Does asbestos exposure cause airway obstruction, in the absence of confirmed asbestosis?
BACKGROUND
Whether occupational exposure to asbestos causes airway obstruction remains controversial.


OBJECTIVE
This study evaluated lung function in relation to cumulative exposure to asbestos in a large cohort of retired or unemployed workers exposed to asbestos.


METHODS
The study population consisted of 3,660 volunteer subjects. An individual cumulative exposure index to asbestos was calculated for each subject, and information was obtained on smoking status. Pulmonary function tests were performed in all subjects; high-resolution chest computed tomography was also performed in 3,335 subjects.


RESULTS
Values of FEV(1)/FVC and FEF(25-75%) did not differ between five classes (quintiles) of cumulative exposure to asbestos, and no significant correlation was observed between cumulative exposure to asbestos and pulmonary function parameters, after adjustment for sex, tobacco consumption, emphysema, and body mass index. Furthermore, the proportion of abnormal pulmonary function tests did not differ between the five classes of cumulative exposure to asbestos.


CONCLUSIONS
The results do not support a causal relationship between asbestos exposure alone and airway obstruction. However, the study sample may not be representative of all people occupationally exposed to asbestos, because a fraction of subjects with previously diagnosed asbestosis probably did not participate in this screening program.
Ameille
Jacques
J
Occupational Diseases Department, Hôpital Raymond Poincaré, Garches, France. jacques.ameille@rpc.aphp.fr
Letourneux
Marc
M
Paris
Christophe
C
Brochard
Patrick
P
Stoufflet
Audrey
A
Schorle
Evelyne
E
Gislard
Antoine
A
Laurent
François
F
Conso
Françoise
F
Pairon
Jean-Claude
JC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000453:epidemiology* / Q000209:etiology; D001194:Asbestos / Q000009:adverse effects*; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005540:Forced Expiratory Flow Rates; D005541:Forced Expiratory Volume; D005602:France; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D012129:Respiratory Function Tests / Q000379:methods / Q000706:statistics & numerical data; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000706:statistics & numerical data; D014797:Vital Capacity
D001194:Asbestos