Emphysema findings associated with heavy asbestos-exposure in high resolution computed tomography of Finnish construction workers
Emphysema findings associated with heavy asbestos-exposure in high resolution computed tomography of Finnish construction workers
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DOI：
10.1539/joh.46.266
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发表时间：
2004-07-01
影响因子：
3
通讯作者：
Vehmas, T
中科院分区：
文献类型：
--
作者：
Huuskonen, O;Kivisaari, L;Vehmas, T
芬兰建筑工人高分辨率计算机断层扫描中与重度石棉暴露相关的肺气肿发现：Olli HUUSKONEN等人，芬兰职业健康研究所，赫尔辛基，芬兰-石棉纤维已知会导致肺纤维化，但其在肺气肿中的作用尚不清楚。我们想通过使用高分辨率计算机断层扫描（HRCT）来评估石棉暴露与肺气肿之间的关系。对600名患有石棉相关职业病的吸烟建筑工人进行了常规和高分辨率CT检查。肺气肿亚型（小叶中心型、间隔旁型、全小叶性肺气肿和大疱）分别在0 - 5分的半定量量表上评分，这些评分相加得到肺气肿总评分。职业，暴露时间，年龄，包年和石棉肺诊断进行了分析，在一般的线性模型与肺气肿的可能关联。各亚型评分的观察者间一致性（二次加权kappa，kappa（qw）=0.46-0.72）和观察者内一致性（K-qw=0.78-0.94）以及总分的可靠性（Cronbach α =0.87）均良好。绝缘子有一个显着更高的间隔，全小叶和总得分比其他职业组调整年龄和吸烟。石棉肺的诊断也是一个重要的独立预测较高的总评分。当工人患有石棉沉着症或大量暴露于石棉（绝缘体）时，肺气肿更常见，但由于混杂因素，石棉在肺气肿中的致病作用需要进一步研究。
Emphysema Findings Associated with Heavy Asbestos-Exposure in High Resolution Computed Tomography of Finnish Construction Workers: Olli HUUSKONEN, et al. Finnish Institute of Occupational Health, Helsinki, Finland-Asbestos fibers are known to cause lung fibrosis, but their role in emphysema is unclear. We wanted to evaluate the relationship between asbestos exposure and emphysema by using high-resolution computed tomography (HRCT). Conventional and high resolution CT was performed on 600 smoking construction workers with an asbestos-related occupational disease. Emphysema subtypes (centrilobular, paraseptal, panlobular emphysema and bullae) were separately scored on a semiquantitative scale from 0 to 5, which scores were added up to yield the total emphysema score. Occupation, exposure duration, age, pack years and asbestosis diagnosis were analyzed in general linear models for possible associations with emphysema. The inter- (quadratic weighted kappa, kappa(qw)=0.46-0.72) and intraobserver (K-qw=0.78-0.94) agreements for the subtype-scores and the reliability of the total score (Cronbach's alpha=0.87) were good. Insulators had a significantly higher paraseptal, panlobular and total score than the other occupational groups when adjusted for age and smoking. An asbestosis diagnosis was also a significant independent predictor of a higher total score. Emphysema was more common when workers had asbestosis or were heavily exposed to asbestos (insulators), but due to confounding factors the causative role of asbestos in emphysema needs further study.