Štěpánek Ladislav, Nakládalová Marie, Janošíková Magdaléna, Štěpánek Lubomír, Boriková Alena
Department of Occupational Medicine, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Zdravotníků 248/7, Olomouc, 77900, Czech Republic.
Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovská 1, Prague, 12000, Czech Republic.
Int Arch Occup Environ Health. 2025 Aug;98(6):497-505. doi: 10.1007/s00420-025-02143-w. Epub 2025 May 22.
Occupational asbestos exposure was widespread before regulatory bans, and it remains a risk during renovations or demolitions of older buildings. While asbestos-related diseases are well-documented, less is known about minor radiological changes in exposed individuals. This longitudinal study aimed to identify predictors of pleural and parenchymal lung disorders in individuals with previous occupational asbestos exposure, focusing on both established asbestos-related diseases and minor radiological abnormalities.
The study tracked 445 former employees (334 men, 111 women) of two Czech asbestos-processing plants, who underwent regular examinations from the 1980s to December 2022. Cox proportional hazards regression models were employed to analyse predictors of asbestos-related diseases, as well as minor radiological findings alone.
Over a median latency of 37 years, 127 participants (28.5%) developed asbestos-related diseases, mainly pleural mesothelioma (59 cases). An additional 168 participants (37.8%) exhibited minor radiological findings, predominantly pleural plaques (129 cases), while 150 (33.7%) had no abnormalities. Substantial cumulative exposure was a strong predictor for minor radiological findings (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.18-3.35, p = 0.010) and any endpoint, including diseases (OR 1.89, 95% CI 1.18-3.02, p = 0.008). Respiratory symptoms and impaired spirometry results significantly increased the likelihood of endpoint occurrence. No significant differences emerged between settings with predominantly chrysotile exposure and those with a chrysotile-crocidolite mixture.
This study highlights the predictive value of cumulative exposure and the need for ongoing surveillance of occupationally exposed individuals to better understand radiological changes, their significance, and to refine risk assessment models.
在监管禁令实施之前，职业性石棉暴露很普遍，并且在旧建筑的翻新或拆除过程中仍然存在风险。虽然与石棉相关的疾病有充分记录，但对于暴露个体的轻微放射学变化了解较少。这项纵向研究旨在确定既往有职业性石棉暴露个体的胸膜和肺实质疾病的预测因素，重点关注已确诊的石棉相关疾病和轻微放射学异常。
该研究追踪了捷克两家石棉加工厂的445名前雇员（334名男性，111名女性），他们从20世纪80年代到2022年12月接受了定期检查。采用Cox比例风险回归模型分析石棉相关疾病以及仅轻微放射学检查结果的预测因素。
在中位潜伏期为37年的时间里，127名参与者（28.5%）患上了石棉相关疾病，主要是胸膜间皮瘤（59例）。另外168名参与者（37.8%）有轻微放射学检查结果，主要是胸膜斑（129例），而150名（33.7%）没有异常。大量累积暴露是轻微放射学检查结果（优势比[OR]1.98，95%置信区间[CI]1.18 - 3.35，p = 0.010）以及任何终点事件（包括疾病，OR 1.89，95% CI 1.18 - 3.02，p = 0.008）的有力预测因素。呼吸道症状和肺功能测定结果受损显著增加了终点事件发生的可能性。主要接触温石棉的环境与接触温石棉 - 青石棉混合物的环境之间未出现显著差异。
本研究强调了累积暴露的预测价值以及对职业暴露个体进行持续监测的必要性，以便更好地了解放射学变化、其意义并完善风险评估模型。
