Validity of static lungs compliance in asbestos-induced diseases of lung

Status:

completed 12/2005

Aims:

Reports about suspicion of lung-asbestosis or other lung-diseases caused by asbestos-dust in accordance with Annex 1, No. 4103, Ordinance on occupational diseases, indicate a persistently upward trend for decades.
The health impairment due to lung-/pleura diseases arising from asbestos-dust is depending on the restriction of lung function. The characteristic pulmonary dysfunction in case of lung asbestosis shows a restrictive respiratory disorder.
Within the framework of this research project the relevance of lung function parameter particularly static compliance to patients with lung asbestosis and/or patients with lung-diseases caused by asbestos in different forms will be investigated. Furthermore a correlation of conventional x-ray images of thorax organs and high resolution computer tomography examinations (HRCT) including lung function parameters, particularly the static compliance of patients with already acknowledged occupational disease No. 4103 BKV, should be made.

Activities/Methods:

N=175 patients examined at the BG Clinic Bad Reichenhall in the time for 1991-1993 as part of special curative procedure have to be included in this study.
The following data are available:
1. Pulmonary function test (spirometry, whole-body plethysmography, particularly static and dynamic compliance).
2. X-ray images of thorax organs. The coding standardised to the International Classification of Radiographs of Pneumoconioses ILO 1980/BRD, takes place by an experienced B-Reader.
3. Workplace anamnesis.
4. High resolution computer tomography examinations (HRCT). The images are evaluated by following the International Classification of Radiographs of Pneumoconioses. Provided are registration and description of the data as well as preparation of correlations and statistical evaluation.

Results:

The inter-observer comparison of the ILO codes using conventionally chest X-ray images shows a satisfactory agreement between A- and B-reader in detection of asbestos dust caused lung and pleura diseases.
Computed tomography, especially in high resolution technique (HRCT) allows an earlier and more accurate detection of asbestos induced diseases of the pleura. Also in the diagnosis of parenchymal changes in lung tissue, the HRCT technique is more sensitive than conventionally chest X-ray radiographs.
The severity of the conventional chest X-ray images correlate more closely with the reduction of lung function analysis than those of the HRCT diagnosis.
Restrictive ventilation disorder as a typical sign of parenchymal fibrosis was detectable only to a small extent. Patients suffering only from circumscribed pleural plaques did not show any impairment. Obstructive ventilation pattern were not associated with asbestosis in this study.
Pulmonary function increments as the vital capacity, the diffusion parameters and the static lung compliance correlated with severity of pulmonary fibrosis in conventional chest X-ray but not with the HRCT.
Correlations of conventional radiographs or HRCT with the static compliance could not be detected. The Compliance measurement does not represent an appropriate method for early detection of radiographically confirmed asbestosis.

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