Gothi Dipti, Gahlot Tanushree, Sah Ram B, Saxena Mayank, Ojha U C, Verma Anand K, Spalgais Sonam
Department of Pulmonary Medicine, ESI-PGIMSR, New Delhi, India.
Institute of Occupational Health and Environment Research, New Delhi, India.
Indian J Occup Environ Med. 2016 May-Aug;20(2):95-102. doi: 10.4103/0019-5278.197533.
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.
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.
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).
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%.
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.
青石棉品种的石棉已被禁止使用。然而，未被禁止的温石棉仍在发展中国家用于制造离合器片等产品。一家小型离合器片制造工厂的14名工人因一名同事死于石棉肺而接受了石棉所致肺病的分析。
本研究旨在评估工人的知晓情况、石棉所致肺病的患病率和类型，以及弥散试验的敏感性和特异性。
对所有工人进行了病史采集、体格检查、胸部X线摄影、肺功能弥散测定以及胸部高分辨率计算机断层扫描（HRCT）。基于HRCT怀疑石棉所致肺病的诊断，随后经支气管肺活检（TBLB）得以证实。
没有一名工人掌握有关石棉及其不良影响的详细信息。14名工人中有11名（71.42%）患有石棉所致肺病。所有11名患者均有小气道疾病（SAD）。3名患者仅有SAD，6名患者伴有间质性肺病（ILD），2名患者伴有ILD和慢性阻塞性肺疾病。残气量（RV）或肺总量（TLC）检测SAD的敏感性和特异性分别为90%和100%，一氧化碳弥散量（DLCO）检测ILD的敏感性为100%。
小型离合器片制造行业对石棉的知晓情况较差。由于发病率和死亡率较高，应严格管制温石棉的使用。DLCO和RV/TLC在检测非恶性石棉所致肺病方面具有敏感性和特异性。
