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Carneiro APS, da Silva LL, Silva FDCL, Hering KG, Algranti E. Volume-based tomography for the diagnosis of incipient silicosis in former gold miners. Occup Environ Med 2022; 79:427-432. [DOI: 10.1136/oemed-2021-107922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/05/2022] [Indexed: 11/04/2022]
Abstract
ObjectiveTo evaluate silicosis diagnosed through CT, with integration of clinical-occupational data, in silica-exposed workers presenting chest X-rays within International Labor Organization (ILO) category 0.MethodsCross-sectional study with 339 former gold miners, with comparable exposures and X-rays classified as ILO subcategory 0/0 (n=285) and 0/1 (n=54) were submitted to volume-based CT. The findings were classified according to the International Classification of HRCT CT for Occupational and Environmental Respiratory Diseases.ResultsA profusion degree of round opacities (RO)>1 was found in 22.4% (76/339) of the CT exams. After integrating the CT findings with clinical and occupational data, silicosis was diagnosed as follows: 43/285 (15.1%) and 14/54 (25.9%) in workers whose X-rays had been classified as 0/0 and 0/1, respectively. There was an upward trend towards longer exposures, reaching 38.9% when working more than 10 years underground and classified as 0/1 (p=0019). Those with presence of RO whose final diagnosis was not silicosis were mainly cases of tuberculosis or ‘indeterminate nodules’. Emphysema was found in 65/339 (19.1%), only 5 being detected in the X-ray.ConclusionVolume-based CT proved to be useful in the investigation of silicosis among individuals with a relevant exposure to silica, capturing diagnoses that had not been identified on X-rays. A response gradient of silicosis was showed by CT even in this population with ILO category 0 radiographs. It can be indicated based on quantitative and/or qualitative criteria of occupational exposure, especially considering the possibilities of low CT dosage.
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Early Detection Methods for Silicosis in Australia and Internationally: A Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158123. [PMID: 34360414 PMCID: PMC8345652 DOI: 10.3390/ijerph18158123] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 12/30/2022]
Abstract
Pneumoconiosis, or occupational lung disease, is one of the world’s most prevalent work-related diseases. Silicosis, a type of pneumoconiosis, is caused by inhaling respirable crystalline silica (RCS) dust. Although silicosis can be fatal, it is completely preventable. Hundreds of thousands of workers globally are at risk of being exposed to RCS at the workplace from various activities in many industries. Currently, in Australia and internationally, there are a range of methods used for the respiratory surveillance of workers exposed to RCS. These methods include health and exposure questionnaires, spirometry, chest X-rays, and HRCT. However, these methods predominantly do not detect the disease until it has significantly progressed. For this reason, there is a growing body of research investigating early detection methods for silicosis, particularly biomarkers. This literature review summarises the research to date on early detection methods for silicosis and makes recommendations for future work in this area. Findings from this review conclude that there is a critical need for an early detection method for silicosis, however, further laboratory- and field-based research is required.
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Franquet T, Franks TJ, Galvin JR, Marchiori E, Giménez A, Mazzini S, Johkoh T, Lee KS. Non-Infectious Granulomatous Lung Disease: Imaging Findings with Pathologic Correlation. Korean J Radiol 2021; 22:1416-1435. [PMID: 34132073 PMCID: PMC8316771 DOI: 10.3348/kjr.2020.1082] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022] Open
Abstract
Non-infectious granulomatous lung disease represents a diverse group of disorders characterized by pulmonary opacities associated with granulomatous inflammation, a relatively nonspecific finding commonly encountered by pathologists. Some lesions may present a diagnostic challenge because of nonspecific imaging features; however, recognition of the various imaging manifestations of these disorders in conjunction with patients' clinical history, such as age, symptom onset and duration, immune status, and presence of asthma or cutaneous lesions, is imperative for narrowing the differential diagnosis and determining appropriate management of this rare group of disorders. In this pictorial review, we describe the pathologic findings of various non-infectious granulomatous lung diseases as well as the radiologic features and high-resolution computed tomography imaging features.
