title: Diffuse pleural fibrosis--an unreliable indicator of heavy asbestos exposure?
abstract: OBJECTIVE
  This study aimed at testing the hypothesis that diffuse pleural fibrosis is associated with a heavier exposure to asbestos than that of benign pleural plaques, and hence diffuse pleural fibrosis can be used as a marker of heavy exposure.
  
  
  METHODS
  Asbestos burden was estimated for 192 naval dockyard workers (96 with diffuse pleural fibrosis, 96 with plaques) by calculating the exposure ratings from the trade and the years spent in that trade. In 53 cases the diffuse pleural fibrosis was bilateral.
  
  
  RESULTS
  No difference was found in the mean estimated asbestos burden between all diffuse pleural fibrosis and plaques, nor between plaques and unilateral and bilateral diffuse pleural fibrosis, analyzed separately by a one-factor analysis of variance. The mean asbestos burden was significantly greater for bilateral than for unilateral diffuse pleural fibrosis. A wide spread of asbestos exposure was noted among the men with diffuse pleural fibrosis.
  
  
  CONCLUSIONS
  Diffuse pleural fibrosis may arise after widely varying exposure to asbestos. The mean exposure ratings for diffuse pleural fibrosis do not differ from those for pleural plaques, although the ratings are significantly higher for men with bilateral diffuse pleural fibrosis than for those with unilateral diffuse pleural fibrosis. Diffuse pleural fibrosis cannot be used as a reliable marker of heavy asbestos exposure.
authors.affiliation: Department of Respiratory Medicine, Derriford Hospital, Plymouth, United Kingdom.
authors.forename: Katharine A
authors.initials: KA
authors.lastname: Smith
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Sykes
authors.forename: Clive R
authors.initials: CR
authors.lastname: McGavin
mesh_terms: D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D005355:Fibrosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D010994:Pleura / Q000473:pathology; D010995:Pleural Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000453:epidemiology; D011859:Radiography; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D001194:Asbestos