RESUMO
Asbestos-related diseases are caused by the inhalation of asbestos fibers in their variety chrysotile or white asbestos. Although the ban in Argentina dates from 2003, there are numerous industries where work continues with this mineral, including iron and steel industries. It is currently known the high pathogenicity of this material, so that in many countries there are programs to monitoring the exposed workers. Here we describe the general characteristics and pulmonary manifestations in 27 patients who had worked in a very huge steel factory in South America. The diagnosis of asbestos-related diseases was made by a medical-occupational record, history of asbestos exposure, additional studies of lung function and chest images. Then the sources of exposure (occupational, domestic and environmental), exposure time and latency period were analyzed, in those patients in whom a related disease was detected. Smoking history was also taken into account. Twenty-two patients had benigns pathologies (81.4%), sixteen of them with lesions localyzed in pleura, and other six pulmonary asbestosis. The malignant pathologies occurred in five patients (18.5%), in four of them mesothelioma and in other one lung cancer. The problem of asbestos exposure has contemporary relevance. Hence the need for a surveillance program in workers exposed to asbestos in the past or currently, to detect, report, record and investigate the characteristics of these pathologies.
Assuntos
Amianto/efeitos adversos , Asbestose/etiologia , Metalurgia , Exposição Ocupacional/efeitos adversos , Doenças Pleurais/etiologia , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Asbestose/diagnóstico por imagem , Asbestose/patologia , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/patologia , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Radiografia , Fumar/epidemiologia , AçoRESUMO
Las enfermedades relacionadas al amianto se producen por la inhalación de fibras de asbestos en su variedad crisotilo o amianto blanco. A pesar de que en la Argentina la prohibición data del año 2003, existen numerosas industrias donde se sigue trabajando con este mineral, entre ellas las metalúrgicas y acerías. Actualmente se conoce la alta patogenicidad de este material, por lo que en muchos países existen programas de seguimiento de los trabajadores expuestos. Se describen las características generales y manifestaciones clínicas pulmonares de 27 pacientes que trabajaron en una gran acería de América del Sur. El diagnóstico de amiantopatías se realizó mediante historia clínica laboral, antecedente de exposición al amianto, estudios complementarios de función pulmonar e imágenes del tórax. Se analizaron la fuente de exposición (laboral, doméstica y ambiental), tiempo de exposición y período de latencia en los pacientes de los cuales se detectó enfermedad relacionada. Los antecedentes de tabaquismo fueron tenidos en cuenta para el análisis. En 22 pacientes se presentaron patologías benignas (81.4%), 16 de ellos tenían lesiones exclusivamente pleurales y otros 6 asbestosis. Las patologías malignas se presentaron en 5 pacientes (18.5%), en 4 fueron mesoteliomas y en uno carcinoma pulmonar. El problema de la exposición al amianto tiene vigencia actual. De ahí la necesidad de un programa de vigilancia en trabajadores expuestos al amianto actualmente o en el pasado, para detectar, notificar, registrar e investigar las características de estas patologías.
Asbestos-related diseases are caused by the inhalation of asbestos fibers in their variety chrysotile or white asbestos. Although the ban in Argentina dates from 2003, there are numerous industries where work continues with this mineral, including iron and steel industries. It is currently known the high pathogenicity of this material, so that in many countries there are programs to monitoring the exposed workers. Here we describe the general characteristics and pulmonary manifestations in 27 patients who had worked in a very huge steel factory in South America. The diagnosis of asbestos-related diseases was made by a medical-occupational record, history of asbestos exposure, additional studies of lung function and chest images. Then the sources of exposure (occupational, domestic and environmental), exposure time and latency period were analyzed, in those patients in whom a related disease was detected. Smoking history was also taken into account. Twenty-two patients had benigns pathologies (81.4%), sixteen of them with lesions localyzed in pleura, and other six pulmonary asbestosis. The malignant pathologies occurred in five patients (18.5%), in four of them mesothelioma and in other one lung cancer. The problem of asbestos exposure has contemporary relevance. Hence the need for a surveillance program in workers exposed to asbestos in the past or currently, to detect, report, record and investigate the characteristics of these pathologies.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amianto/efeitos adversos , Asbestose/etiologia , Metalurgia , Exposição Ocupacional/efeitos adversos , Doenças Pleurais/etiologia , Argentina/epidemiologia , Asbestose/patologia , Asbestose , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares , Doenças Pleurais/patologia , Doenças Pleurais , Neoplasias Pleurais/patologia , Neoplasias Pleurais , Aço , Fumar/epidemiologiaRESUMO