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Affiliation(s)
- Tomás Franquet
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain.
| | - Teri J Franks
- Department of Defense, Pulmonary & Mediastinal Pathology, The Joint Pathology Center, Silver Spring, MD, USA
| | - Jeffrey R Galvin
- Department of Diagnostic Radiology, Chest Imaging, & Pulmonary Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Edson Marchiori
- Department of Radiology, Hospital Universitário Clementino Fraga Filho-Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Ana Giménez
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Sandra Mazzini
- Department of Diagnostic Radiology, Hospital de Sant Pau, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Takeshi Johkoh
- Department of Radiology, Kansai Rosai Hospital, Hyogo, Japan
| | - Kyung Soo Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, Korea
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Perret JL, Miles S, Brims F, Newbigin K, Davidson M, Jersmann H, Edwards A, Zosky G, Frankel A, Johnson AR, Hoy R, Reid DW, Musk AW, Abramson MJ, Edwards B, Cohen R, Yates DH. Respiratory surveillance for coal mine dust and artificial stone exposed workers in Australia and New Zealand: A position statement from the Thoracic Society of Australia and New Zealand. Respirology 2020; 25:1193-1202. [PMID: 33051927 PMCID: PMC7702073 DOI: 10.1111/resp.13952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/19/2020] [Accepted: 08/11/2020] [Indexed: 12/17/2022]
Abstract
Coal mine lung dust disease (CMDLD) and artificial stone (AS) silicosis are preventable diseases which have occurred in serious outbreaks in Australia recently. This has prompted a TSANZ review of Australia's approach to respiratory periodic health surveillance. While regulating respirable dust exposure remains the foundation of primary and secondary prevention, identification of workers with early disease assists with control of further exposure, and with the aims of preserving lung function and decreasing respiratory morbidity in those affected. Prompt detection of an abnormality also allows for ongoing respiratory specialist clinical management. This review outlines a medical framework for improvements in respiratory surveillance to detect CMDLD and AS silicosis in Australia. This includes appropriate referral, improved data collection and interpretation, enhanced surveillance, the establishment of a nationwide Occupational Lung Disease Registry and an independent advisory group. These measures are designed to improve health outcomes for workers in the coal mining, AS and other dust-exposed and mining industries.
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Affiliation(s)
- Jennifer L. Perret
- Allergy and Lung Health Unit, Centre for Epidemiology and BiostatisticsThe University of MelbourneMelbourneVICAustralia
| | - Susan Miles
- Department of MedicineCalvary Mater NewcastleNewcastleNSWAustralia
- School of Medicine and Public HealthUniversity of NewcastleNewcastleNSWAustralia
| | - Fraser Brims
- Curtin Medical SchoolCurtin UniversityPerthWAAustralia
- Department of Respiratory MedicineSir Charles Gairdner HospitalPerthWAAustralia
| | | | - Maggie Davidson
- Health and Management School of ScienceWestern Sydney UniversitySydneyNSWAustralia
| | - Hubertus Jersmann
- Department of Thoracic MedicineRoyal Adelaide HospitalAdelaideSAAustralia
| | - Adrienne Edwards
- Christchurch Public HospitalCanterbury District Health BoardChristchurchNew Zealand
| | - Graeme Zosky
- Menzies Institute for Medical Research, College of Health and MedicineUniversity of TasmaniaHobartTASAustralia
- School of Medicine, College of Health and MedicineUniversity of TasmaniaHobartTASAustralia
| | - Anthony Frankel
- Bankstown HospitalSouth Western Sydney Local Heath DistrictSydneyNSWAustralia
