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Environmental Research Apr 1993This review begins with the classic physiologic syndrome of interstitial lung disease (ILD) described in established asbestosis in the 1950s: reduced VC and pulmonary... (Review)
Review
This review begins with the classic physiologic syndrome of interstitial lung disease (ILD) described in established asbestosis in the 1950s: reduced VC and pulmonary compliance, maintenance of airflow (measured indirectly), decreased diffusing capacity (a laborious undertaking in those years), and hyperventilation, increased dead space (VD/VT), and desaturation on exercise. Small airways dysfunction (SAD) was recognized in the 1960s and 1970s as the physiologic counterpart of the early peripheral bronchiolar inflammatory and fibrotic narrowing reported in experimental animals and in asbestos workers. SAD is nonspecific and is often overshadowed by more severe obstruction caused by smoking or by the countervailing effects of increased lung recoil caused by interstitial fibrosis. Airtrapping secondary to SAD may explain some of the reduction in VC in asbestos exposed workers whose FEV1/FVC is normal. There may be a greater frequency of obstructive airways disease in asbestos workers who smoke than in other smokers, suggesting an interaction between these two noxious inhalants. An interaction is seen in the greater frequency and severity of radiographic asbestosis in smokers at equivalent durations of exposure and in the greater reduction in FVC in smokers at equivalent ILO profusion scores. The functional importance of PT is well documented by lower values for FVC at equivalent profusions of parenchymal disease. This is true of circumscribed PT but much more so of diffuse PT, which can occasionally result in ventilatory failure and death. Incremental exercise testing often reveals evidence of excessive ventilation and abnormal gas exchange (VD/VT) attributable to ILD, when standard tests of pulmonary function and chest radiography are normal. These abnormalities help explain dyspnea in such patients.
Topics: Asbestos; Asbestosis; Exercise Test; Humans; Pleural Diseases; Respiratory Mechanics; Smoking
PubMed: 8472663
DOI: 10.1006/enrs.1993.1044 -
Radiology Aug 1990High-resolution computed tomography (HRCT) was performed in seven inflated and fixed postmortem lungs from seven asbestos-exposed patients with pathologically proved...
High-resolution computed tomography (HRCT) was performed in seven inflated and fixed postmortem lungs from seven asbestos-exposed patients with pathologically proved asbestosis. The parenchymal abnormalities seen at in vitro HRCT included thickened intralobular lines (n = 7), thickened interlobular lines (n = 7), pleural-based opacities (n = 7), parenchymal fibrous bands (n = 5), subpleural curvilinear shadows (n = 4), ground-glass appearance (n = 4), traction bronchiectasis (n = 4), and honeycombing (n = 2). The thickened intralobular lines were shown histologically to be due to peribronchiolar fibrosis. Thickened interlobular lines were due mainly to interlobular fibrotic thickening in four lungs and edema in three. The peribronchiolar fibrosis was most severe in the subpleural lung regions, creating curvilinear line shadows and pleural-based areas of opacity. Some subpleural fibrosis extended proximally along the bronchovascular sheath to create bandlike lesions. Areas of ground-glass appearance on HRCT scans were shown to be the result of mild alveolar wall and interlobular septal thickening due to fibrosis or edema. Postmortem HRCT findings were similar to premortem HRCT findings and correlated well with the pathologic findings of asbestosis.
Topics: Aged; Asbestosis; Female; Humans; Lung; Male; Middle Aged; Tomography, X-Ray Computed
PubMed: 2367652
DOI: 10.1148/radiology.176.2.2367652 -
Annals of the New York Academy of... Dec 1991Interobserver variation continues to be a substantial problem for interpretation of asbestos-workers' X-rays, despite incremental improvements in the International... (Comparative Study)
Comparative Study Review
Interobserver variation continues to be a substantial problem for interpretation of asbestos-workers' X-rays, despite incremental improvements in the International Labour Office (ILO) classification system. The apparent degree of agreement/variability is affected by the population disease prevalence. For most populations, experts will be able to agree routinely about normal films. Yet designed trials show that selected experts exhibit a two-fold or greater range for perceived prevalence of abnormal profusions. This degree of variability would be adequate for many population studies were it achieved under real-life conditions of interpretation. Unfortunately, the realistic degree of interobserver variability is probably much higher under actual population surveillance conditions. Asbestos population surveillance programs have provided little or no quality assurance for ILO interpretations, so the very high variability suggested by available data are not surprising and are not the fault of the classification. Recommendations include required participation in quality-assurance panels for those who wish to be certified as interpreters, with consistent feedback and the dropping of outliers. If quality-assurance programs are implemented, the classification will achieve its intended epidemiologic purposes.
