Chest ultrasonography in health surveillance of asbestos-related lung diseases.
OBJECTIVE
Exposure to asbestos fibers can lead to different lung diseases, such as pleural thickening and effusion, asbestosis, mesothelioma, and lung cancer. These diseases are expected to peak in the next few years. The aim of the study was to validate ultrasonography (US) as a diagnostic tool in the management of lung diseases in subjects with a history of occupational exposure to asbestos.


METHODS
Fifty-nine retired male workers previously exposed to asbestos were enrolled in the study. Chest US was performed in all the subjects. The US operator was blinded to earlier performed computed tomography (CT) scan reports and images. The sonographic pathological findings were pleural thickening (with or without calcifications), peripheral lung consolidation, and focal sonographic interstitial syndrome and diffuse pneumogenic sonographic interstitial syndrome (pulmonary asbestosis). Significant US findings were recorded, stored, and subsequently compared with CT scans.


RESULTS
With some patients falling into more than one category, on CT scan, pleural thickening was reported in 33 cases (56%, 26 with calcifications), focal interstitial peripheral alterations in 23 (39%), asbestosis in 6 (10%), and peripheral lung consolidation in 13 cases (22%). Comparing each pathological condition to CT scan reports, US findings had high levels of sensitivity, specificity, positive, and negative predictive values. US did not prove effective for the detection of central lung nodules or diaphragmatic pleural thickenings. Chest US was considered to be the best technique to detect minimal pleural effusions (six subjects, 10%).


CONCLUSIONS
Chest US might be considered an additional tool to follow up subjects occupationally exposed to asbestos who have already undergone CT scan examination and whose pathology is detectable by US as well.
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Andrea
A
Smargiassi
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Giuliana
G
Pasciuto
3 Pulmonary Medicine Department, OORR Area Nolana-ASL Napoli3 Sud, Pollena Trocchia, Italy.
Ilaria
I
Pedicelli
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Erminia
E
Lo Greco
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Mariarosaria
M
Calvello
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Riccardo
R
Inchingolo
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Gioacchino
G
Schifino
2 Department of Public Health, University of Naples-Federico II, Naples, Italy.
Patrizio
P
Capoluongo
3 Pulmonary Medicine Department, OORR Area Nolana-ASL Napoli3 Sud, Pollena Trocchia, Italy.
Pasquale
P
Patriciello
2 Department of Public Health, University of Naples-Federico II, Naples, Italy.
Maurizio
M
Manno
5 Department of Prevention, Service of Hygiene and Occupational Medicine-ASL Napoli3 Sud, Pompei, Italy.
Alfonso
A
Cirillo
1 Pulmonary Medicine Department, University Hospital "A. Gemelli"-Università Cattolica del Sacro Cuore, Rome, Italy.
Giuseppe Maria
GM
Corbo
4 Emergency Department, Valle del Serchio General Hospital, Castelnuovo Garfagnana, Italy.
Gino
G
Soldati
2 Department of Public Health, University of Naples-Federico II, Naples, Italy.
Ivo
I
Iavicoli
D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000633:toxicity*; D001195:Asbestosis / Q000000981:diagnostic imaging*; D015992:Body Mass Index; D015331:Cohort Studies; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D001194:Asbestos
Asbestos; lung cancer; lung ultrasound; occupational exposure; pleural diseases; workers