Document Detail


Reduced diffusing capacity as an isolated finding in asbestos- and silica-exposed workers.
MedLine Citation:
PMID:  2163299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
From a cohort of 286 patients referred to an Occupational Medicine Clinic because of exposure to asbestos and/or silica, we identified 53 patients with a reduced diffusing capacity (Dco) (less than 75 percent predicted) as their only abnormality. Specifically, their clinical evaluation, chest roentgenograms, and remaining pulmonary function test results were all normal. These patients were divided into non-smokers (n = 13) and smokers (n = 40). The significance of the isolated reduction in diffusing capacity in these patients (n = 53) was explored with graded exercise testing (n = 19) and bronchoalveolar lavage (BAL) (n = 50). The results obtained from the patients with reduced diffusion were compared with those obtained from comparable smoking (n = 35) and nonsmoking patients (n = 37) in the original cohort who had normal chest roentgenograms and normal results of pulmonary function studies, including normal Dco values (greater than or equal to 75 percent of predicted value). Patients with low diffusion demonstrated a tendency for elevated alveolar to arterial O2 differences both at rest and during exercise, and a significant reduction in exercise capacity (VO2 max) was observed in the smoking patients with reduced diffusion when compared with their smoking counterparts with normal diffusion. All other exercise testing indexes were normal in the study groups and there was no correlation between the percent predicted Dco value and any of the exercise variables. In contrast, BAL revealed significant differences between patient groups. Both the smoking and nonsmoking patient groups with low Dco values had greater numbers of total BAL cells, alveolar macrophages, neutrophils, lymphocytes, and eosinophils in their BAL fluid than did their comparable controls with normal diffusion values. These differences were statistically significant (p less than .05) for total BAL cells and total macrophages in the nonsmoking patients and for total BAL cells, total macrophages, and total lymphocytes in the smoking patients expressed as either the total cell number per BAL or total cells per milliliter of BAL. In contrast to the observed exercise testing results, there was significant and inverse correlation between Dco values and each BAL cell type for all four groups combined as well as nonsmokers alone. The Dco values from smokers were significantly and inversely correlated with total BAL cells and total macrophages. These results suggest that the finding of a reduced Dco may be related to an active inflammatory process in the lung caused by occupational dust exposure.(ABSTRACT TRUNCATED AT 400 WORDS)
Authors:
J G Garcia; D E Griffith; J S Williams; W J Blevins; R S Kronenberg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Chest     Volume:  98     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1990 Jul 
Date Detail:
Created Date:  1990-08-08     Completed Date:  1990-08-08     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  105-11     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Texas Health Center, Tyler.
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MeSH Terms
Descriptor/Qualifier:
Air Pollutants, Occupational / adverse effects*,  analysis
Asbestos / adverse effects*
Bronchoalveolar Lavage Fluid / cytology
Cohort Studies
Exercise Test
Humans
Incidence
Middle Aged
Pulmonary Diffusing Capacity / physiology*
Pulmonary Gas Exchange / physiology
Respiratory Function Tests
Retrospective Studies
Silicon Dioxide / adverse effects*
Smoking / epidemiology,  pathology,  physiopathology
Spirometry
Grant Support
ID/Acronym/Agency:
K08 02312//PHS HHS
Chemical
Reg. No./Substance:
0/Air Pollutants, Occupational; 1332-21-4/Asbestos; 7631-86-9/Silicon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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