Las enfermedades relacionadas al amianto se producen por la inhalación de fibras de asbestos en su variedad crisotilo o amianto blanco. A pesar de que en la Argentina la prohibición data del año 2003, existen numerosas industrias donde se sigue trabajando con este mineral, entre ellas las metalúrgicas y acerías. Actualmente se conoce la alta patogenicidad de este material, por lo que en muchos países existen programas de seguimiento de los trabajadores expuestos. Se describen las características generales y manifestaciones clínicas pulmonares de 27 pacientes que trabajaron en una gran acería de América del Sur. El diagnóstico de amiantopatías se realizó mediante historia clínica laboral, antecedente de exposición al amianto, estudios complementarios de función pulmonar e imágenes del tórax. Se analizaron la fuente de exposición (laboral, doméstica y ambiental), tiempo de exposición y período de latencia en los pacientes de los cuales se detectó enfermedad relacionada. Los antecedentes de tabaquismo fueron tenidos en cuenta para el análisis. En 22 pacientes se presentaron patologías benignas (81.4%), 16 de ellos tenían lesiones exclusivamente pleurales y otros 6 asbestosis. Las patologías malignas se presentaron en 5 pacientes (18.5%), en 4 fueron mesoteliomas y en uno carcinoma pulmonar. El problema de la exposición al amianto tiene vigencia actual. De ahí la necesidad de un programa de vigilancia en trabajadores expuestos al amianto actualmente o en el pasado, para detectar, notificar, registrar e investigar las características de estas patologías.(AU)
Asbestos-related diseases are caused by the inhalation of asbestos fibers in their variety chrysotile or white asbestos. Although the ban in Argentina dates from 2003, there are numerous industries where work continues with this mineral, including iron and steel industries. It is currently known the high pathogenicity of this material, so that in many countries there are programs to monitoring the exposed workers. Here we describe the general characteristics and pulmonary manifestations in 27 patients who had worked in a very huge steel factory in South America. The diagnosis of asbestos-related diseases was made by a medical-occupational record, history of asbestos exposure, additional studies of lung function and chest images. Then the sources of exposure (occupational, domestic and environmental), exposure time and latency period were analyzed, in those patients in whom a related disease was detected. Smoking history was also taken into account. Twenty-two patients had benigns pathologies (81.4%), sixteen of them with lesions localyzed in pleura, and other six pulmonary asbestosis. The malignant pathologies occurred in five patients (18.5%), in four of them mesothelioma and in other one lung cancer. The problem of asbestos exposure has contemporary relevance. Hence the need for a surveillance program in workers exposed to asbestos in the past or currently, to detect, report, record and investigate the characteristics of these pathologies.(AU)
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Amianto/efeitos adversos , Asbestose/etiologia , Metalurgia , Exposição Ocupacional/efeitos adversos , Doenças Pleurais/etiologia , Argentina/epidemiologia , Asbestose/patologia , Asbestose/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Doenças Pleurais/patologia , Doenças Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Neoplasias Pleurais/diagnóstico por imagem , Fumar/epidemiologia , AçoRESUMO
BACKGROUND: This study was designed to assess the effect of asbestos exposure on longitudinal lung function decline. METHODS: A group of 502 former asbestos-cement workers with at least two spirometry tests 4 years apart. Repeated evaluations included respiratory symptoms questionnaire, spirometry and chest imaging. Asbestos exposure was ascertained as years of exposure, an index of cumulative exposure and latency time. The mixed effects model was used to evaluate the effect of exposure on the level and rate of change in forced expiratory volume in 1 s (FEV(1)) and forced vital capacity (FVC). RESULTS: Mean age at entry was 51 (SD 9.9) years, mean latency time 25.6 (SD 10.0) years, mean follow-up time 9.1 (SD 2.8) years and mean number of spirometry tests 3.5. The FEV(1) level was significantly related to pack-years of smoking at entry and during the follow-up, the index of cumulative asbestos exposure at entry, and the presence of asbestosis at follow-up. The FVC level was significantly related to pack-years of smoking during the follow-up, cumulative asbestos exposure at entry, asbestosis and pleural thickening at follow-up, and body mass index at entry. Asbestos exposure was not associated with increasing rates of FEV(1) and FVC decline. However, FEV(1) regression slopes with age, estimated by terciles of cumulative exposure, showed significant differences. Combined effects of smoking and exposure conferred further acceleration in lung function decline. CONCLUSIONS: Occupational exposure in asbestos-cement industry was a risk factor for increased lung function decline. The effect seems to be mostly concentrated during the working period. Smoking and exposure had synergic effects.
