Chest
Occupational and Environmental Lung DiseaseChanging Patterns in Asbestos-Induced Lung Disease
Section snippets
Materials and Methods
To test this hypothesis, we assessed patterns of asbestos-induced lung disease from a registry of asbestos-exposed workers (n = 3,383) established as the Selikoff registry. All patients were referred for independent medical evaluation. Entry criteria for an independent medical evaluation included documented workplace asbestos exposure, an elapsed time from date of first exposure (latency) of > 10 years, and an abnormal chest radiograph pattern consistent with the history of asbestos exposure.
Demographics
The mean age (± SD) of the study population was 65.1 ± 9.9 years (range, 28 to 93 years) [white race, 93%; male gender, 96%]. Six percent of the individuals were African Americans, and 1% characterized themselves as “other” race. Nearly two thirds of the workers could be classified with six job descriptors (Fig 1). A small number of subjects had a diagnosis of lung cancer (1.9%) or mesothelioma (2.4%). These individuals tended to be older than control subjects and subjects with nonmalignant
Discussion
In this study, we found that most subjects had normal pulmonary function. When pulmonary function abnormalities were present, the dominant finding was airways obstruction. Spirometric evaluation in the absence of lung volume measurements caused misclassification of subjects who had obstruction with coexistent airtrapping as part of the mixed-pattern group. This misclassification resulted in overestimation of the presence of a restrictive pattern of pulmonary function by attributing causation of
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Dr. Ohar has served as an expert witness for both the defense and plaintiffs in judicial pleadings for compensation for asbestos-induced diseases.
Financial support was provided by the Selikoff Fund, Saint Louis University.