Original scientific paper
Clinical and Radiological Manifestations of Asbestosis Depending on the Mineralogic Characteristics of Asbestos
Stipan Janković
Ivan Šimundić
Jadranka Tocilj
Kornelija Miše
Vesna Čapkun
Tade Tadić
Abstract
Dependence of the incidence of pulmonary/pleural asbestosis on the mineralogic characteristics of asbestos and sensitivity of chest roentgenogram and high-resolution computed tomography on analyzing this pathology are presented. This retrospective / prospective study was conducted in 109 patients, workers of Plobest Ltd Asbestos Industry in Ploče (group 1, predominantly inhaling chrysotile asbestos) and 216 workers of Salonit Ltd from Vranjic near Split and Split Shipyard (group 2, predominantly inhaling crocidolite asbestos) with the diagnosis of pulmonary/ pleural asbestosis. Statistical analysis was done by Kappa test, c2-test, and analysis of variance. Test results are shown in diagrams and table. Pulmonary asbestosis was confirmed in 38 (35%), pulmonary and pleural asbestosis in 49 (45%), and pleural asbestosis in 22 (20%) group 1 patients (exposed to chrysotile). In group 2 patients (exposed to crocidolite asbestos), pulmonary asbestosis was confirmed in only 9 (4%), pleural asbestosis in 117 (54%), and pleural and pulmonary asbestosis in 90 (42%) patients. In 35 (32.1%) group 1 patients with normal chest roentgenograms (International Labour Organization (ILO) perfusion categories 0/0 and 0/1), high-resolution computed tomography revealed initial or moderate stage of interstitial pulmonary fibrosis. Interpretation of chest roentgenograms showed good, almost excellent agreement between the results obtained by three observers on ILO profusion categories 0/0, 0/1 and 1/0, and "normal" agreement for profusion category 31/1. For pleural asbestosis, two readers had excellent agreement (Kappa test = 79%) in group 1 and good agreement in group 2. It was concluded that the incidence of pulmonary and pleural asbestosis was much higher in persons exposed to the inhalation of chrysotile and crocidolite, respectively. It is recommended that in radiologic diagnosis, high-resolution computed tomography should always be used in addition to ILO classification, particularly in the initial stages of the lung and pleural disease.
Keywords
Hrčak ID:
14769
URI
Publication date:
10.6.2002.
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