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Title: Lung Diffusing Capacity Relates Better to Short-Term Progression on HRCT Abnormalities Than Spirometry in Mild Asbestosis
Authors: Nogueira, Cristiano Rabelo [UNIFESP]
Napolis, Lara Maris [UNIFESP]
Bagatin, Ericson
Terra-Filho, Mario
Mueller, Nestor L.
Silva, C. Isabela S.
Rodrigues, Reynaldo Tavares [UNIFESP]
Alberto Neder, J. [UNIFESP]
Nery, Luiz E. [UNIFESP]
Universidade Federal de São Paulo (UNIFESP)
Universidade Estadual de Campinas (UNICAMP)
Med Sch Jundiai
Universidade de São Paulo (USP)
Univ British Columbia
Keywords: asbestos
pulmonary function tests
high-resolution computed tomography
occupational lung disease
lung diffusing capacity
Issue Date: 1-Mar-2011
Publisher: Wiley-Blackwell
Citation: American Journal of Industrial Medicine. Hoboken: Wiley-liss, v. 54, n. 3, p. 185-193, 2011.
Abstract: Background Pulmonary function tests (PFT), particularly spirometry and lung diffusing capacity for carbon monoxide (DL(CO)), have been considered useful methods for the detection of the progression of interstitial asbestos abnormalities as indicated by high-resolution computed tomography (HRCT). However, it is currently unknown which of these two tests correlates best with anatomical changes over time.Methods in this study, we contrasted longitudinal changes (3-9 years follow-up) in PFTs at rest and during exercise with interstitial abnormalities evaluated by HRCT in 63 ex-workers with mild-to-moderate asbestosis.Results At baseline, patients presented with low-grade asbestosis (Huuskonen classes I-II), and most PFT results were within the limits of normality. in the follow-up, most subjects had normal spirometry, static lung volumes and arterial blood gases. in contrast, frequency of DL(CO) abnormalities almost doubled (P < 0.05). Twenty-three (36.5%) subjects increased the interstitial marks on HRCT. These had significantly larger declines in DL(CO) compared to patients who remained stable (0.88 vs. 0.31 ml/min/mm Hg/year and 3.5 vs. 1.2%/year, respectively; P < 0.05). in contrast, no between-group differences were found for the other functional tests, including spirometry (P > 0.05).Conclusions These data demonstrate that the functional consequences of progression of HRCT abnormalities in mild-to-moderate asbestosis are better reflected by decrements in DL(CO) than by spirometric changes. These results might have important practical implications for medico-legal evaluation of this patient population. Am. J. Ind. Med. 54:185-193, 2011. (c) 2010 Wiley-Liss, Inc.
ISSN: 0271-3586
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