Abstract
Background: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. Results: Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19–0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95–5.07). Exposure was elevated among maintenance workers, compared to other jobs (p = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18–54.5). Conclusions: Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.
Highlights
Asbestos-related disorders remain an occupational health concern in most developing countries, and continue to be a major cause of morbidity and mortality in developed countries, despite stricter regulations in the first, and the ban of asbestos use in the second during the last decades [1].According to the 2012 International Agency for Research on Cancer IARC evaluation, asbestos is a well-established cause of mesothelioma and cancer of the lung, larynx, and ovary, as confirmed in several epidemiological studies in humans and experimental animals
Over the whole study population, the time-weighted average exposure to asbestos was relatively low and the average cumulative exposure was 4.51 f/mL-years
Exposure was higher among maintenance workers, compared to plant operators, and service workers, whose direct contact with asbestos was only occasional, and exposure had been mainly as bystanders or from the work environment
Summary
Asbestos-related disorders remain an occupational health concern in most developing countries, and continue to be a major cause of morbidity and mortality in developed countries, despite stricter regulations in the first, and the ban of asbestos use in the second during the last decades [1].According to the 2012 International Agency for Research on Cancer IARC evaluation, asbestos is a well-established cause of mesothelioma and cancer of the lung, larynx, and ovary, as confirmed in several epidemiological studies in humans and experimental animals. Exposure to asbestos fibers can induce a series of benign conditions, such as diffuse pleural thickening with or without calcifications, and interstitial fibrosis of the lung parenchyma (asbestosis) [1]. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18–54.5)
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