- Department of MedicineUniversity of New South WalesSydneyNSWAustralia
| | | | - Ryan Hoy
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - David W. Reid
- QIMR‐Berghofer Institute of Medical ResearchBrisbaneQLDAustralia
| | - A. William Musk
- Department of Respiratory MedicineSir Charles Gairdner HospitalPerthWAAustralia
- School of Population HealthUniversity of Western AustraliaPerthWAAustralia
| | - Michael J. Abramson
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVICAustralia
| | - Bob Edwards
- Wesley Dust Disease Research CentreBrisbaneQLDAustralia
| | - Robert Cohen
- School of Public Health, University of IllinoisChicagoILUSA
| | - Deborah H. Yates
- Department of Thoracic MedicineSt Vincent's HospitalSydneyNSWAustralia
- University of NSWSydneyNSWAustralia
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León-Jiménez A, Hidalgo-Molina A, Conde-Sánchez MÁ, Pérez-Alonso A, Morales-Morales JM, García-Gámez EM, Córdoba-Doña JA. Artificial Stone Silicosis. Chest 2020; 158:1060-1068. [DOI: 10.1016/j.chest.2020.03.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 02/26/2020] [Accepted: 03/01/2020] [Indexed: 11/30/2022] Open
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Suleiman ME, Rickard M, Brennan PC. Perfecting detection through education. Radiography (Lond) 2020; 26 Suppl 2:S49-S53. [PMID: 32698948 PMCID: PMC7369166 DOI: 10.1016/j.radi.2020.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 12/28/2022]
Abstract
Introduction Radiologists’ image reading skills vary, such variations in image interpretations can influence the effectiveness of the early treatment of disease and may have important clinical and economic implications. In screening mammography, clinical audits are used to assess radiologists’ performance annually, however, the nature of these audits prevent robust data analysis due to the low prevalence of breast cancer and the long waiting periods for the audit results. Research-based evidence revealed a need for changes in the methods utilised to optimise the assessment of the efficacy of radiologists’ interpretations. Methods A cloud-based platform was developed to assess and enhance radiologists’ performance help reduce variability in medical image interpretations in a research environment; however, to address a number of limitations, the platform was commercialised to make it available worldwide. Results DetectED-X’s team have been able to make their cloud-based platform available worldwide, tailored to the needs of radiologists and accredited for continuing medical/professional education; thus, changing the continuous professional development practice globally. Conclusion DetectED-X’s Rivelato, was developed to address a need for effective, available and affordable educational solutions for clinicians and health care workers wherever they are located. A true fusion of industry, academia, clinics and consumer to adapt to the growing needs of clinicians’ around the world, the latest being COVID-19 global pandemic. DetectED-X repurposed its platform to educate physicians around the world on the appearances of COVID-19 on Lung Computed Tomography scans, introducing CovED to clinicians worldwide free of charge as a multi-national consortium of collaboration to help fight COVID-19, showing how research-based evidence can create effective and scalable change globally.
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Affiliation(s)
- M E Suleiman
- L02 H04, Merewether Building, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - M Rickard
- L02 H04, Merewether Building, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - P C Brennan
- The University of Sydney, Faculty of Health Sciences, M205, Cumberland Campus, 75 East St, Lidcombe, NSW, 2141, Australia.