Topics: Asbestosis; Environmental Exposure; Humans; International Agencies; Radiography; Severity of Illness Index
PubMed: 1809123
DOI: 10.1111/j.1749-6632.1991.tb24451.x -
Arkhiv Patologii 1962
Topics: Asbestosis; Humans
PubMed: 13888776
DOI: No ID Found -
Nederlands Tijdschrift Voor Geneeskunde Mar 1967
Topics: Asbestosis; Brain Neoplasms; Bronchial Neoplasms; Humans; Male; Middle Aged
PubMed: 6042297
DOI: No ID Found -
Duodecim; Laaketieteellinen... 1996
Review
Topics: Asbestosis; Bronchoalveolar Lavage Fluid; Environmental Monitoring; Epidemiological Monitoring; Finland; Humans; Incidence; Occupational Diseases; Occupational Exposure; Prognosis; Risk Factors; Tomography, X-Ray Computed
PubMed: 10596176
DOI: No ID Found -
Toxicologic Pathology Oct 2015Asbestosis is a chronic lung disease caused by inhalation of asbestos, a fibrous mineral. It is one of the most severe diseases resulting from environmental...
Asbestosis is a chronic lung disease caused by inhalation of asbestos, a fibrous mineral. It is one of the most severe diseases resulting from environmental contamination. We found asbestosis in a female Japanese macaque over 25 years of age that died from senility. Clear needle-like crystals were deposited throughout the lung lobes, particularly in the perivascular areas. Asbestos bodies were observed in some of these crystals. Fibrosis without inflammation was observed in the periarterial and peribronchiolar regions. The crystals were identified as tremolite, and a total of 16,633,968 asbestos bodies and 465,334,411 tremolite fibers were observed in 1 g of dry lung tissue. No tumors or pleural adhesions were seen. This is the first report of spontaneous asbestosis in a nonhuman animal.
Topics: Animals; Asbestos, Amphibole; Asbestosis; Female; Macaca
PubMed: 26056144
DOI: 10.1177/0192623315587594 -
American Journal of Industrial Medicine 1985
Topics: Asbestos; Asbestosis; Humans; Jurisprudence; Pleural Diseases; Terminology as Topic
PubMed: 4073050
DOI: 10.1002/ajim.4700080603 -
Revue Des Maladies Respiratoires Dec 1999Despite the lack of precision of asbestos exposure assessments and the limitations of the main diagnostic epidemiological tool for asbestos-related diseases (i.e.... (Review)
Review
Despite the lack of precision of asbestos exposure assessments and the limitations of the main diagnostic epidemiological tool for asbestos-related diseases (i.e. standard X ray films), several issues concerning the risk of development of asbestos-related diseases are well established. For asbestosis, now a rare disease, the existence of a positive dose-response relationship, with a threshold or no-effect level, has been clearly demonstrated. The slope of the relationship curve is steeper for amphiboles than for chysotile, as it is for increased fiber length. Asbestosis is associated with an increased risk of bronchial carcinoma, however it is now known that exposure to asbestos of itself increases the risk of cancer even in the absence of any radiographic signs of pulmonary fibrosis. Pleural plaques occur even when the level of asbestos exposure is low. They are not only dose-dependent but are also latency-related. They have no prognostic significance in asbestos-exposed workers, but are associated with an increased risk for the subsequent development of mesothelioma and bronchial carcinoma when compared to the risk of the general population. Diffuse pleural thickening is associated with higher levels of asbestos exposure than those associated with pleural plaques. It usually follows a benign pleural effusion, which is a less frequent but earlier consequence of asbestos exposure than the other asbestos-related diseases documented above.
Topics: Asbestosis; Bronchial Neoplasms; Dose-Response Relationship, Drug; Environmental Exposure; Humans; Lung Neoplasms; Risk Assessment; Time Factors
PubMed: 10897848
DOI: No ID Found -
Archives of Pathology & Laboratory... Feb 1984
Topics: Asbestosis; Diagnosis, Differential; Humans; Lung
PubMed: 6546497
DOI: No ID Found