The diagnosis of asbestosis in the 21^st century: a clinicopathological correlation of 102 cases

ABSTRACT

Asbestosis, defined as diffuse pulmonary fibrosis caused by inhalation of asbestos fibers, occurs after heavy exposures to asbestos dust over several decades. Because workplace exposures have been significantly curtailed since the banning of asbestos in insulation products, we were interested in examining the clinicopathological characteristics of cases diagnosed in the 21^st century. The consultation files of one of the authors (VLR) were reviewed for cases of asbestosis diagnosed since 1/1/2001. 102 cases were identified, with a median age of 75 years (range: 45–89). There were 100 men and 2 women. The women were from Turkey and Brazil (none from the United States). Malignancies were present in 78 cases, including 38 lung cancers, 29 pleural mesotheliomas, and 8 peritoneal mesotheliomas. The grade of asbestosis was available in 88 cases (median severity of 2; scale: 1–4). Pleural plaque was present in 94% of cases. The most common exposure categories were insulators (39), shipyard workers (16), asbestos manufacturing (9), boiler workers (8) and pipefitter/welders (6). The median duration of exposure was 33 years (range: 2–49 years). Lung fiber burden analysis was performed in 34 cases, with amosite being the predominant fiber type. Results were compared with similar information for 475 cases diagnosed prior to 1/1/2001.

KEYWORDS:

• Amphibole fibers
• asbestos
• asbestosis
• fiber analysis
• occupational exposure
• scanning electron microscopy

Acknowledgments

The authors would like to thank Dr. Vera Capelozzi from Sao Paulo, Brazil and Dr. Handan Zeren from Adana, Turkey for submitting cases for review. We would also like to express our appreciation to other pathologists in the United States for referring cases for consultation. Finally, we would like to express our appreciation to Ms. Melinda Swift for her valuable assistance in analyzing the data.

Disclosure statement

Dr. Roggli and Dr. Sporn have consulted with plaintiff and defense attorneys in medical legal cases. Dr. Carney and Dr. Pavlisko have consulted with defense attorneys in medical legal cases.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.