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7
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Abstract
Recently, there has been a worldwide resurgence in pneumoconiosis, or pulmonary fibrosis due to occupational mineral dust exposure. In Queensland, Australia, there has been a re-emergence of coal workers' pneumoconiosis and silicosis. Some coal mining communities have experienced a resurgence of progressive massive fibrosis in the USA and a worldwide epidemic is occurring of accelerated silicosis due to exposure to artificial stone. These diseases are all preventable and should not be occurring in the 21st century. Best practice prevention includes reduction of exposure to mineral dusts or, ideally, prevention of exposure altogether. However, where dust exposure has occurred, respiratory surveillance can provide a strategy for early disease detection. It is important to identify early signs of occupational lung disease at a stage where intervention may be beneficial, though it must be acknowledged that progression may occur even after cessation of exposure to dusts. Respiratory surveillance should be distinguished from population screening and case finding, which are different methods used for disease investigation and control. Designing an ideal respiratory surveillance programme is challenging, as there is no single test that accurately identifies early disease. Several different respiratory disorders may occur related to the same exposure(s). Physicians organising and interpreting tests used in respiratory surveillance must be aware of the broad range of potential work-related respiratory conditions, complexities in diagnosis, and appropriate interpretation of the exposure history, as well as current management options. A working knowledge of the compensation and medicolegal avenues available to workers in individual jurisdictions is also useful. Organising and interpreting respiratory surveillance for mineral dust-exposed workers requires specialist knowledge and understanding of the potential range of diseases, as well as a detailed occupational historyhttp://bit.ly/37KXSE4
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Affiliation(s)
- Clare Wood
- Wood Consulting Partners, Brisbane, Australia
| | - Deborah Yates
- Dept of Thoracic Medicine, St Vincent's Public Hospital, Sydney, Australia
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8
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Chang Q, Zhang H, Zhao Y. Ambient air pollution and daily hospital admissions for respiratory system-related diseases in a heavy polluted city in Northeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:10055-10064. [PMID: 31933086 DOI: 10.1007/s11356-020-07678-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 01/07/2020] [Indexed: 05/25/2023]
Abstract
Respiratory disease admission has been increasing in the recent 5 years due to heavy air pollutions and bad weather conditions in China. We investigated the short-term association of ambient air pollution with daily counts of hospital admissions due to respiratory infection diseases with stratified analysis by age (0-18, 19-65, and > 65 years old), gender (male, female), season (spring, summer, autumn, winter), and disease type (lung infections, asthma, COPD (chronic obstructive disease), URI (upper respiratory infections)) in heavy polluted city of Shenyang in China. Daily ambient air pollution concentrations, weather conditions, and hospital admission counts for 53 months (from November 1, 2013 to March 25, 2018) were extracted from related authorities in electronic databases. Associations between outdoor air pollution levels and hospital admissions were estimated for time lags of 0-7 days using quasi-Poisson additive regression models, adjusted for meteorological variables, holidays, day of week, and season, as well as eliminating autocorrelations. Single pollutant analysis results showed lung infection diseases were related to all pollutant concentration change with no lag effects. After adjusting for other pollutants and confounding factors, we found NO2 was associated with daily admissions of lung infections (ER = 6.75%, 95% CI 1.24, 12.55), asthma (ER = 20.36%, 95% CI 4.26, 38.95; lag day 5, ER = 18.48%, 95% CI 2.83, 36.51), and COPD (ER = 13.27%, 95% CI 0.46, 27.71); CO was associated with lung infections and asthma with lag effects on lag days 1 and 4; and PM2.5 was associated with COPD admissions on lag day 6. Respiratory hospital admissions in female over 65 years old and autumn were more associated with increased air pollutant levels. Our study results might add more detail evidences for relationship studies between air pollution exposure and respiratory diseases and contribute to the precise respiratory disease prevention and air pollution control strategies.
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Affiliation(s)
- Qing Chang
- Department of Graduate Medical Training, Shengjing Hospital of China Medical University, Sanhao Street No. 36, Heping, Shenyang, China
| | - Hehua Zhang
- Clinical Research Center, Shengjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, Shenyang, China
| | - Yuhong Zhao
- Department of Graduate Medical Training, Shengjing Hospital of China Medical University, Sanhao Street No. 36, Heping, Shenyang, China.
- Clinical Research Center, Shengjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, Shenyang, China.
- Clinical Research Center, Shenjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, Shenyang, China.
