title: Asbestos-induced lung disease in small-scale clutch manufacturing workers.
abstract: BACKGROUND
  The crocidolite variety of asbestos is banned. However, chrysotile, which is not prohibited, is still used in developing countries in making products such as clutch plate. Fourteen workers from a small-scale clutch plate-manufacturing factory were analyzed for asbestos-induced lung disease as one of their colleagues had expired due to asbestosis.
  
  
  OBJECTIVE
  This study was conducted to evaluate the awareness of workers, the prevalence and type of asbestos-induced lung disease, and the sensitivity and specificity of diffusion test.
  
  
  METHODS
  History, examination, chest radiograph, spirometry with diffusion, and high resolution computed tomography (HRCT) thorax was performed in all the workers. The diagnosis of asbestos-induced lung disease was suspected on the basis of HRCT. This was subsequently confirmed on transbronchial lung biopsy (TBLB).
  
  
  RESULTS
  None of the workers had detailed information about asbestos and its ill effects. Eleven out of 14 (71.42%) workers had asbestos-induced lung disease. All 11 had small airway disease (SAD). Three had SAD alone, 6 had additional interstitial lung disease (ILD), and 2 patients had additional ILD and chronic obstructive pulmonary disease. Sensitivity and specificity of residual volume (RV) or total lung capacity (TLC) for detecting SAD was 90% and 100%, respectively, and that of diffusion capacity of lung for carbon monoxide (DLCO) for detecting ILD was 100%.
  
  
  CONCLUSIONS
  The awareness about asbestos in small-scale clutch-plate manufacturing industry is poor. The usage of chrysotile should be strictly regulated as morbidity and mortality is high. DLCO and RV/TLC are sensitive and specific in detecting nonmalignant asbestos induced lung disease.
authors.affiliation: Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
authors.forename: Dipti
authors.initials: D
authors.lastname: Gothi
authors.affiliation: Institute of Occupational Health and Environment Research, New Delhi, India.
authors.forename: Tanushree
authors.initials: T
authors.lastname: Gahlot
authors.affiliation: Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
authors.forename: Ram B
authors.initials: RB
authors.lastname: Sah
authors.affiliation: Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
authors.forename: Mayank
authors.initials: M
authors.lastname: Saxena
authors.affiliation: Department of Pathology, ESI-PGIMSR, New Delhi, India.
authors.forename: U C
authors.initials: UC
authors.lastname: Ojha
authors.affiliation: Department of Pulmonary Medicine, Lady Harding Medical College, New Delhi, India.
authors.forename: Anand K
authors.initials: AK
authors.lastname: Verma
authors.affiliation: Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
authors.forename: Sonam
authors.initials: S
authors.lastname: Spalgais
keywords: Asbestos; nonmalignant; small airway disease