Am. J. Respir. Crit. Care Med., Vol 153, No. 1, Jan 1996, 301-306.
Asbestos-related bilateral diffuse pleural thickening: natural history of radiographic and lung function abnormalities
DH Yates, K Browne, PN Stidolph and E Neville
Medical Boarding Centre for Respiratory Diseases, Department of Social Security, London, United Kingdom.
Sixty-four subjects with asbestos-related diffuse pleural thickening
attending the London Medical Boarding Centre for Respiratory Diseases
(formerly, the Central Pneumoconiosis Panel) were studied to investigate
symptomatology, lung function, and radiographic change over an average
period of 8 to 9 yr. Chest pain was a common symptom, occurring in over
half of the subjects. Approximately one-third of the subjects had a history
of pleurisy or pleural effusion. Full long function, available in all
cases, showed a highly significant decrement (p < 0.001) compared with
predicted values in all variables except gas transfer coefficient (Kco) at
initial presentation, consistent with a restrictive ventilatory defect.
Longitudinal lung function, available over a mean period of 8.9 yr in 36
subjects, showed a significant decrement above that predicted in FEV1 and
FVC only (p < 0.05). Decreases in other parameters were observed,
although statistical significance was not achieved. Radiographic score
increased with time but there was no correlation between change in lung
function and increasing radiographic score, probably reflecting the initial
severity of the disease in subjects studied. These observations confirm an
initial decrement in lung function in diffuse pleural thickening which is
followed by comparatively little change over time.
