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PubMed1986

Pathophysiologic correlations in asbestos-induced airway disease in the guinea pig.

To determine whether asbestos-induced changes in the structure of the walls of small airways might be associated with abnormalities of pulmonary function, guinea pigs were given 10 mg of amosite asbestos (test group) or saline (control group) by intratracheal instillation. Pulmonary function tests performed 6 months later revealed significant increases in FRC, RV, and TLC in the test group. Measurement of airway wall thickness showed that both membranous and respiratory bronchioles were significantly thickened in the test group; this group also had airways of smaller internal diameter than the controls. Analysis for lung collagen content as hydroxyproline showed a 50% increase in the asbestos exposed animals. There was, however, only minimal and very focal interstitial fibrosis (asbestosis) in the lung parenchyma. Analysis of fiber size indicated that the fibers obtained by digestion of the tissue or from the lavage fluid were significantly longer and wider than those in the original asbestos sample; however, the tissue contained considerably larger fibers than the lavage fluid. We conclude that: Asbestos can produce airway fibrosis and narrowing causing air trapping on pulmonary function examination; this process occurs in the absence of significant interstitial fibrosis of the parenchyma (asbestosis), implying that abnormalities of pulmonary function which are consistent with airflow obstruction in asbestos exposed animals can be caused by pathologic changes in the small airways alone; long asbestos fibers are preferentially retained in the lung, and the longest fibers appear to be in a compartment inaccessible to lavage, presumably, in this model, in airway walls. Enhanced penetration of long fibers into tissue may be one reason why long fibers are more pathogenic than short ones.

Animals↗
PubMed1999

[Nonmalignant asbestos-related diseases].

Non malignant asbestos diseases are dominated numerically by pleural plaques. This form of circumscribed fibrosis of the parietal pleural is generally asymptomatic and its potential for evolution is weak. More rarely diffuse pleural fibrosis results from disease of the visceral pleura with a secondary fusion of the two pleural layers. Usually it follows a pleural effusion which resolves spontaneously. Its functional effects are sometimes important. The generalised practice of computerized tomographic scanning as a work up for asbestos related disease has revealed the frequent association of this diffuse pleural fibrosis with a particular form of peripheral pulmonary collapse called round atelectasis. Asbestosis or pulmonary fibrosis induced by the inhalation of asbestos has become rarer due to the improvement in working conditions in the asbestos industry. It develops following heavy exposure. The frequency of bronchopulmonary cancer is increased when asbestosis exists although it is not currently possible to say if the two disorders are independent and each is only conditioned by exposure to asbestos or if the two diseases are inextricably linked by the same physiopathological process.

Asbestos↗
PubMed1975

[Asbestos as an envoronmental carcinogen (author's transl)].

Relations between asbestosis and bronchial carcinoma and also since a long time for diffuse malignant pelural and peritoneal mesothelioma have been ascertained for professional exposure to asbestos. On the other hand such relations can be proved statistically for non-professional environmental influence only with malignant serosa tumors. Their increased occurrence goes parallel to the hyaline (calcified) pleura-plaques, to another professional and non-professional consequence of asbestos dust inhalations. There is not enough evidence to accuse asbestos to be a carcinogen causing also other malignomas. It is sure, the number of uncontrolled persons, occupationally or nonoccupationally exposed to asbestos, is still very high. Nevertheless no increased risk of cancer, provoked by asbestos can be supposed for the public at present. For selected population groups, however, increased occurence of mesothelioma cannot be denied, at least in the past. Favorable Favorable conditions exist for the solution of problems still unsolved in asbestosis control, due to the registration of all persons exposed to asbestos dust, and due to the commitment of notifying all tumors.

Asbestos↗
PubMed1992

Occupational exposure and respiratory morbidity among asbestos workers in Taiwan.

