Chest
Clinical Investigations: Occupational/EnvironmentalAirways Obstruction From Asbestos Exposure: Effects of Asbestosis and Smoking
Section snippets
Methods
The 1,146 men with asbestosis and the 1,146 age-matched asbestos-exposed comparison men were from 8,720 workers studied at 47 sites across the United States from California to Florida. The asbestos exposed men (ILO profusion 0/0 and 0/1) were individually matched for age to men with asbestosis (ILO profusion 1/0 to 3/3) in each smoking category using a computer algorithm. A few current and ex-smokers, older than 65 years, were matched to the next youngest or oldest individual if the match pool
Results
There were 1,146 white men in both asbestos-exposed and asbestosis groups. Each group included 119 who had never smoked cigarettes, 722 current cigarette smokers, and 305 ex-smokers. Groups were compared as means and their pulmonary functions as mean percent predicted horizontally for the effect of asbestos and vertically for effect of smoking (Table 2).
Progressive Functional Impairment From Asbestosis
Asbestos without personal cigarette smoking caused progressive asbestos lung disease. Its course has been approximated from these observations. Analysis by difference in means, differences in residuals (observation minus group mean), and by regression agreed that physiologic abnormalities worsened as asbestosis was recognized and increased in severity on radiographs. First, with asbestos exposure alone, was reduced flow in small airways suggesting obstruction with air trapping as the earliest
ACKNOWLEDGMENT
We are grateful for the assistance of Robert G. Fraser, M.D., Professor of Radiology, University of Alabama, Birmingham, School of Medicine, and Daniel Powers, M.D., Los Angeles, as radiologists and “B” readers. Each read several hundred chest radiographs.
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Presented, in part, at the Annual meeting, American Thoracic Society, Cincinnati, May 16, 1989.