Clinical and HRCT screening of heavily asbestos-exposed workers.
OBJECTIVE
To characterize asbestosis today and to clarify the indications for high-resolution computed tomography (HRCT) in the surveillance of heavily exposed workers.


METHODS
Six hundred and twenty-seven workers were screened and HRCT findings were classified and divided in two groups: pulmonary fibrosis (n = 86) and no fibrosis (n = 541).


RESULTS
Most (65/86 = 76%) of the detected fibrosis cases were mild. The magnitude of asbestos exposure showed an unexpected inverse relation with fibrosis. In multivariate analyses, age, forced expiratory volume in 1 s/forced vital capacity ratio, and poor diffusing capacity were associated with HRCT fibrosis, but asbestos exposure was not.


CONCLUSIONS
Asbestosis seems to be characterized by mild fibrosis today even in heavily exposed workers. To avoid radiation exposure in HRCT, age and lung function data may be used only to a limited extent to select imaging candidates. Selection and recollection biases may distort the relation between asbestos exposure and fibrosis.
Vierikko
Tuula
T
The Department of Diagnostic Radiology, Tampere University Hospital, Teiskontie 35, 33521, Tampere, Finland. tuula.vierikko@fimnet.fi
Järvenpää
Ritva
R
Toivio
Pauliina
P
Uitti
Jukka
J
Oksa
Panu
P
Lindholm
Tuula
T
Vehmas
Tapio
T
D000367:Age Factors; D000368:Aged; D000395:Air Pollutants, Occupational / Q000633:toxicity*; D001194:Asbestos / Q000633:toxicity*; D042241:Early Diagnosis; D005355:Fibrosis; D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016273:Occupational Exposure / Q000009:adverse effects*; D010994:Pleura / Q000000981:diagnostic imaging / Q000473:pathology; D012129:Respiratory Function Tests; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D000395:Air Pollutants, Occupational; D001194:Asbestos