To determine the prevalence of asbestos-related lung disease and the impairment of lung function among asbestos workers, we conducted a cross-sectional health survey of 459 workers in 33 asbestos-related factories in Taiwan. Each worker was asked about his medical and occupational history and was given a medical examination, chest roentgenogram and pulmonary function test. Manufacturing processes included production of asbestos cements, textiles, friction materials and insulation products. Exposure assessments were based on asbestos sampling and counting using a phase contrast microscope. The average age of the participants in the study was 41.6 years. They had an average of 8.1 years of dust exposure, with a range of one to 42 years. The majority had a cumulative asbestos exposure of less than 20 fiber years/mL. No case of asbestos-related lung disease was found during our investigation. No roentgenogram showed unequivocal changes of asbestosis. However, a multiple linear regression analysis of the pulmonary function test showed that both FVC and FEV1 decreased significantly with an increasing cumulative dose of exposure after controlling for age, height and smoking effects during analysis. FEV1/FVC and FEF25-75% were not affected by exposure dose. The absence of asbestosis and other asbestos-related lung diseases may be due to an inadequate induction time of asbestos exposure and a possible healthy selection of workers. We conclude that among workers in Taiwan, there is a significant effect on the respiratory system, especially pulmonary function, due to asbestos exposure.

Adolescent↗
PubMed1992

Computed tomography in the evaluation of benign asbestos-related disorders.

High-resolution CT is more sensitive than chest radiography and conventional CT in the detection and assessment of benign asbestos-related pleural and parenchymal diseases. The HRCT features of asbestosis correlate with clinical and functional restriction. The specificity of HRCT findings of asbestosis needs further evaluation. Given its low cost and availability, chest radiography remains the mainstay of imaging in benign asbestos-related diseases. CT (conventional or high-resolution) is not recommended as a universal screening test in asbestos-exposed workers. It has a useful role in identifying and quantitating pulmonary fibrosis distinct from emphysema and pleural disease, in distinguishing pleural disease from normal extrapleural soft tissues, and in clarifying the confusing chest radiograph or conflicting pulmonary function data. CT is useful in excluding a mass that may be obscured by extensive pleural and parenchymal fibrosis and is helpful in the follow-up of benign fibrotic masses or in the direction of their biopsy.

Asbestosis↗
PubMed1992

[Factors which may mask a possible safe threshold for asbestos fibre].

Five factors are identified which could mask a possible threshold for asbestos fibre as a cause of asbestosis: (i) the definition of asbestosis; (ii) the influence of dust other than asbestos fibre; (iii) the underestimation of the true exposure to fibres; (iv) the non-allowance for random error in the determination of disease; and (v) the overestimation of early (high) exposures coupled with the underestimation of later (low) exposures. The manner in which each of these factors may tend to mask the existence of a threshold is dealt with. It is concluded that one or more of the factors could have been responsible for some of the unsuccessful past attempts to demonstrate a safe concentration for asbestos fibre. It is recommended that in future, exposure-response studies should take these factors into account.

Asbestos↗
PubMed2006

[Prophylactic examinations of workers formerly employed in asbestos processing plants: outcome of the Amiantus project in 2000-2004].

BACKGROUND: Prophylactic examinations of workers formerly employed in asbestos processing plants were performed by virtue of the Act, dated 19 June 1997, putting a ban on the production of asbestos-containing products. To enforce the provisions of the Act, the Ministry of Health has initiated the Amiantus project implemented by 13 Occupational Medicine Centers throughout the country and coordinated by the Nofer Institute of Occupational Medicine (IMP) in Lódź. MATERIAL AND METHODS: All the Centers perform diagnostic procedures according to the same criteria (clinical, radiological, spirometric and histological), based on the 1997 Helsinki criteria, to diagnose asbestos-related diseases. A specific "Examination Form", developed for the needs of the Amiantus project, is completed by an occupational physician during examinations and sent to the IMP, where health effects in the whole population covered by the project are monitored. Periodical medical examinations are performed at least every three years and they include: general examination, chest x-ray, resting spirometric examination and supplementary examinations (e.g., resting gasometric examination) or other diagnostic examinations if necessary (e.g., computed tomography). RESULTS: Owing to the project implementation, it was possible to collect in the database information on 5466 persons who underwent 8763 prophylactic examinations in 2000-2004. Of the total population examined during a five-year period, occupational disease was certified in 728 (13%) persons. Asbestosis was diagnosed in 790 persons, lung cancer in 19 persons and pleural mesothelioma in 12 persons. Pleural changes in x-ray imaging were found in 1662 (30%) persons and opacities in pulmonary parenchyma in 2088 (38%) persons. Having compared these results with those from previous examinations, the total health condition deterioration was observed in 882 (16%) persons, including worsening of the lung x-ray imaging in 512 (9%) persons. An analysis showed the highest incidence of asbestos-related pathologies in workers of asbestos-cement plants. The collected data also confirmed an upward trend in the incidence of asbestosis and changes in the lung x-ray imaging related to age, duration of employment and latency. CONCLUSION: The implementation of the Amiantus project has contributed to an increased detection of pathologies related with exposure to asbestos fibers. A growing proportion of radiograms, which indicate worsening of health condition provides evidence that morbid processes in the respiratory system are progressing in persons who in the past were occupationally exposed to asbestos dust.

