Asbestos-Related Radiographic Abnormalities in Public School Custodians

Abstract

A cross-sectional prevalence study of 120 public school custodians was carried out to investigate the prevalence of asbestos-related disease and to determine the proportion with disease attributable to asbestos exposures in school buildings. Medical and occupational histories, flow-volume loops, and posterior-anterior, lateral, and anterior oblique (AO) chest radiographs were obtained. Single breath DLCO was measured and chest auscultation performed. The present report describes radiographic abnormalities and associations with exposure. Mean age of subjects was 57 years and mean duration of work as a custodian, 27 years. Fifty-seven (47.5%) had no known or likely exposure to asbestos outside of their work as a school custodian (NOE). Pleural plaques (PP) occurred in 40 (33%) of the total group and 12 (21%) of the group with NOE. Multivariate analysis revealed significant associations (p < 0.05) between PP and duration of asbestos exposure. The proportion with PP increased with increasing years of latency. AO radiographs increased PP detection by a factor of 1.9. Our results reveal PP prevalence in excess of background in the study population and indicate that PP are attributable to asbestos exposure in schools in a subset with NOE. Prudent management of asbestos in buildings is indicated for the prevention of related disease.

Keywords

asbestos-containing material (ACM)no outside exposure (NOE)pleural plaques anterior oblique chest radiographs

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References

ADAMS

G.D.

, KEHOE

, LESCH

, and GLASSROTH

(1988). Amiodarone-induced pneumonitis. Assessment of risk factors and possible risk reduction. Chest 93(2):254–262.

ALBELDA

S.M.

, EPSTEIN

D.M.

, GEFTER

W.B.

, and MILLER

W.T.

(1982). Pleural thickening: Its significance and relationship to asbestos dust exposure. Am Rev Respir Dis 126:621–624.

BAKER

E.L.

and GREENE

(1982). Incremental value of oblique chest radiographs in the diagnosis of asbestos-induced pleural disease. Am J Ind Med 3:17–22.

BECKLAKE

M.R.

(1976). Asbestos-related diseases of the lung and other organs: Their epidemiology and implications for clinical practice. Am Rev Respir Dis 114:55–95.

Classification of radiographs of pneumoconioses (1981). Med Radiogr Photogr 57:1–17.

CORDIER

, LAZAR

, BROCHARD

, BIGNON

, AMEILLE

, and PROTEAU

(1987). Epidemiologic investigation of respiratory effects related to environmental exposure to asbestos inside insulated buildings. Arch Environ Health 42:303–309.

EPLER

G.R.

, MCLOUD

T.C.

, and GAENSLER

E.A.

(1982). Prevalence and incidence of benign asbestos pleural effusion in a working population. JAMA 247:617–622.

Federal Register. 47 RF23360-23389, May 27, 1982.

FERRIS

B.G.

(1978). Epidemiology standardization project. Am Rev Respir Dis 118:1–87.

10.

FLETCHER

C.M.

, ELMES

P.C.

, FAIRBAIRN

A.S.

, and WOOD

C.H.

(1959). The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J 2:257–266.

11.

GREENE

, BOGGIS

, and JANTSCH

(1984). Asbestos-related pleural thickening: Effect of threshold criteria on interpretation. Radiology 152:569–573.

12.

LILIS

, DAUM

, ANDERSON

, SINOTA

, ANDREWS

, and SELIKOFF

I.J.

(1979). Asbestos disease in maintenance workers of the chemical industry. Ann NY Acad Sci 330:127–135.

13.

SAWYER

R.N.

and SPOONER

C.M.

(1978). Sprayed Asbestos-Containing Materials in Buildings. A Guidance Document. U.S. Environmental Protection Agency. EPA 450/2-78-014.

14.

Survey for Friable Asbestos-Containing Materials in the City of Boston Public School. (1983). Hygeia Inc., Boston, MA.

15.

YOUNG

, WEST

, JACKSON

, and CANTRELL

(1981). Prevalence of asbestos-related lung disease among employees in non-asbestos industries. Med J Aust 1:464–467.