Cumulative asbestos exposure as a key predictor of long-term pleuropulmonary outcomes: insights from decades of follow-up.

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

International Archives of Occupational and Environmental Health Pub Date : 2025-05-22 DOI:10.1007/s00420-025-02143-w

Ladislav Štěpánek, Marie Nakládalová, Magdaléna Janošíková, Lubomír Štěpánek, Alena Boriková

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引用次数: 0

Abstract

Purpose: Occupational asbestos exposure was widespread before regulatory bans, and it remains a risk during renovations or demolitions of older buildings. While asbestos-related diseases are well-documented, less is known about minor radiological changes in exposed individuals. This longitudinal study aimed to identify predictors of pleural and parenchymal lung disorders in individuals with previous occupational asbestos exposure, focusing on both established asbestos-related diseases and minor radiological abnormalities.

Methods: The study tracked 445 former employees (334 men, 111 women) of two Czech asbestos-processing plants, who underwent regular examinations from the 1980s to December 2022. Cox proportional hazards regression models were employed to analyse predictors of asbestos-related diseases, as well as minor radiological findings alone.

Results: Over a median latency of 37 years, 127 participants (28.5%) developed asbestos-related diseases, mainly pleural mesothelioma (59 cases). An additional 168 participants (37.8%) exhibited minor radiological findings, predominantly pleural plaques (129 cases), while 150 (33.7%) had no abnormalities. Substantial cumulative exposure was a strong predictor for minor radiological findings (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.18-3.35, p = 0.010) and any endpoint, including diseases (OR 1.89, 95% CI 1.18-3.02, p = 0.008). Respiratory symptoms and impaired spirometry results significantly increased the likelihood of endpoint occurrence. No significant differences emerged between settings with predominantly chrysotile exposure and those with a chrysotile-crocidolite mixture.

Conclusion: This study highlights the predictive value of cumulative exposure and the need for ongoing surveillance of occupationally exposed individuals to better understand radiological changes, their significance, and to refine risk assessment models.

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累积石棉暴露作为长期胸膜肺预后的关键预测因子：来自数十年随访的见解。

目的：在法规禁止之前，职业性石棉暴露很普遍，并且在旧建筑物的翻新或拆除期间仍然存在风险。虽然与石棉有关的疾病有充分的记录，但对接触者的轻微放射变化知之甚少。本纵向研究旨在确定既往职业性石棉暴露个体胸膜和肺实质疾病的预测因素，重点关注已确定的石棉相关疾病和轻微的放射学异常。方法：该研究追踪了两家捷克石棉加工厂的445名前雇员（334名男性，111名女性），他们从20世纪80年代到2022年12月接受了定期检查。采用Cox比例风险回归模型分析石棉相关疾病的预测因子，以及单独的轻微放射学发现。结果：在37年的中位潜伏期中，127名参与者（28.5%）发展为石棉相关疾病，主要是胸膜间皮瘤（59例）。另外168名参与者（37.8%）表现出轻微的放射学发现，主要是胸膜斑块（129例），而150名参与者（33.7%）没有异常。大量累积暴露是轻微放射学表现（比值比[OR] 1.98, 95%可信区间[CI] 1.18-3.35, p = 0.010）和包括疾病在内的任何终点（比值比[OR] 1.89, 95% CI 1.18-3.02, p = 0.008）的有力预测因子。呼吸道症状和肺活量测定结果受损显著增加了终点发生的可能性。温石棉为主暴露环境与温石棉-青石棉混合暴露环境之间没有显著差异。结论：本研究强调了累积暴露的预测价值，以及对职业暴露个体进行持续监测的必要性，以更好地了解放射学变化及其意义，并完善风险评估模型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.60

自引率

6.70%

发文量

127

审稿时长

3 months

期刊介绍： International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.