Adult↗
PubMedDate not supplied

[Markers of fibrogenesis in bronchoalveolar lavage and in serum of workers exposed to asbestos].

The N-terminal peptide of type III procollagen (PIIIP) and fibronectin (FBN), two markers possibly implicated in the pathogenesis of pulmonary fibrosis, were determined in bronchoalveolar lavage fluid (BAL) and in serum of 27 subjects with a history of occupational exposure to asbestos, in 10 sarcoidosis patients and in 7 healthy controls. At the same time, the study of the cell populations and asbestos bodies count in BAL were also performed. In BAL of sarcoidosis patients the mean concentration of PI-IIIP was higher compared to that of the other two groups, and the difference was significant compared with the healthy controls. Among the group of asbestos workers, both PIIIP and FBN were significantly higher in subjects with radiological signs of pulmonary asbestosis compared with those with no signs of asbestosis. On the basis of BAL cytology, the asbestos-exposed were divided into two subgroups, with or without signs of alveolitis: the mean concentrations of BAL PIIIP was significantly higher in the subgroup with alveolitis. Moreover, in this subgroup there was a positive correlation between total number of cells and PIIIP, and between the number of asbestos bodies and PIIIP in BAL. Serum PIIIP values did not differ significantly among the various groups, with the exception of higher values in sarcoidosis patients. The results of this study seem to confirm the usefulness of PIIIP and FBN determinations in BAL, as indicators of the activity of the fibrotic process which, in particular cases, might also assume a prognostic significance.

Adult↗
PubMed1990

[Chronic background and pretumorous diseases of the respiratory organs in manufacturing contingents in contact with industrial carcinogens].

The authors have carried out hygienic, clinical and epidemiological studies among workers engaged in graphite and asbestos industries. Occupational diseases--carboconioses and dust bronchitis that occur in workers engaged in graphite industry may be attributed to the preceding diseases conducive to the development of lung carcinoma. Among patients with asbestosis, the risk for lung carcinoma is 2 times higher than in workers exposed to asbestos-containing dust, who do not suffer from asbestosis. The latter condition can also be regarded as a preceding illness that contributes to the development of lung carcinoma in workers engaged in asbestos industry. To enhance the efficacy of preventing cancer diseases of the respiratory organs, it is suggested that examinations for oncological diseases be included into the screening programs for workers exposed to carcinogenic agents.

Asbestosis↗
PubMed1990

[Expert assessment of asbestos-induced lung damage].

Asbestos is a mineral of special technical properties and therefore used in many products all over the world. The inhalation of asbestos causes chronic inflammation of lung--the asbestosis--and pleura--pleuraplaques and pleuritis--and is responsible for mesothelioma and lung cancer. Under normal conditions the diagnosis asbestosis is easy because of the typical x-ray findings and the history of intensive exposure of asbestos. In rare conditions the history of exposure is uncertain and the diagnosis might be difficult. The expected anuity depends on the loss of lung-function. First we find a restrictive ventilatory disorder i.e. a reduction in VC and compliance. Later after progress of the disease the gasexchange is impaired. In case of mesothelioma or lungcancer the person is generally expected to be unable to work.

Asbestosis↗
PubMed1979

Angiotensin-converting enzyme. I. Activity and correlation with serum lysozyme in sarcoidosis, other chest or lymph node diseases and healthy persons.

