Lung function in asbestos-exposed workers, a systematic review and meta-analysis.

Dennis Wilken,Ulf Manuwald,Xaver Baur,Marcial Velasco Garrido

doi:10.1186/1745-6673-6-21

Abstract

BackgroundA continuing controversy exists about whether, asbestos exposure is associated with significant lung function impairments when major radiological abnormalities are lacking. We conducted a systematic review and meta-analysis in order to assess whether asbestos exposure is related to impairment of lung function parameters independently of the radiological findings.MethodsMEDLINE was searched from its inception up to April 2010. We included studies that assessed lung function parameters in asbestos exposed workers and stratified subjects according to radiological findings. Estimates of VC, FEV1 and FEV1/VC with their dispersion measures were extracted and pooled.ResultsOur meta-analysis with data from 9,921 workers exposed to asbestos demonstrates a statistically significant reduction in VC, FEV1 and FEV1/VC, even in those workers without radiological changes. Less severe lung function impairments are detected if the diagnoses are based on (high resolution) computed tomography rather than the less sensitive X-ray images. The degree of lung function impairment was partly related to the proportion of smokers included in the studies.ConclusionsAsbestos exposure is related to restrictive and obstructive lung function impairment. Even in the absence of radiological evidence of parenchymal or pleural diseases there is a trend for functional impairment.

Highlights

Asbestos fibres are one of the most pervasive environmental hazards because of their worldwide use in the last 100 years as a cheap and effective thermal, sound and electrical insulation material, especially in the construction, shipping and textile industries
A total of 542 papers were identified by the electronic literature database search and a further 46 papers through manual searching in congress reports, reference scanning and from our own archive (Figure 1)
These findings extend the meta-analysis by Filippelli, Martines et al [35] who found statistically significant reductions in all investigated lung function parameters in subjects exposed to asbestos, the authors did not account for different radiological findings

Summary

Introduction

Asbestos fibres are one of the most pervasive environmental hazards because of their worldwide use in the last 100 years as a cheap and effective thermal, sound and electrical insulation material, especially in the construction, shipping and textile industries. Lung and laryngeal cancer, asbestos has long been known to cause non-. We have conducted a systematic review and a metaanalysis of the literature with the aim of identifying and quantifying alterations of lung function parameters in subjects occupationally exposed to asbestos. The leading question was whether occupational exposure to asbestos leads to impairments of lung function independently from the non-malignant radiological findings (i.e. normal chest radiograph (X-ray) or (high resolution) computed tomography (HR)CT, pleural plaques and diffuse pleural thickening or asbestosis). A continuing controversy exists about whether, asbestos exposure is associated with significant lung function impairments when major radiological abnormalities are lacking. We conducted a systematic review and meta-analysis in order to assess whether asbestos exposure is related to impairment of lung function parameters independently of the radiological findings

Methods

Results

Discussion

Conclusion