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Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography

BACKGROUND: Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR´s ability in detecting the expected reduction in the...

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Autores principales: Terra-Filho, Mario, Bagatin, Ericson, Nery, Luiz Eduardo, Nápolis, Lara Maris, Neder, José Alberto, de Souza Portes Meirelles, Gustavo, Silva, C. Isabela, Muller, Nestor L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366170/
https://www.ncbi.nlm.nih.gov/pubmed/25790222
http://dx.doi.org/10.1371/journal.pone.0118585
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author Terra-Filho, Mario
Bagatin, Ericson
Nery, Luiz Eduardo
Nápolis, Lara Maris
Neder, José Alberto
de Souza Portes Meirelles, Gustavo
Silva, C. Isabela
Muller, Nestor L.
author_facet Terra-Filho, Mario
Bagatin, Ericson
Nery, Luiz Eduardo
Nápolis, Lara Maris
Neder, José Alberto
de Souza Portes Meirelles, Gustavo
Silva, C. Isabela
Muller, Nestor L.
author_sort Terra-Filho, Mario
collection PubMed
description BACKGROUND: Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR´s ability in detecting the expected reduction in the frequency of these asbestos-related abnormalities (ARA) as exposure decreases. METHODS: Clinical evaluation, CXR, Thin-section CT and spirometry were obtained in 1418 miners and millers who were exposed to progressively lower airborne concentrations of asbestos. They were separated into four groups according to the type, period and measurements of exposure and/or procedures for controlling exposure: Group I (1940–1966/tremolite and chrysotile, without measurements of exposure and procedures for controlling exposure); Group II (1967–1976/chrysotile only, without measurements of exposure and procedures for controlling exposure); Group III (1977–1980/chrysotile only, initiated measurements of exposure and procedures for controlling exposure) and Group IV (after 1981/chrysotile only, implemented measurements of exposure and a comprehensive procedures for controlling exposure). RESULTS: In all groups, CXR suggested more frequently interstitial abnormalities and less frequently pleural plaques than observed on Thin-section CT (p<0.050). The odds for asbestosis in groups of decreasing exposure diminished to greater extent at Thin-section CT than on CXR. Lung function was reduced in subjects who had pleural plaques evident only on Thin-section CT (p<0.050). In a longitudinal evaluation of 301 subjects without interstitial and pleural abnormalities on CXR and Thin-section CT in a previous evaluation, only Thin-section CT indicated that these ARA reduced as exposure decreased. CONCLUSIONS: CXR compared to Thin-section CT was associated with false-positives for interstitial abnormalities and false-negatives for pleural plaques, regardless of the intensity of asbestos exposure. Also, CXR led to a substantial misinformation of the effects of the progressively lower asbestos concentrations in the occurrence of asbestos-related diseases in miners and millers.
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spelling pubmed-43661702015-03-23 Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography Terra-Filho, Mario Bagatin, Ericson Nery, Luiz Eduardo Nápolis, Lara Maris Neder, José Alberto de Souza Portes Meirelles, Gustavo Silva, C. Isabela Muller, Nestor L. PLoS One Research Article BACKGROUND: Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR´s ability in detecting the expected reduction in the frequency of these asbestos-related abnormalities (ARA) as exposure decreases. METHODS: Clinical evaluation, CXR, Thin-section CT and spirometry were obtained in 1418 miners and millers who were exposed to progressively lower airborne concentrations of asbestos. They were separated into four groups according to the type, period and measurements of exposure and/or procedures for controlling exposure: Group I (1940–1966/tremolite and chrysotile, without measurements of exposure and procedures for controlling exposure); Group II (1967–1976/chrysotile only, without measurements of exposure and procedures for controlling exposure); Group III (1977–1980/chrysotile only, initiated measurements of exposure and procedures for controlling exposure) and Group IV (after 1981/chrysotile only, implemented measurements of exposure and a comprehensive procedures for controlling exposure). RESULTS: In all groups, CXR suggested more frequently interstitial abnormalities and less frequently pleural plaques than observed on Thin-section CT (p<0.050). The odds for asbestosis in groups of decreasing exposure diminished to greater extent at Thin-section CT than on CXR. Lung function was reduced in subjects who had pleural plaques evident only on Thin-section CT (p<0.050). In a longitudinal evaluation of 301 subjects without interstitial and pleural abnormalities on CXR and Thin-section CT in a previous evaluation, only Thin-section CT indicated that these ARA reduced as exposure decreased. CONCLUSIONS: CXR compared to Thin-section CT was associated with false-positives for interstitial abnormalities and false-negatives for pleural plaques, regardless of the intensity of asbestos exposure. Also, CXR led to a substantial misinformation of the effects of the progressively lower asbestos concentrations in the occurrence of asbestos-related diseases in miners and millers. Public Library of Science 2015-03-19 /pmc/articles/PMC4366170/ /pubmed/25790222 http://dx.doi.org/10.1371/journal.pone.0118585 Text en © 2015 Terra-Filho et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Terra-Filho, Mario
Bagatin, Ericson
Nery, Luiz Eduardo
Nápolis, Lara Maris
Neder, José Alberto
de Souza Portes Meirelles, Gustavo
Silva, C. Isabela
Muller, Nestor L.
Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title_full Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title_fullStr Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title_full_unstemmed Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title_short Screening of Miners and Millers at Decreasing Levels of Asbestos Exposure: Comparison of Chest Radiography and Thin-Section Computed Tomography
title_sort screening of miners and millers at decreasing levels of asbestos exposure: comparison of chest radiography and thin-section computed tomography
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4366170/
https://www.ncbi.nlm.nih.gov/pubmed/25790222
http://dx.doi.org/10.1371/journal.pone.0118585
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