Serum angiotensin-converting enzyme (ACE) activity was studied in healthy controls, in 57 untreated sarcoidosis patients, and in 164 patients with other chest or lymph node diseases. The serum ACE activity of healthy persons was independent of sex, intake of meals, and smoking habits. There were no diurnal variations. Healthy children had a significantly higher ACE mean value than adults, whose ACE activity was not affected by age. The sarcoidosis patients had the highest ACE mean values, but those of patients with silicosis and asbestosis were also significantly elevated. Pulmonary cancer patients had decreased serum ACE activity, which was probably due to antimitotic treatment. Serum lysozyme (LZM) concentrations did not correlate with normal ACE activity, but the correlation between elevated ACE and LZM was significant in sarcoidosis and silicosis, and the trend was clearly the same for asbestosis. This indicates separate sources for these enzymes when ACE activity is normal, and a common source, i.e. macrophages, when ACE activity is increased. ACE production in certain diseases involving macrophages may be due to the bradykinin inhibiting effect of this enzyme.

Adolescent↗
PubMed1990

[CA 19-9 in patients with benign pulmonary diseases].

Although serum CA 19-9 is considered to be a useful and specific tumor marker for pancreatic cancer, some patients with benign pulmonary diseases show elevated serum CA 19-9 levels. We measured serum CA 19-9 levels of 156 patients with benign pulmonary diseases (55 with asbestosis, 11 with bronchial asthma, 32 with bronchiectasis, 16 with idiopathic pulmonary fibrosis (IPF), 13 with healed pulmonary tuberculosis (HPT) and 29 other benign diseases). The percentage of patients with positive serum CA 19-9 was 42.3% (14.5% in asbestosis, 27.3% in bronchial asthma, 59.4% in bronchiectasis, 81.3% in IPF, 61.5% in HPT and 51.7% in others). In some patients, serum CA 19-9 levels were as high as those found in malignant gastrointestinal diseases. Serum CA 19-9 levels correlated well with disease activity. Immunohistochemically, CA 19-9 was expressed in mucous cells of the bronchial gland and surface of the bronchiolar surface epithelium cells in benign pulmonary disease. Gel filtration study suggested some difference in molecular weight between the serum CA 19-9 antigen of lung cancer and that of benign pulmonary diseases. It is suggested that serum CA 19-9 increases in the case of hyperplasia of the bronchiolar epithelium cells or the mucous cells of the bronchial gland. We conclude that benign pulmonary disease is one of the factors that affect serum CA 19-9 levels.

Aged↗
PubMed1989

[Application of polarized microscopy and analytic electron microscopy in pneumoconiotic pathologic examination].

38 cases of pneumoconiotic pathologic slides have been reexamined by polarized microscopy, among this, 3 cases (every 1 case of silicosis, asbestosis, cement dusts pneumoconiosis) have investigated by analytic electron microscopy. Authors presented, crystal silica and asbestos fiber may be showing under polarized light, and often associated with carbon dusts or fibrotic proliferation. So that, polarized microscopy may be as a preliminary detect method for silica and uncoated asbestos fiber from histologic slide, according to its dimension, color, lightness, morphologic feature and position were differential diagnosis from other positive substance under routine pathologic examination, further demonstration must to be reduced to ashes and re-observation under polarized microscopy. Also we selected 3 cases of silicosis, asbestosis, cement dusts pneumoconiosis specimen prepared to ultramicrotomic slides and examined by H-800 electron microscopy, when discovered some particles (such as crystal, non-crystal or fibrotic dusts) in cytoplasm of macrophages or interstitial space then used EDAX estimated. Its elements distribution were conformity with dusts (silica, asbestos, cement dusts).

Anthracosilicosis↗
PubMed1978

Asbestos exposure as a cause of immunological stimulation.

Twenty immunological parameters were determined for 37 asbestos-exposed workers with no radiographic pulmonary fibrosis and 132 asbestosis patients, 37 of whom formed a matched referent group for the non-diseased workers. No clear differences between the matched groups were found for the autoantibodies tested, but the prevalence of autoantibodies was increased in both groups in comparison with the prevalence among Finnish blood donor candidates. This phenomenon may reflect a general immunological activity caused by asbestos dust, and this immunological activity may act as an adjuvant in immunisation. The patients revealed a high level of IgA, C3, C4 and alpha-1-antitrypsin. This result indicates that these factors may be related to the development of asbestosis, and could therefore be utilized in the evaluation of diffuse pulmonary fibrosis among workers with asbestos exposure.

Adult↗
PubMed1986

Gallium-67 uptake in the lung of asbestos exposed sheep: early association with enhanced macrophage-derived fibronectin accumulation.

