09:30 - 12:30, 3 hours, International Conference Hall
Plenary Session 4
Medical Aspects: Surveillance and Treatment of Asbestos-related Diseases
4-B: Diagnosis and Treatment of Asbestos-Related Diseases
Chairs: Bruce Robinsoni [not-confirmed] and Takashi Nakano
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Hirotaro Miura
Yokosuka Kyosai Hospital, Japan
ABSTRACT:
INTRODUCTION:
Asbestos exposure causes the fibrosis of pulmonary parenchyma and/or pleura. The former is pneumoconiosis, named asbestosis, followed by various grades of respiratory dysfunction. Diffuse pleural thickening (DPT) is a disease with diffuse fibrosis of pleura also often followed by severe pulmonary dysfunction. It is necessary that the visceral pleura is affected for this disease, though the parietal one is also frequently damaged and accompanied by adhesion of both ones in contrast to pleural plaque. Asbestos exposure is known to be one of the causes of the DPT.
RATIONALE:
To clarify the incidence of DPT and estimate the grade of pulmonary dysfunction due to DPT, the CXRs, CTs including HRCTs, spirometries and medical records on the checkups for the retired asbestos workers. All of them had CXR findings of 1/0 or less grade compared to the ILO standard films and almost of them had clear pleural plaques.
EXAMINEES:
From 2001 to 2003 there were 93 examinees who had CXR and CT in the same time, pulmonary function test within 3 years, and no ill history affected with pleura except of asbestos exposure.
RESULTS:
Among 93 examinees there were 8 ones (9%) with bilateral DPT on CXR which had signs affected with visceral pleura on CT. Their spirometries showed that the average of %VC was 65.0% (ranged from 47.1% to 96.7%) and the average of FEV1% was 80.7% (ranged from 61.1% to 95.2%). There were 2 persons having the %VC under 60%.
About 9% of the persons having no obvious asbestosis but clear asbestos exposure were revealed that they possessed the disease of diffuse pleural thickening and tendency to restrictive pulmonary function. One fourth of them showed having severe pulmonary dysfunction. The follow-up of the diffuse pleural thickening patients related to asbestos exposure must be more carefully done.