Disorders of the Pleura |

Asbestos-Related Diffuse Pleural Thickening in Japan: A Retrospective Analysis FREE TO VIEW

Nobukazu Fujimoto, MD; Katsuya Kato, MD; Ikuji Usami, MD; Fumikazu Sakai, MD; Takeshi Tokuyama, MD; Seiji Hayashi, MD; Kenji Miyamoto, MD; Takumi Kishimoto, MD
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Okayama Rosai Hospital, Okayama, Japan

Chest. 2014;146(4_MeetingAbstracts):445A. doi:10.1378/chest.1987424
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SESSION TITLE: Pleural Disease Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: The pathogenesis and clinical features of asbestos-related diffuse pleural thickening (DPT) remain unclear; therefore, we conducted a retrospective study of patients with DPT in Japan.

METHODS: Medical data from patients with asbestos-related DPT were collected, including a history of occupational or neighborhood asbestos exposure, initial symptoms, modified Medical Research Council dyspnea grade, smoking history, radiological findings, and respiratory function test results.

RESULTS: There were 106 DPT patients between 2005 and 2010 (103 men [97.2%] and three women [2.8%]). Median age at diagnosis was 69 (range 46-88) years. Patient occupations related to asbestos exposure included 17 asbestos-product manufacturing; 14 shipbuilding industry; 13 construction industry; 12 moisturizing work; seven each of plumbing, asbestos spraying, and electrical work; and four each of transportation and demolition work. Median duration of asbestos exposure was 25 (range 2-54) years, and median latency period for onset of DPT was 46 (range 25-66) years. The craniocaudal extension of pleural thickening, as determined and scored on chest X-ray, was negatively correlated with the percent vital capacity (%VC) (r=−0.483, p<0.01). Involvement of the costophrenic angle was also negatively correlated with %VC (r= −0.448, p<0.01). Pleural thickness and the craniocaudal and horizontal extension of pleural thickening, as determined by chest CT, were also negatively correlated with %VC (r=−0.226, p<0.05; r=−0.409, p<0.01; and r=−0.408, p<0.01, respectively).

CONCLUSIONS: DPT develops after a long latency period following occupational asbestos exposure and causes marked respiratory dysfunction. Some of the radiological features of DPT may reflect the extent of impaired respiratory function.

CLINICAL IMPLICATIONS: Physicians should be informed about the features of asbestos-related DPT. Knowledge of the mMRC dyspnea scale score, the involvement of the costophrenic angle on chest X-ray, and the extent of pleural thickening on CT are useful when evaluating DPT.

DISCLOSURE: The following authors have nothing to disclose: Nobukazu Fujimoto, Katsuya Kato, Ikuji Usami, Fumikazu Sakai, Takeshi Tokuyama, Seiji Hayashi, Kenji Miyamoto, Takumi Kishimoto

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