To evaluate the time course and mechanisms of enhanced 67Ga lung uptake in asbestosis, we exposed two groups of sheep every 2 wk to either 100 ml saline (controls) or 100 mg UICC chrysotile fibers in 100 ml saline. The sheep were evaluated periodically by pulmonary function tests (PFT), thoracic radiograph (TR), 67Ga lung scan bronchoalveolar lavage (BAL), and transbronchial lung biopsy (TLB). By month 24 of the study, 9/15 exposed sheep had developed the initial alveolitis and had significant changes in PFT, TR, and TLB. The other six exposed sheep differed from controls only by a 75% increase in BAL fibronectin until month 30, where significant changes in albumin occurred and 67Ga scan score increased. The nine sheep with alveolitis had significant sustained increases in 67Ga scan and BAL levels from month 6, associated with a 150% increase in BAL fibronectin and other parameters of disease activity changed from month 18 to 30. We concluded that in the sheep model of asbestosis, significant changes in 67Ga scan, 67Ga BAL counts, and excessive elevation of BAL fibronectin preceded other parameters of disease activity. The data suggest that excessively activated macrophages are primarily responsible for the early 67Ga lung uptake.

Animals↗
PubMed1986

Asbestos diseases and pulmonary symptoms and signs in shipyard workers and their families in Los Angeles.

Families of 338 male and 81 female shipyard workers (SYW), including 280 wives, 144 daughters, and 81 sons, were examined for diseases resulting from asbestos. The workers were initially exposed to asbestos at least 20 years prior to the study date. Radiographic signs of asbestosis (using standard criteria international Labor Office 1980) were found in 64% of 288 male SYW and 21% of 71 female SYW. After excluding those with any occupational exposure to asbestos, asbestosis prevalence was 11% in wives, 8% in sons, and 2% in daughters. Asbestos disease prevalence in workers and in wives increased with the number of years from initial exposure. Male SYW who had smoked had airway obstruction without volume loss. Nonsmokers had normal pulmonary functions. In SYW households prevalences of respiratory diseases, wheezing on physical examination, and symptoms of asthma and chronic bronchitis, exceeded those in the comparison (Michigan) population, even for the younger daughters and sons. These differences, and airway obstruction and distribution defects reported earlier were not explained by cigarette smoking or by asbestos exposure. Instead, they are tentatively ascribed to long-term exposure to ambient air pollution in Los Angeles.

Age Factors↗
PubMed1985

[Lessons from a long-term survey on the effects of massive occupational exposure to asbestos. The AMISOL affair 10 years later].

For the past 10 years the authors have followed up a cohort of workers who had been massively exposed to dust in an asbestos textile factory which closed down in 1974. They report on the difficulties of all kinds they encountered during this epidemiological survey. The most original result is that they were able to establish that the radiological and functional manifestations of asbestosis pursue their course after the subjects have ceased to be exposed. Another important point is the early development of lesions in peripheral bronchioles, detected by volume-flow loops. The authors insist on the psycho-social problems at the site of work or in daily life which arise from the use of asbestos or of fibres with similar properties. Social protection, at present well organized, should suppress the risk of asbestosis in Western countries. However, a number of problems remain to be solved, notably those concerning the long-term risk of pleural mesothelioma, the mode of action of the fibers and the immune reactions they induce, and the economic and social consequences of a hypothetical ban on asbestos--a material very difficult to replace. This study embodies, in miniature, all the problems of society associated with asbestos during this second half of the XX th century.

Asbestosis↗
PubMed1979

[Clinical aspects and prevention of pneumoconiosis caused by inorganic dusts (author's transl)].

Anthracosilicosis and asbestosis are the most important types of pneumoconioses induced by inorganic dust. They produce entirely different damage to the broncho-pulmonary system. Anthracosilicosis graded B or C roentgenographically is very often accompanied by obstructive respiratory disorders; in asbestosis restrictive disturbances predominate. The question whether obstructive lesions also tend to occur remains to be solved. Dyspnoea often accompanied by bronchitis is the main clinical feature. Anthrocosilicosis is amenable to therapeutic measures which have resulted in a considerable prolongation of the life span of these cases. Improved dust control is the most rational prophylactic measure. Abstention from smoking also plays a part.

Airway Obstruction↗