusion capacity for carbon monoxide [DLco]) in an asbestos‐exposed population 21,22 …”

Section: Introductionmentioning

confidence: 99%

Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure

Harris

Lim²,

Moodley³

et al. 2021

American J Industrial Med

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Background The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT‐detected interstitial lung abnormalities (ILA). Methods The Asbestos Review Program offers annual LDCT, health assessments, and pulmonary function tests to an asbestos‐exposed cohort. Asbestosis was defined using the Helsinki Consensus statement and the presence of ILA defined using a protocol for occupational CT reports. At least two of three pulmonary function tests: forced expiratory volume in 1 s (FEV1); forced vital capacity (FVC); and diffusion capacity for carbon monoxide (DLco) were required for analysis of physiological decline. Results From 1513 cases, radiological ILA was present in 485 (32%). The cohort was 83.5% male with a median age of 68.3 years and a median (IQR) asbestos exposure of 0.7 (0.09–2.32) fiber/ml‐year. A mixed occupation, mixed asbestos fiber cohort comprised the majority of the cohort (65.8%). Of those with ILA, 40 (8.2%) had an FVC decline of ≥10% and 30 (6.2%) had a DLco decline of ≥15% per year. Time since first exposure, increasing tobacco exposure and reported dyspnea were independently associated with the presence of ILA. Conclusions In this population with relatively low asbestos exposure, LDCT‐detected ILA that fits criteria for asbestosis is common, but physiological decline is not. This mild chronic stable phenotype of asbestos‐associated ILA contrasts with the traditionally accepted views that asbestosis requires high exposures.

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“…The true prevalence of asbestos‐related lung disease in the general Australian population is not known. Recent data from the Western Australian Asbestos Review Program 39 show the presence of pleural plaques in 64% of patients, diffuse pleural thickening in 8%, and one‐quarter having computed tomography (CT) evidence of asbestosis 40 …”

Section: Asbestos‐related Lung Diseasesmentioning

confidence: 99%

“…Recent data from the Western Australian Asbestos Review Program 39 show the presence of pleural plaques in 64% of patients, diffuse pleural thickening in 8%, and one-quarter having computed tomography (CT) evidence of asbestosis. 40 Asbestos-related lung disease has a higher risk of development with increasing cumulative exposure and time since first exposure. 37 Occupations where the risk of asbestos-related lung disease is substantial include mining, processing and transportation of raw asbestos.…”

Section: Asbestos-related Lung Diseasesmentioning

confidence: 99%

Occupational lung diseases in Australia

Hoy

Brims²

2017

Medical Journal of Australia

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Occupational exposures are an important determinant of respiratory health. International estimates note that about 15% of adult-onset asthma, 15% of chronic obstructive pulmonary disease and 10-30% of lung cancer may be attributable to hazardous occupational exposures. One-quarter of working asthmatics either have had their asthma caused by work or adversely affected by workplace conditions. Recently, cases of historical occupational lung diseases have been noted to occur with new exposures, such as cases of silicosis in workers fabricating kitchen benchtops from artificial stone products. Identification of an occupational cause of a lung disease can be difficult and requires maintaining a high index of suspicion. When an occupational lung disease is identified, this may facilitate a cure and help to protect coworkers. Currently, very little information is collected regarding actual cases of occupational lung diseases in Australia. Most assumptions about many occupational lung diseases are based on extrapolation from overseas data. This lack of information is a major impediment to development of targeted interventions and timely identification of new hazardous exposures. All employers, governments and health care providers in Australia have a responsibility to ensure that the highest possible standards are in place to protect workers' respiratory health.

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Ultra low dose CT screen‐detected non‐malignant incidental findings in the Western Australian Asbestos Review Programme

Cited by 15 publications

References 29 publications

Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology

Year in review 2016: Respiratory infections, acute respiratory distress syndrome, pleural diseases, lung cancer and interventional pulmonology

Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure

Occupational lung diseases in Australia

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