Assuntos
Amianto/efeitos adversos , Asbestose/etiologia , Asbestose/fisiopatologia , Indústrias , Pulmão/efeitos dos fármacos , Exposição Ocupacional/efeitos adversos , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Asbestose/patologia , Índice de Massa Corporal , Volume Expiratório Forçado , Humanos , Pulmão/fisiopatologia , Pessoa de Meia-Idade , Pleura/patologia , Fatores de Risco , Fumar/efeitos adversos , Espirometria , Inquéritos e Questionários , Capacidade VitalRESUMO
Asbestos-related diseases are caused by the inhalation of asbestos fibers in their variety chrysotile or white asbestos. Although the ban in Argentina dates from 2003, there are numerous industries where work continues with this mineral, including iron and steel industries. It is currently known the high pathogenicity of this material, so that in many countries there are programs to monitoring the exposed workers. Here we describe the general characteristics and pulmonary manifestations in 27 patients who had worked in a very huge steel factory in South America. The diagnosis of asbestos-related diseases was made by a medical-occupational record, history of asbestos exposure, additional studies of lung function and chest images. Then the sources of exposure (occupational, domestic and environmental), exposure time and latency period were analyzed, in those patients in whom a related disease was detected. Smoking history was also taken into account. Twenty-two patients had benigns pathologies (81.4
), sixteen of them with lesions localyzed in pleura, and other six pulmonary asbestosis. The malignant pathologies occurred in five patients (18.5
), in four of them mesothelioma and in other one lung cancer. The problem of asbestos exposure has contemporary relevance. Hence the need for a surveillance program in workers exposed to asbestos in the past or currently, to detect, report, record and investigate the characteristics of these pathologies.
Assuntos
Amianto/efeitos adversos , Asbestose/etiologia , Metalurgia , Exposição Ocupacional/efeitos adversos , Doenças Pleurais/etiologia , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Asbestose/patologia , Asbestose/diagnóstico por imagem , Feminino , Humanos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/patologia , Doenças Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Neoplasias Pleurais/diagnóstico por imagem , Fumar/epidemiologia , AçoRESUMO
BACKGROUND: Pulmonary function tests (PFT), particularly spirometry and lung diffusing capacity for carbon monoxide (DL(CO) ), have been considered useful methods for the detection of the progression of interstitial asbestos abnormalities as indicated by high-resolution computed tomography (HRCT). However, it is currently unknown which of these two tests correlates best with anatomical changes over time. METHODS: In this study, we contrasted longitudinal changes (3-9 years follow-up) in PFTs at rest and during exercise with interstitial abnormalities evaluated by HRCT in 63 ex-workers with mild-to-moderate asbestosis. RESULTS: At baseline, patients presented with low-grade asbestosis (Huuskonen classes I-II), and most PFT results were within the limits of normality. In the follow-up, most subjects had normal spirometry, static lung volumes and arterial blood gases. In contrast, frequency of DL(CO) abnormalities almost doubled (P < 0.05). Twenty-three (36.5%) subjects increased the interstitial marks on HRCT. These had significantly larger declines in DL(CO) compared to patients who remained stable (0.88 vs. 0.31 ml/min/mm Hg/year and 3.5 vs. 1.2%/year, respectively; P < 0.05). In contrast, no between-group differences were found for the other functional tests, including spirometry (P > 0.05). CONCLUSIONS: These data demonstrate that the functional consequences of progression of HRCT abnormalities in mild-to-moderate asbestosis are better reflected by decrements in DL(CO) than by spirometric changes. These results might have important practical implications for medico-legal evaluation of this patient population.
Assuntos
Asbestose/diagnóstico , Doenças Profissionais/diagnóstico , Capacidade de Difusão Pulmonar/instrumentação , Tomografia Computadorizada por Raios X/instrumentação , Asbestos Serpentinas/toxicidade , Asbestose/diagnóstico por imagem , Asbestose/patologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/diagnóstico por imagem , Doenças Profissionais/patologia , Exposição Ocupacional/efeitos adversos , Estudos Prospectivos , Capacidade de Difusão Pulmonar/métodos , Testes de Função Respiratória , Índice de Gravidade de Doença , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodosRESUMO
Este presente trabalho busca construir uma revisão de literatura sobre a asbestose, uma pneumoconiose, nas últimas décadas. Descrevo seu histórico na século XX, sua epidemiologia e de algumas neoplasias associadas, a mineralogia com seus dois grandes grupos, a importância da exposição ocupacional, sua patogênese ainda não totalmente compreendida, sua histopatologia, suas manifestações clínicas típicas, a conduta médica para o diagnóstico e prognóstico, usando exames complementares e o manejo desta doença ocupacional nas complicações, no tratamento e na profilaxia. Analiso sua relação com o desenvolvimento do mesotelioma, o principal tumor maligno. Conclui que a asbestose é uma pneumoconiose grave e não havendo tratamento efetivo, as medidas adotadas no controle desta doença ocupacional são as profiláticas e principalmente sua proibição.
