Adverse effects of asbestos exposure and smoking on lung function.
BACKGROUND
Exposure to asbestos is a well-recognized cause of both malignant and nonmalignant diseases of lung parenchyma and pleura. This study was conducted to determine the adverse effects of exposure to asbestos and smoking on pulmonary function.


METHODS
Four hundred and sixty-eight workers who were occupationally exposed to asbestos for an average of 13 years were selected from an asbestos-product factory in China. Of them, 85 workers were diagnosed with asbestosis. Additionally, 282 workers who had no experience of exposure to industrial dust were included as a control group. A questionnaire was administered during a face-to-face interview and spirometric maneuvers and single-breath CO diffusing capacity (DL(CO)) were performed.


RESULTS
Multivariate regression analysis showed that exposure to asbestos was more strongly associated with decreased forced vital capacity (FVC) and DL(CO), and asbestosis more strongly associated with decreased FVC, while smoking was a major contributing factor to reduced FEV1/FVC. The results were confirmed by a further analysis where the subjects were grouped exclusively by smoking, asbestos exposure, and chest radiographic changes. No interaction or joint effect was observed between asbestos exposure and smoking.


CONCLUSIONS
This analysis suggested that asbestos and smoking might play independent roles, in which asbestos caused mainly a restrictive impairment, and smoking was a major causal factor for airway obstruction in the workers who were intensively exposed to asbestos.
Harvard School of Public Health, Boston, MA 02115, USA.
Xiaorong
X
Wang
Eiji
E
Yano
Zhiming
Z
Wang
Mianzheng
M
Wang
David C
DC
Christiani
D000328:Adult; D000402:Airway Obstruction / Q000209:etiology*; D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires; D014797:Vital Capacity
D001194:Asbestos