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9
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Edwards G. Accelerated Silicosis-An Emerging Epidemic Associated with Engineered Stone. Comment on Leso, V. et al. Artificial Stone Associated Silicosis: A Systematic Review. Int. J. Environ. Res. Public Health 2019, 16 (4), 568, doi:10.3390/ijerph16040568. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071179. [PMID: 30986926 PMCID: PMC6480259 DOI: 10.3390/ijerph16071179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 03/27/2019] [Indexed: 11/16/2022]
Abstract
The systematic review by Leso et al. (16 February 2019) is a timely contribution to the body of knowledge concerning silicosis. It highlights the lack of quality data necessary to inform both occupational health risk management and the clinical management of workers exposed to respirable crystalline silica. This communication highlights current activity being undertaken in Queensland, Australia, that will further inform our knowledge concerning this entirely preventable disease. We are about half-way through a government-funded, case-finding program involving over 800 workers from the engineered stone bench-top fabrication industry. As of 15 February 2019, 99 confirmed cases of silicosis associated with engineered stone work were identified; nearly all were asymptomatic. The empirically observed false negative rate of ILO CXRs in this high-risk group appeared significantly greater than 10%. From pooled data, we hope to develop an appropriate index of exposure to trigger health surveillance using low-dose chest HRCT. Once a worker develops symptoms of silicosis, apart from lung transplantation, there are no treatment options currently available.
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Affiliation(s)
- Graeme Edwards
- The Work Doctor, Gold Coast, QLD 4214 Queensland, Australia.
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10
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Affiliation(s)
- Kiran Batra
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX.
| | - Muhammad U Aziz
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - Traci N Adams
- Department of Pulmonary and Critical Care Medicine, University of Texas Southwestern Medical Center, Dallas, TX
| | - J David Godwin
- Department of Radiology, University of Washington Medical center, Seattle, WA
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11
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Jeny F, Brillet PY, Kim YW, Freynet O, Nunes H, Valeyre D. The place of high-resolution computed tomography imaging in the investigation of interstitial lung disease. Expert Rev Respir Med 2018; 13:79-94. [PMID: 30517828 DOI: 10.1080/17476348.2019.1556639] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION High-resolution computed tomography (HRCT) has revolutionized the diagnosis, prognosis and in some cases the prediction of therapeutic response in interstitial lung disease (ILD). HRCT represents an essential second step to a patient's clinical history, before considering any other investigation, including lung biopsy. Areas covered: This review describes the current place of HRCT in the diagnosis, prognosis and monitoring of ILD. It also lists some perspectives for the near future. Expert commentary: Since the 1980s, HRCT and its interpretation have improved, the diagnosis value of patterns, and the integration of bio-clinical elements to HRCT have been better standardized. The interobserver agreement has been investigated, allowing a better use of some limits in the interpretation of various signs. It not only takes into account one particular predominant sign, but the combination of patterns and the distribution of findings. Thanks to HRCT, the range of diagnoses and their probability are more accurately identified. The contribution of HRCT has been optimized during the multidisciplinary discussion that a difficult diagnosis calls for. HRCT quantification of the extent of diffuse lung disease becomes possible and is linked to prognosis. In the future, artificial intelligence may significantly modify the practice of radiology.
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Affiliation(s)
- Florence Jeny
- a Université Paris 13, EA2363 "Hypoxie & Poumon" , Sorbonne-Paris-Cité , Bobigny, France.,b Service de pneumologie , hôpital Avicenne , Bobigny , France
| | - Pierre-Yves Brillet
- b Service de pneumologie , hôpital Avicenne , Bobigny , France.,c Service de radiologie , hôpital Avicenne , Bobigny , France
| | - Young-Wouk Kim
- c Service de radiologie , hôpital Avicenne , Bobigny , France
| | - Olivia Freynet
- b Service de pneumologie , hôpital Avicenne , Bobigny , France
| | - Hilario Nunes
- a Université Paris 13, EA2363 "Hypoxie & Poumon" , Sorbonne-Paris-Cité , Bobigny, France.,b Service de pneumologie , hôpital Avicenne , Bobigny , France
| | - Dominique Valeyre
- a Université Paris 13, EA2363 "Hypoxie & Poumon" , Sorbonne-Paris-Cité , Bobigny, France.,b Service de pneumologie , hôpital Avicenne , Bobigny , France
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12
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de la Hoz RE, Weber J, Xu D, Doucette JT, Liu X, Carson DA, Celedón JC. Chest CT scan findings in World Trade Center workers. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2018; 74:263-270. [PMID: 29543564 PMCID: PMC6474817 DOI: 10.1080/19338244.2018.1452712] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 03/10/2018] [Indexed: 06/17/2023]
Abstract
We examined the chest CT scans of 1,453 WTC responders using the International Classification of High-resolution CT for Occupational and Environmental Respiratory Diseases. Univariate and bivariate analyses of potential work-related pleural abnormalities were performed with pre-WTC and WTC-related occupational exposure data, spirometry, demographics and quantitative CT measurements. Logistic regression was used to evaluate occupational predictors of those abnormalities. Chest CT scans were performed first at a median of 6.8 years after 9/11/2001. Pleural abnormalities were the most frequent (21.1%) across all occupational groups In multivariable analyses, significant pre-WTC occupational asbestos exposure, and work as laborer/cleaner were predictive of pleural abnormalities, with prevalence being highest for the Polish subgroup (n = 237) of our population. Continued occupational lung disease surveillance is warranted in this cohort.
