title: A systematic review of the association between pleural plaques and changes in lung function.
abstract: OBJECTIVE
  To conduct a systematic review of changes in lung function in relation to presence of pleural plaques in asbestos-exposed populations.
  
  
  METHODS
  Database searches of PubMed and Web of Science were supplemented by review of papers' reference lists and journals' tables of contents. Methodological features (eg, consideration of potential confounding by smoking) of identified articles were reviewed by ≥ two reviewers. Meta-analyses of 20 studies estimated a summary effect of the decrements in per cent predicted (%pred) forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) associated with presence of pleural plaques.
  
  
  RESULTS
  Among asbestos-exposed workers, the presence of pleural plaques was associated with statistically significant decrements in FVC (4.09%pred, 95% CI 2.31 to 5.86) and FEV1 (1.99%pred, 95% CI 0.22 to 3.77). Effects of similar magnitude were seen when stratifying by imaging type (X-ray or high-resolution CT) and when excluding studies with potential methodological limitations. Undetected asbestosis was considered as an unlikely explanation of the observed decrements. Several studies provided evidence of an association between size of pleural plaques and degree of pulmonary decrease, and presence of pleural plaques and increased rate or degree of pulmonary impairment.
  
  
  CONCLUSIONS
  The presence of pleural plaques is associated with a small, but statistically significant mean difference in FVC and FEV1 in comparison to asbestos-exposed individuals without plaques or other abnormalities. From a public health perspective, small group mean decrements in lung function coupled with an increased rate of decline in lung function of the exposed population may be consequential.
authors.affiliation: National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Washington DC, USA.
authors.forename: Leonid
authors.initials: L
authors.lastname: Kopylev
authors.affiliation: National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Washington DC, USA.
authors.forename: Krista Yorita
authors.initials: KY
authors.lastname: Christensen
authors.affiliation: National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Washington DC, USA.
authors.forename: James S
authors.initials: JS
authors.lastname: Brown
authors.affiliation: National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Washington DC, USA.
authors.forename: Glinda S
authors.initials: GS
authors.lastname: Cooper
mesh_terms: D001194:Asbestos / Q000009:adverse effects*; D001195:Asbestosis / Q000150:complications; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000209:etiology* / Q000503:physiopathology; D009784:Occupational Diseases / Q000209:etiology* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects*; D010994:Pleura / Q000187:drug effects* / Q000473:pathology; D010995:Pleural Diseases / Q000209:etiology* / Q000473:pathology; D012907:Smoking; D014797:Vital Capacity
chemical_list: D001194:Asbestos
keywords: FEV1; FVC; pleural plaque