Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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CT Characteristics of Pleural Plaques Related to Occupational or Environmental Asbestos Exposure from South Korean Asbestos Mines

  • Kim, Yookyung (Department of Radiology, School of Medicine, Ewha Womans University) ;
  • Myong, Jun-Pyo (Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jeong Kyong (Department of Radiology, School of Medicine, Ewha Womans University) ;
  • Kim, Jeung Sook (Department of Radiology, Dongguk University Ilsan Hospital) ;
  • Kim, Yoon Kyung (Department of Radiology, Gachon University Gil Medical Center) ;
  • Jung, Soon-Hee (Department of Pathology, Yonsei University Wonju College of Medicine)
  • Received : 2015.04.11
  • Accepted : 2015.06.02
  • Published : 2015.09.01
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Abstract

Objective: This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups. Materials and Methods: This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups. Results: Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, $5.4{\pm}2.7mm$) and lengths (5-310 mm; $72.6{\pm}54.8mm$). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05). Conclusion: Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.

Keywords

References

  1. McDonald JC, McDonald AD, Armstrong B, Sebastien P. Cohort study of mortality of vermiculite miners exposed to tremolite. Br J Ind Med 1986;43:436-444
  2. Artvinli M, Baris YI. Malignant mesotheliomas in a small village in the Anatolian region of Turkey: an epidemiologic study. J Natl Cancer Inst 1979;63:17-22
  3. Jones RN, McLoud T, Rockoff SD. The radiographic pleural abnormalities in asbestos exposure: relationship to physiologic abnormalities. J Thorac Imaging 1988;3:57-66 https://doi.org/10.1097/00005382-198810000-00009
  4. Larson TC, Lewin M, Gottschall EB, Antao VC, Kapil V, Rose CS. Associations between radiographic findings and spirometry in a community exposed to Libby amphibole. Occup Environ Med 2012;69:361-366 https://doi.org/10.1136/oemed-2011-100316
  5. Clin B, Paris C, Ameille J, Brochard P, Conso F, Gislard A, et al. Do asbestos-related pleural plaques on HRCT scans cause restrictive impairment in the absence of pulmonary fibrosis? Thorax 2011;66:985-991 https://doi.org/10.1136/thoraxjnl-2011-200172
  6. Cugell DW, Kamp DW. Asbestos and the pleura: a review. Chest 2004;125:1103-1117 https://doi.org/10.1378/chest.125.3.1103
  7. Friedman AC, Fiel SB, Fisher MS, Radecki PD, Lev-Toaff AS, Caroline DF. Asbestos-related pleural disease and asbestosis: a comparison of CT and chest radiography. AJR Am J Roentgenol 1988;150:269-275 https://doi.org/10.2214/ajr.150.2.269
  8. Aberle DR, Gamsu G, Ray CS, Feuerstein IM. Asbestos-related pleural and parenchymal fibrosis: detection with highresolution CT. Radiology 1988;166:729-734 https://doi.org/10.1148/radiology.166.3.3340770
  9. Gamsu G, Aberle DR, Lynch D. Computed tomography in the diagnosis of asbestos-related thoracic disease. J Thorac Imaging 1989;4:61-67 https://doi.org/10.1097/00005382-198901000-00012
  10. Elshazley M, Shibata E, Hisanaga N, Ichihara G, Ewis AA, Kamijima M, et al. Pleural plaque profiles on the chest radiographs and CT scans of asbestos-exposed Japanese construction workers. Ind Health 2011;49:626-633 https://doi.org/10.2486/indhealth.MS1268
  11. Korosteleva O. Nonparametric regression. In: Korosteleva O, ed. Nonparametric methods in statistics with SAS applications. Florida: CRC Press Taylor & Francis Group, 2013:75-96
  12. Kim HR. Overview of asbestos issues in Korea. J Korean Med Sci 2009;24:363-367 https://doi.org/10.3346/jkms.2009.24.3.363
  13. Metintas S, Metintas M, Ucgun I, Oner U. Malignant mesothelioma due to environmental exposure to asbestos: follow-up of a Turkish cohort living in a rural area. Chest 2002;122:2224-2229 https://doi.org/10.1378/chest.122.6.2224
  14. Liu XZ, Luo SQ, Wang ZM, Wang MZ, Zhan CL. An investigation of crocidolite contamination and mesothelioma in a rural area of China. Biomed Environ Sci 1990;3:156-165
  15. Baris B, Demir AU, Shehu V, Karakoca Y, Kisacik G, Baris YI. Environmental fibrous zeolite (erionite) exposure and malignant tumors other than mesothelioma. J Environ Pathol Toxicol Oncol 1996;15:183-189
  16. Peipins LA, Lewin M, Campolucci S, Lybarger JA, Miller A, Middleton D, et al. Radiographic abnormalities and exposure to asbestos-contaminated vermiculite in the community of Libby, Montana, USA. Environ Health Perspect 2003;111:1753-1759 https://doi.org/10.1289/ehp.6346
  17. Metintas M, Metintas S, Hillerdal G, Ucgun I, Erginel S, Alatas F, et al. Nonmalignant pleural lesions due to environmental exposure to asbestos: a field-based, cross-sectional study. Eur Respir J 2005;26:875-880 https://doi.org/10.1183/09031936.05.00136404
  18. Cvitanovic S, Znaor L, Konsa T, Ivancevic Z, Peric I, Erceg M, et al. Malignant and non-malignant asbestos-related pleural and lung disease: 10-year follow-up study. Croat Med J 2003;44:618-625
  19. Rohs AM, Lockey JE, Dunning KK, Shukla R, Fan H, Hilbert T, et al. Low-level fiber-induced radiographic changes caused by Libby vermiculite: a 25-year follow-up study. Am J Respir Crit Care Med 2008;177:630-637 https://doi.org/10.1164/rccm.200706-841OC
  20. Larson TC, Meyer CA, Kapil V, Gurney JW, Tarver RD, Black CB, et al. Workers with Libby amphibole exposure: retrospective identification and progression of radiographic changes. Radiology 2010;255:924-933 https://doi.org/10.1148/radiol.10091447
  21. Churg A, Wright JL, DePaoli L, Wiggs B. Mineralogic correlates of fibrosis in chrysotile miners and millers. Am Rev Respir Dis 1989;139:891-896 https://doi.org/10.1164/ajrccm/139.4.891
  22. Churg A, Wright J, Wiggs B, Depaoli L. Mineralogic parameters related to amosite asbestos-induced fibrosis in humans. Am Rev Respir Dis 1990;142(6 Pt 1):1331-1336 https://doi.org/10.1164/ajrccm/142.6_Pt_1.1331
  23. Aberle DR, Gamsu G, Ray CS. High-resolution CT of benign asbestos-related diseases: clinical and radiographic correlation. AJR Am J Roentgenol 1988;151:883-891 https://doi.org/10.2214/ajr.151.5.883
  24. Jarad NA, Wilkinson P, Pearson MC, Rudd RM. A new high resolution computed tomography scoring system for pulmonary fibrosis, pleural disease, and emphysema in patients with asbestos related disease. Br J Ind Med 1992;49:73-84

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