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Lung diffusing capacity relates better to short‐term progression on HRCT abnormalities than spirometry in mild asbestosis
Author(s) -
Nogueira Cristiano Rabelo,
Nápolis Lara Maris,
Bagatin Ericson,
TerraFilho Mario,
Müller Nestor L.,
Silva C. Isabela S.,
Rodrigues Reynaldo Tavares,
Neder J. Alberto,
Nery Luiz E.
Publication year - 2011
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20922
Subject(s) - medicine , spirometry , asbestosis , diffusing capacity , high resolution computed tomography , pulmonary function testing , cardiology , population , lung volumes , lung , dlco , radiology , lung function , asthma , environmental health
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. © 2010 Wiley‐Liss, Inc.