Prazakova Silvie, Thomas Paul S, Sandrini Alessandra, Yates Deborah H
Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Respiratory Medicine Department, Prince of Wales Hospital, Sydney, NSW, Australia.
Clin Respir J. 2014 Jan;8(1):1-10. doi: 10.1111/crj.12028. Epub 2013 Jul 31.
The asbestos-related disorders (ARDs) are currently of significant occupational and public health concern. Asbestos usage has been banned in most developed countries, but asbestos is still used in many developing countries and the number of cases of ARDs worldwide is rising. Many countries are now experiencing an epidemic of ARDs that is the legacy of occupational exposure in the 1960s-1980s because of the long latency period between asbestos exposure and manifestation of disease. It is likely that asbestos-related mortality and morbidity will continue to increase. Although the most feared complications of asbestos inhalation are the malignant conditions such as mesothelioma and lung cancer, asbestos inhalation more frequently results in benign conditions such as pleural plaques, diffuse pleural thickening, and asbestosis (pulmonary fibrosis due to asbestos exposure). Over recent years, there have been changes in the epidemiology of mesothelioma, in clinical management of ARDs and developments in new techniques for early detection of malignancy. This review provides an update on the respiratory manifestations of asbestos exposure and also considers advances in screening methods that may affect future management in the workplace.
石棉相关疾病(ARDs)目前是重大的职业和公共卫生问题。在大多数发达国家,石棉的使用已被禁止,但在许多发展中国家仍在使用,并且全球范围内ARDs的病例数正在上升。由于石棉暴露与疾病表现之间存在较长的潜伏期,许多国家目前正经历着ARDs的流行,这是20世纪60年代至80年代职业暴露遗留下来的问题。石棉相关的死亡率和发病率可能会继续上升。尽管吸入石棉最令人担忧的并发症是恶性疾病,如间皮瘤和肺癌,但吸入石棉更常见的结果是良性疾病,如胸膜斑、弥漫性胸膜增厚和石棉肺(因接触石棉导致的肺纤维化)。近年来,间皮瘤的流行病学、ARDs的临床管理以及恶性肿瘤早期检测新技术都有了变化。本综述提供了石棉暴露的呼吸道表现的最新情况,并探讨了可能影响未来工作场所管理的筛查方法的进展。