Open AccessAssociation between increased small airway obstruction and asbestos exposure in patients with asbestosis
Author(s) -
Yang Xiaoli,
Yan Yongji,
Xue Changjiang,
Du Xuqin,
Ye Qiao
Publication year - 2018
Publication title -
the clinical respiratory journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.789
H-Index - 33
eISSN - 1752-699X
pISSN - 1752-6981
DOI - 10.1111/crj.12728
Subject(s) - asbestosis , medicine , asbestos , airway obstruction , vital capacity , lung volumes , pulmonary function testing , airway , cardiology , lung , lung function , surgery , diffusing capacity , materials science , metallurgy
Background Asbestos exposure may cause asbestos‐related lung diseases including asbestosis, pleural abnormalities and malignancies. The role of asbestos exposure in the development of small airway obstruction remains controversial. Anatomic and physiologic small airway abnormalities may develop as part of the pathophysiologic process of asbestosis. We hypothesized that inhalation of asbestos may induce small airway defects in addition to asbestosis and pleural abnormalities. Methods In total, 281 patients with newly diagnosed asbestosis were evaluated. Clinical data were collected from the patients' medical charts. The patients were classified into various stages according to their chest X‐ray findings using the International Labour Organization classification. Pulmonary function was evaluated by plethysmography and the forced oscillation technique. Results Expiratory flow, including the predicted values of the maximum expiratory flow between 25% and 50% of the forced vital capacity (MEF 25‐50 ), was significantly lower in the different stages of asbestosis. Accordingly, the predicted percentage of R 5 – R 20 was significantly higher with increasing stages of asbestosis. Furthermore, the duration of exposure to asbestos was significantly associated with the forced expiratory volume in the first second (FEV 1 )/forced vital capacity (FVC) ratio and the predicted percentage of MEF 25 or MEF 50 according to the regression analysis in non‐smoking patients with asbestosis. The predicted percentage of FEV 1 or the FEV 1 /FVC ratio was significantly lower and the predicted percentage of R 5 – R 20 was significantly higher in smokers than non‐smokers. Conclusions The patients with asbestosis have small airway obstructive defects that are significantly associated with asbestos exposure.