Abstract
BackgroundDust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure.MethodsTo reduce confounding factors, subjects with normal spirometry without fibrosis, asthma and pneumonia histories were only selected, and a propensity score matching was applied to match age, sex, height, smoking status, and pack-years. Thus, from a larger data set (N = 609), only 41 cement dust-exposed subjects were compared with 164 non-cement dust-exposed subjects. QCT imaging metrics of airway hydraulic diameter (Dh), wall thickness (WT), and bifurcation angle (θ) were extracted at total lung capacity (TLC) and functional residual capacity (FRC), along with their deformation ratios between TLC and FRC.ResultsIn TLC scan, dust-exposed subjects showed a decrease of Dh (airway narrowing) especially at lower-lobes (p < 0.05), an increase of WT (wall thickening) at all segmental airways (p < 0.05), and an alteration of θ at most of the central airways (p < 0.001) compared with non-dust-exposed subjects. Furthermore, dust-exposed subjects had smaller deformation ratios of WT at the segmental airways (p < 0.05) and θ at the right main bronchi and left main bronchi (p < 0.01), indicating airway stiffness.ConclusionsDust-exposed subjects with normal spirometry demonstrated airway narrowing at lower-lobes, wall thickening at all segmental airways, a different bifurcation angle at central airways, and a loss of airway wall elasticity at lower-lobes. The airway structural alterations may indicate different airway pathophysiology due to cement dusts.
Highlights
Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs
Relative to NDE subjects, the Hydraulic diameter (Dh), total lung capacity (TLC) and Dh, functional residual capacity (FRC) of DE subjects were smaller in the airways at right main bronchus (RMB), TriLUL, and TriRUL (Fig. 3b and e)
In conclusion, with quantitative computed tomography (QCT) imaging metrics, we demonstrated that DE subjects had unique features of airway structure, especially in segmental airways, compared with NDE subjects
Summary
Dust exposure has been reported as a risk factor of pulmonary disease, leading to alterations of segmental airways and parenchymal lungs. This study aims to investigate alterations of quantitative computed tomography (QCT)-based airway structural and functional metrics due to cement-dust exposure. Dust exposure has been reported as a risk factor for pulmonary disease. An association between dust exposure and lung function has been reported via cytological and spirometry findings. In dusty areas near cement plants, the serum mercury level of blood samples was correlated with a decrease in the forced expiratory volume in 1 s (FEV1) and a risk of obstructive lung disease [3]. We hypothesize that environmental dust exposure by cements is associated with alterations of quantitative computed tomography (QCT)based airway structural and functional metrics. QCT imaging-based variables are used to investigate structural and functional alterations due to dust exposure
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