«Afollow-up study oflungfunction among ex-asbestos workers with and withoutpleuralplaques». Back ground: Pulmonaryfunction testing is widely accepted as an integraipari ofmedicai surveillance ofoccupational lung diseases. There are several cross-sectional studies evaluating lungfunction among asbestos-exposed workers, but onlyfew longitudine surveys bave been performed Objectives: To evaluate, over ameanfollow-up period of 3.7 (SD 1.8) years, the loss oflungfunction in agroup of103 workers with previous exposure to asbestos (mainly ship building/repairing), according to thepresence or absence ofpleuralplaques at radiologica! examination. Methods: Chest radiographic examination was used to ascertain the presence/absence ofpleuralplaques. Ifchest X-ray films werepositiveforpleuralplaques, HRCT (High Resolution Computed Tomography) was used to exclude any parenchymal disease. The assessment oflungfunction over time included repeated measurement of vital capacity (VC),forced expiratory volume in one second (FEVJ and total lung capacity (TLC). Smoking was assessed in terms ofpack-years. AGeneralized Estimating Equations (GEE) approach to repeated spirometrie measurement was usedto investigate the relationship between the loss ofpulmonaryfunction and (i) presence/absence ofpleural plaques, (ù) smoking status, and (Hi) work seniority in workplaces with exposure to asbestos. Results: In the exasbestos workers, mean age at thefirst examination was 49 (SD 6) years and work seniority averaged 25 (SD 7) years; 36% were non-smokers, 27% smoked <15pack-years, and 37% smoked >15pack-years. Thirty-six workers showedpleuralplaques at radiological examination. Overall, 236 measurements of VC and FEVb and 234 determinations ofTLC were available. Multivariate GEE approach to age- and height-adjusted spirometrie data showed thatpleuralplaques were not associated with asignificant loss ofpulmonaryfunction during thefollowup. When compared with non-smokers, heavy smokers (>15pack-years) showed on average asignificant loss ofVC (-5.30/0, IC 95o/o: -9.4-1.2%), FEV, (-8.40/0, IC 95o/o: -13.2-^-3.5o/o), and TLC (-4.0%, IC 95%: -7.4-0.5%). An occupational history ofprevious exposure to asbestos was significante associated with an 10-year decrease in VC (-3.10/0, IC 95o/o: -5.9-O.30/0) andFEV, (-4.9% IC 95o/o: -8.3—1.5%). Conclusions: The results ofthisfollowup study showed that smoking andprevious asbestos exposure were associated with amild, but statistically signifi cant, loss oflungfunction. Radiologicaifindings ofpleuralplaques were not related to deterioration oflungfunction over thefollow-up period.

Studio longitudinale della funzione ventilatoria in ex esposti ad asbesto con e senza placche pleuriche

NEGRO, CORRADO;BOVENZI, MASSIMO
2004-01-01

Abstract

«Afollow-up study oflungfunction among ex-asbestos workers with and withoutpleuralplaques». Back ground: Pulmonaryfunction testing is widely accepted as an integraipari ofmedicai surveillance ofoccupational lung diseases. There are several cross-sectional studies evaluating lungfunction among asbestos-exposed workers, but onlyfew longitudine surveys bave been performed Objectives: To evaluate, over ameanfollow-up period of 3.7 (SD 1.8) years, the loss oflungfunction in agroup of103 workers with previous exposure to asbestos (mainly ship building/repairing), according to thepresence or absence ofpleuralplaques at radiologica! examination. Methods: Chest radiographic examination was used to ascertain the presence/absence ofpleuralplaques. Ifchest X-ray films werepositiveforpleuralplaques, HRCT (High Resolution Computed Tomography) was used to exclude any parenchymal disease. The assessment oflungfunction over time included repeated measurement of vital capacity (VC),forced expiratory volume in one second (FEVJ and total lung capacity (TLC). Smoking was assessed in terms ofpack-years. AGeneralized Estimating Equations (GEE) approach to repeated spirometrie measurement was usedto investigate the relationship between the loss ofpulmonaryfunction and (i) presence/absence ofpleural plaques, (ù) smoking status, and (Hi) work seniority in workplaces with exposure to asbestos. Results: In the exasbestos workers, mean age at thefirst examination was 49 (SD 6) years and work seniority averaged 25 (SD 7) years; 36% were non-smokers, 27% smoked <15pack-years, and 37% smoked >15pack-years. Thirty-six workers showedpleuralplaques at radiological examination. Overall, 236 measurements of VC and FEVb and 234 determinations ofTLC were available. Multivariate GEE approach to age- and height-adjusted spirometrie data showed thatpleuralplaques were not associated with asignificant loss ofpulmonaryfunction during thefollowup. When compared with non-smokers, heavy smokers (>15pack-years) showed on average asignificant loss ofVC (-5.30/0, IC 95o/o: -9.4-1.2%), FEV, (-8.40/0, IC 95o/o: -13.2-^-3.5o/o), and TLC (-4.0%, IC 95%: -7.4-0.5%). An occupational history ofprevious exposure to asbestos was significante associated with an 10-year decrease in VC (-3.10/0, IC 95o/o: -5.9-O.30/0) andFEV, (-4.9% IC 95o/o: -8.3—1.5%). Conclusions: The results ofthisfollowup study showed that smoking andprevious asbestos exposure were associated with amild, but statistically signifi cant, loss oflungfunction. Radiologicaifindings ofpleuralplaques were not related to deterioration oflungfunction over thefollow-up period.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/1691201
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