title: Do asbestos-related pleural plaques on HRCT scans cause restrictive impairment in the absence of pulmonary fibrosis?
abstract: BACKGROUND
  It is uncertain whether isolated pleural plaques cause functional impairment.
  
  
  OBJECTIVE
  To analyse the relationship between isolated pleural plaques confirmed by CT scanning and lung function in subjects with occupational exposure to asbestos.
  
  
  METHODS
  The study population consisted of 2743 subjects presenting with no parenchymal interstitial abnormalities on the high-resolution CT (HRCT) scan. Asbestos exposure was evaluated by calculation of an individual cumulative exposure index (CEI). Each subject underwent pulmonary function tests (PFTs) and HRCT scanning. Variables were adjusted for age, smoking status, body mass index, CEI to asbestos and the centres in which the pulmonary function tests were conducted.
  
  
  RESULTS
  All functional parameters studied were within normal limits for subjects presenting with isolated pleural plaques and for those presenting with no pleuropulmonary abnormalities. However, isolated parietal and/or diaphragmatic pleural plaques were associated with a significant decrease in total lung capacity (TLC) (98.1% predicted in subjects with pleural plaques vs. 101.2% in subjects free of plaques, p=0.0494), forced vital capacity (FVC) (96.6% vs. 100.4%, p<0.001) and forced expiratory volume in 1 s (FEV(1)) (97.9% vs. 101.9%, p=0.0032). In contrast, no significant relationship was observed between pleural plaques and FEV1/FVC ratio, forced expiratory flow at 25-75% FVC and residual volume. A significant correlation was found between the extent of pleural plaques and the reduction in FVC and TLC, whereas plaque thickness was not related to functional impairment.
  
  
  CONCLUSIONS
  The results show a relationship between isolated parietal and/or diaphragmatic pleural plaques and a trend towards a restrictive pattern, although the observed decrease in FVC and TLC is unlikely to be of real clinical relevance for the majority of subjects in this series.
authors: Cancers and Populations, ERI3 INSERM, Faculty of Medicine, Caen University Hospital, Caen, France. clin-b@chu-caen.fr
authors: Bénédicte
authors: B
authors: Clin
authors: Christophe
authors: C
authors: Paris
authors: Jacques
authors: J
authors: Ameille
authors: Patrick
authors: P
authors: Brochard
authors: Françoise
authors: F
authors: Conso
authors: Antoine
authors: A
authors: Gislard
authors: François
authors: F
authors: Laurent
authors: Marc
authors: M
authors: Letourneux
authors: Amandine
authors: A
authors: Luc
authors: Evelyne
authors: E
authors: Schorle
authors: Jean-Claude
authors: JC
authors: Pairon
mesh_terms: D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D001195:Asbestosis / Q000000981:diagnostic imaging; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D005602:France / Q000453:epidemiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D010995:Pleural Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D012129:Respiratory Function Tests / Q000379:methods; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D014057:Tomography, X-Ray Computed; D014109:Total Lung Capacity; D014797:Vital Capacity / Q000502:physiology
chemical_list: D001194:Asbestos