Assuntos
Humanos , Asbestose/complicações , Asbestose/diagnóstico , Asbestose/epidemiologia , Asbestose/patologia , Asbestose/prevenção & controle , Asbestose/terapia , Mesotelioma , Saúde Ocupacional , Medicina do Trabalho , Doenças Profissionais , Exposição Ocupacional , PneumoconioseRESUMO
As doenças asbesto-induzidas constituem um grave problema de saúde em decorrência de um grande número de trabalhadores expostos ao asbesto ao longo dos últimos 50 anos. Processos judiciais contra indústrias que lidam com asbesto somam centenas, com crescente adição de novos casos. O assunto relativo à asbestose é complexo, e muito embora a história natural das doenças induzidas esteja bem estabelecida, muitas áreas importantes, como a patologia, permanecem ainda pouco compreendidas. No Brasil, desde 1940, o asbesto é explorado comercialmente, sendo que nos últimos anos sua produção é da ordem de 200.000 toneladas por ano, estimando-se que na atividade de mineração cerca de 10.000 trabalhadores foram expostos a essa fibra, desconhecendo-se a estimativa do número de pessoas expostas na produção de fibrocimento, especialmente telhas e caixas d'água. Um estudo, de cunho inter-institucional, com metodologia de investigação científica apropriada, para avaliar as repercussões sobre a saúde dos trabalhadores nas minas de asbesto, em nosso país foi elaborado e intitulado "Moralidade e Mortalidade Entre Trabalhadores Expostos ao Asbesto na Atividade de Mineração 1940-1996". O objetivo deste trabalho foi fornecer uma visão ampla das doenças asbesto-induzida, com ênfase às dificuldades no diagnóstico histopatológico, através da experiência adquirida com o desenrolar desse projeto.
Asbestos-related diseases constitute a major health problem due to the great number of workers exposed to asbestos over the past 50 years. Personal injury lawsuits against industries that deal with asbestos number in the hundreds, and new cases continue to be filed. The scientific issues related to asbestos are complex, and, although the broad outlines of asbestos-related diseases have been well-established, many significant aspects (such as the pathology involved) are poorly understood. In Brazil, asbestos has been mined commercially since 1940, with production levels recently approaching 200,000 tons/year, resulting in the asbestos exposure of approximately 10,000 workers in the mining activity, and an unknown number of workers in asbestos-cement industry, primarily roofers and concrete rooftop water tank installers. One study, using appropriate methods of scientific investigation to evaluate the effects of such exposure on the health of asbestos mine workers in Brazil was conducted as part of a multicenter study and entitled "Morbidity and Mortality Among Workers Exposed to Asbestos in Mining Activities, 1940-1996". Drawing upon the experience acquired during the course of that study, the objective of the current report was to give an overview of asbestos-related diseases, with a special focus on the difficulties involved in establishing the histopathological diagnosis.
Assuntos
Humanos , Poluentes Ocupacionais do Ar/efeitos adversos , Amianto/efeitos adversos , Exposição por Inalação/efeitos adversos , Pneumopatias/etiologia , Doenças Pleurais/etiologia , Asbestose/etiologia , Asbestose/patologia , Pneumopatias/patologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/patologia , Mesotelioma/etiologia , Mesotelioma/patologia , Fibras Minerais/efeitos adversos , Doenças Pleurais/patologiaRESUMO
Asbestos-related diseases constitute a major health problem due to the great number of workers exposed to asbestos over the past 50 years. Personal injury lawsuits against industries that deal with asbestos number in the hundreds, and new cases continue to be filed. The scientific issues related to asbestos are complex, and, although the broad outlines of asbestos-related diseases have been well-established, many significant aspects (such as the pathology involved) are poorly understood. In Brazil, asbestos has been mined commercially since 1940, with production levels recently approaching 200,000 tons/year, resulting in the asbestos exposure of approximately 10,000 workers in the mining activity, and an unknown number of workers in asbestos-cement industry, primarily roofers and concrete rooftop water tank installers. One study, using appropriate methods of scientific investigation to evaluate the effects of such exposure on the health of asbestos mine workers in Brazil was conducted as part of a multicenter study and entitled "Morbidity and Mortality Among Workers Exposed to Asbestos in Mining Activities, 1940-1996". Drawing upon the experience acquired during the course of that study, the objective of the current report was to give an overview of asbestos-related diseases, with a special focus on the difficulties involved in establishing the histopathological diagnosis.