title: [Analysis of changes in radiographic lung image and lung ventilation disorders in workers occupationally exposed to chrysotile in the past].
abstract: BACKGROUND
  The adverse health effects of occupational exposure to asbestos dust may occur several years after first exposure. The objective of the study was to assess the relationship between lesions in the respiratory system and the factors contributing to occupational exposure to asbestos described in the first medical examination as well as to analyze the factors responsible for the progression of these changes in further medical tests.
  
  
  METHODS
  The study group comprised 591 former workers of asbestos processing plant "Gambit" in Lubawka. The results of medical examinations carried out in 2001-2012 were assessed. Statistical inference was performed based on bilateral significance tests at the 0.05 level of significance.
  
  
  RESULTS
  A higher risk of interstitial lung changes along with an increase in the cumulative concentration of asbestos was indicated; for the employees with the highest exposure, the adjusted odds ratio (OR) was 1.63 (95% confidence interval (CI): 0.99-2.71), while for changes with the severity degree qualifying for asbestosis diagnosis, the risk was significantly increased, over fivefold higher, compared to subjects employed in the lowest exposure. The analysis of the relationship between the progression of interstitial changes and the exposure to asbestos dust showed a fourfold higher risk of the progression in workers employed in the highest exposure. Mean values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity), FEV1/FVC (forced expiratory volume in 1 s to forced vital capacity) were significantly lower in the subjects working in a higher asbestos exposure. The effect of tobacco smoking on the occurrence of interstitial lung changes and their progression was also confirmed.
  
  
  CONCLUSIONS
  The results of prophylactic medical examinations of the health status of workers formerly employed in the plants using chrysotile indicate the importance andthe need for a long-term clinical follow-up and the promotion of anti-smoking prevention in this group of former employees. Med Pr 2017;68(2):247-258.
authors.affiliation: Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu, Oddział Jelenia Góra / Regional Centre of Occupational Medicine, Jelenia Góra Department, Wrocław, Poland (Dyrektor Oddziału / Head of the Department). womp.jg@womp.wroc.pl.
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Cwynar
authors.affiliation: Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Insttitute of Occupational Medicine, Łódź, Poland (Zakład Epidemiologii Środowiskowej / Department of Environmental Epidemiology). beata_sn@imp.lodz.pl.
authors.forename: Beata
authors.initials: B
authors.lastname: Świątkowska
authors.affiliation: Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu / Regional Centre of Occupational Medicine, Wrocław, Poland (Dyrektor Ośrodka / Head of the Centre). womp@womp.wroc.pl.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Tomczyk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017632:Asbestos, Serpentine / Q000009:adverse effects*; D001195:Asbestosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D004391:Dust; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D011044:Poland; D012123:Pulmonary Ventilation; D013902:Radiography, Thoracic
chemical_list: D017632:Asbestos, Serpentine; D004391:Dust
keywords: asbestosis; chrysotile; cumulative exposure; interstitial lung changes; occupational exposure; spirometric parameters