Chest
Clinical InvestigationsTotal Lung Capacity: An Insensitive Measure of Impairment in Patients with Asbestosis and Chronic Obstructive Pulmonary Disease?
Section snippets
Population
The eligible population was comprised of all patients seen in the Occupational Medicine Programs diagnostic clinic in whom a retrospective chart review identified a history of exposure to asbestos and the presence of interstitial fibrosis (International Labor Organizations [ILO] profusion greater than or equal to 1/0, referred to as ILO≥1/0), and for whom TLC, D, and arterial blood gas levels had been obtained.7 The eligible population consisted of 141 subjects; among these, 64 had radiographic
RESULTS
There were no significant differences between groups 1 and 2 in age, race, or height (Table 1). Additionally, there were no significant differences between groups 1 and 2 in pack-years of smoking or mean number of years from first exposure to asbestos (Table 2). Group 1 had fewer individuals at higher grades of profusion compared to group 2 (53 percent [9/17] of group 1 and 63 percent [15/24] of group 2 had ILO profusion grades of ≥1/1), but neither this nor the prevalence of pleural
DISCUSSION
Asbestosis continues to be a pneumoconiosis of high prevalence among workers of many trades, including construction and shipbuilding.1 Given the long latency of 20 or more years between the first exposure and the development of interstitial fibrosis, and the continued heavy exposure of many workers to asbestos fibers into the 1970s, the prevalence of asbestos-related pulmonary disease will continue to remain high through the end of this century.12 Because asbestos exposure has been associated
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Manuscript received March 30; revision accepted July 13.
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American College of Physicians Teaching and Research Scholar
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Henry J. Kaiser Family Foundation Faculty Scholar in General Internal Medicine