Harvard School of Public Health, Boston, MA, USA.
J Occup Med Toxicol. 2010 Jun 3;5:12. doi: 10.1186/1745-6673-5-12.
Restrictive patterns of pulmonary function abnormalities associated with asbestos exposure are well described. Studies are less consistent, however, regarding the association of asbestos inhalation with airway dysfunction and obstructive impairment.
We compared pulmonary function test results between 277 chrysotile exposed workers (22% non-smokers) and 177 unexposed controls (50.3% non-smokers). Information on exposure and smoking were collected using a standardized questionnaire. Standardized spirometric and DCLO Measurement methods were utilized. CXRs were read based on ILO pneumoconiosis guidelines.
Asbestos exposed subjects had significantly reduced FVC, FEV1, FEV1/FVC and DLCO. Restricting the analysis to non-smokers, asbestos workers still had about 3% lower FEV1/FVC ratio than controls, but this difference did not reach statistical significance. Among exposed workers, the presence of radiographic evidence of asbestosis further lowered FVC and DLCO but not FEV1/FVC compared to asbestos exposure without radiographic asbestosis. Additionally, smoking asbestos workers had significantly lower DLCO compared to non-smoking workers.
Asbestos exposure, especially when radiographic evidence of interstitial fibrosis from asbestosis is present, leads to significant decreases in FVC, FEV1 and the DLCO. However, asbestos exposure alone is not significantly associated with a reduction of the FEV1/FVC. Smoking-asbestos workers had significantly lower DLCO than their non-smoking counterparts. Whether asbestos interacts with smoking additively or synergistically on DLCO needs further investigation. Similarly, further studies are needed to assess the progression and clinical significance of asbestos induced airway dysfunction.
石棉暴露相关的肺功能异常模式受限已有明确描述。然而，关于石棉吸入与气道功能障碍和阻塞性损害的相关性，研究结果并不一致。
我们比较了 277 名温石棉暴露工人（22%不吸烟者）和 177 名未暴露对照者（50.3%不吸烟者）的肺功能检查结果。使用标准化问卷收集暴露和吸烟信息。采用标准化的肺量计和 DCLO 测量方法。根据 ILO 尘肺指南对 X 射线胸片进行解读。
石棉暴露组的 FVC、FEV1、FEV1/FVC 和 DLCO 明显降低。将分析限制在不吸烟者中，石棉工人的 FEV1/FVC 比值仍比对照组低约 3%，但差异无统计学意义。在暴露工人中，与无石棉性间质性纤维化放射学证据的石棉暴露相比，放射学石棉性间质性纤维化的存在进一步降低了 FVC 和 DLCO，但未降低 FEV1/FVC。此外，与不吸烟的工人相比，吸烟的石棉工人的 DLCO 明显更低。
石棉暴露，尤其是当存在石棉性间质性纤维化的放射学证据时，会导致 FVC、FEV1 和 DLCO 显著下降。然而，单独的石棉暴露与 FEV1/FVC 的降低并无显著相关性。吸烟的石棉工人的 DLCO 明显低于不吸烟的工人。石棉与吸烟在 DLCO 上是否具有相加或协同作用，需要进一步研究。同样，需要进一步研究来评估石棉引起的气道功能障碍的进展和临床意义。