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Affiliation(s)
- Rafael E. de la Hoz
- Department of Environmental Medicine and Public Health,Icahn School of Medicine at Mount Sinai, New York, NY
- Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Jonathan Weber
- Department of Environmental Medicine and Public Health,Icahn School of Medicine at Mount Sinai, New York, NY
| | - Dongming Xu
- Radiology, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - John T. Doucette
- Department of Environmental Medicine and Public Health,Icahn School of Medicine at Mount Sinai, New York, NY
| | - Xiaoyu Liu
- Radiology, and Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Deborah A. Carson
- Department of Environmental Medicine and Public Health,Icahn School of Medicine at Mount Sinai, New York, NY
| | - Juan C. Celedón
- Division of Pediatric Pulmonary Medicine, Allergy and Immunology, Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA
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Gothi D, Gahlot T, Sah RB, Saxena M, Ojha UC, Verma AK, Spalgais S. Asbestos-induced lung disease in small-scale clutch manufacturing workers. Indian J Occup Environ Med 2016; 20:95-102. [PMID: 28194083 PMCID: PMC5299819 DOI: 10.4103/0019-5278.197533] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The crocidolite variety of asbestos is banned. However, chrysotile, which is not prohibited, is still used in developing countries in making products such as clutch plate. Fourteen workers from a small-scale clutch plate-manufacturing factory were analyzed for asbestos-induced lung disease as one of their colleagues had expired due to asbestosis. AIMS This study was conducted to evaluate the awareness of workers, the prevalence and type of asbestos-induced lung disease, and the sensitivity and specificity of diffusion test. MATERIALS AND METHODS History, examination, chest radiograph, spirometry with diffusion, and high resolution computed tomography (HRCT) thorax was performed in all the workers. The diagnosis of asbestos-induced lung disease was suspected on the basis of HRCT. This was subsequently confirmed on transbronchial lung biopsy (TBLB). RESULTS None of the workers had detailed information about asbestos and its ill effects. Eleven out of 14 (71.42%) workers had asbestos-induced lung disease. All 11 had small airway disease (SAD). Three had SAD alone, 6 had additional interstitial lung disease (ILD), and 2 patients had additional ILD and chronic obstructive pulmonary disease. Sensitivity and specificity of residual volume (RV) or total lung capacity (TLC) for detecting SAD was 90% and 100%, respectively, and that of diffusion capacity of lung for carbon monoxide (DLCO) for detecting ILD was 100%. CONCLUSION The awareness about asbestos in small-scale clutch-plate manufacturing industry is poor. The usage of chrysotile should be strictly regulated as morbidity and mortality is high. DLCO and RV/TLC are sensitive and specific in detecting nonmalignant asbestos induced lung disease.
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Affiliation(s)
- Dipti Gothi
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Tanushree Gahlot
- Institute of Occupational Health and Environment Research, New Delhi, India
| | - Ram B Sah
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - Mayank Saxena
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
| | - U C Ojha
- Department of Pathology, ESI-PGIMSR, New Delhi, India
| | - Anand K Verma
- Department of Pulmonary Medicine, Lady Harding Medical College, New Delhi, India
| | - Sonam Spalgais
- Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India
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