Aims 

To determine the essential parameters in pulmonary function and LD HR-TCT for secondary prevention of asbestos-related lung lesions.

Methods 

Data from spirometry, body plethysmography, DLCO, and TCT were retrospectively analyzed from 72 patients examined in 2017-2019. Subjects were divided into 4 subgroups based on the comorbidities of heart disease, obstructive ventilation disorders, lung function consistent with emphysema, or no other lung or heart disease. TCT were evaluated according to the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD). In addition, asbestos-related parameters like subpleural curvilinear lines (SC), parenchymal bands (PB), and rounded atelectasis (RA) were quantified and included in appropriate scores. Correlations, Spearman's rho (?), Cohen?s ?, and accuracy were calculated.

Results

VC shows only marginal reduction in the whole collective (mean 92% pred.), whereas DLCO and DLCO/VA show predominantly pathological values (70% and 87% pred., resp.). On CT scans, 79% (n=57) of patients present signs of pulmonary fibrosis, 81% pleural plaques. SC (54%) and PB (40%) are common. VC correlates with the score of pleural plaques (?=-0.273, p<0.05), DLCO shows better correlation with fibrosis score (?=-0.315, p<0.01). A third, newly developed score, which includes the extent of pleural plaques and additional SC, PB, and RA, shows correlations for both VC and DLCO (?= -0.283, -0.274; p<0.05), also including patients with concomitant diseases.

Conclusions

When PB, SC, and RA are included in addition to pleural plaques, the correlation with VC and DLCO increases. Therefore, these parameters should also be quantified and used to assess disease severity.