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

Autor: Harris EJA; Curtin Medical School, Curtin University, Perth, Western, Australia.; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Washington, USA., Lim KP; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Washington, USA., Moodley Y; Department of Respiratory Medicine, Fiona Stanley Hospital, Perth, Washington, USA., Adler B; Envision Medical Imaging, Perth, Subiaco, Australia., Sodhi-Berry N; School of Population and Global Health, University of Western Australia, Perth, Western, Australia., Reid A; School of Public Health, Curtin University, Perth, Western, Australia., Murray CP; Perth Children's Hospital, Perth, Western, Australia., Franklin PJ; School of Population and Global Health, University of Western Australia, Perth, Western, Australia., Musk AB; School of Population and Global Health, University of Western Australia, Perth, Western, Australia., de Klerk NH; School of Population and Global Health, University of Western Australia, Perth, Western, Australia.; Telethon Kids Institute, Nedlands, Western Australia, Australia., Brims FJH; Curtin Medical School, Curtin University, Perth, Western, Australia.; Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Washington, USA.; National Centre for Asbestos Related Diseases, Institute for Respiratory Health, Perth, Western, Australia.
Jazyk: angličtina
Zdroj: American journal of industrial medicine [Am J Ind Med] 2021 Jul; Vol. 64 (7), pp. 567-575. Date of Electronic Publication: 2021 May 03.
DOI: 10.1002/ajim.23251
Abstrakt: 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 (FEV 1 );​ 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.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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