The overall goals of this project are to improve and advance the current criteria established by the International Labor Organization (ILO) to evaluate chest wall abnormalities and to understand the determinants of restrictive lung function in asbestos-induced pleural fibrosis. Together, circumscribed pleural plaques and diffuse pleural thickening are the most frequent radiographic abnormality among exposed workers. The radiographic criteria established by the ILO to define and classify circumscribed pleural plaques and diffuse pleural thickening have not been adequately evaluated. Moreover, the association between pleural fibrosis and restrictive lung function were not considered when establishing these radiographic criteria. Although several groups have established a relationship between restrictive lung function both and circumscribed pleural plaques and diffuse pleural thickening, the determinants accounting for this association have not been adequately addressed. Our preliminary studies indicate that restrictive lung function among those with asbestos-induced pleural fibrosis is, in part, caused by subradiographic inflammation and fibrosis of the lung parenchyma. These findings lead us to hypothesize that more sensitive indicators of parenchymal injury will allow us to fully understand the determinants of restrictive lung function in persons with asbestos-induced pleural fibrosis. The theses put forth in this proposal are designed to investigate the accuracy of the diagnostic criteria established by the ILO, evaluate the anatomic and functional validity of these criteria, and identify the determinants of restrictive lung function among individuals with asbestos-induced pleural plaques and diffuse pleural thickening. We will use a nested case-control study design with 120 subjects randomly selected from a large cohort (N-1,223) of sheet metal workers who have recently undergone a screening medical evaluation. Using chest x-rays, chest CT scans, and physiologic measures of lung function, we will evaluate the reliability and validity (anatomic and functional) of the current ILO criteria for pleural fibrosis. We will also use sensitive physiologic (progressive cycle ergometry and lung and chest wall compliance), radiographic (high resolution CT scans), and biologic (bronchoalveolar lavage cellularity) measures to control for the presence of parenchymal fibrosis while investigating the relationship between asbestos-induced pleural fibrosis and restrictive lung function.

Agency
National Institute of Health (NIH)
Institute
National Institute for Occupational Safety and Health (NIOSH)
Type
Research Scientist Development Award - Research & Training (K01)
Project #
5K01OH000093-02
Application #
3069001
Study Section
Safety and Occupational Health Study Section (SOH)
Project Start
1990-07-01
Project End
1993-06-30
Budget Start
1991-07-01
Budget End
1992-06-30
Support Year
2
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Iowa
Department
Type
Schools of Medicine
DUNS #
041294109
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Quinn, T J; Donham, K J; Merchant, J A et al. (1995) Peak flow as a measure of airway dysfunction in swine confinement operators. Chest 107:1303-8
Schwartz, D A; Donham, K J; Olenchock, S A et al. (1995) Determinants of longitudinal changes in spirometric function among swine confinement operators and farmers. Am J Respir Crit Care Med 151:47-53
Shih, J F; Wilson, J S; Broderick, A et al. (1994) Asbestos-induced pleural fibrosis and impaired exercise physiology. Chest 105:1370-6
Schwartz, D A; Helmers, R A; Galvin, J R et al. (1994) Determinants of survival in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 149:450-4
Schwartz, D A; Van Fossen, D S; Davis, C S et al. (1994) Determinants of progression in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 149:444-9
Hartley, P G; Galvin, J R; Hunninghake, G W et al. (1994) High-resolution CT-derived measures of lung density are valid indexes of interstitial lung disease. J Appl Physiol 76:271-7
Schwartz, D A; Davis, C S; Merchant, J A et al. (1994) Longitudinal changes in lung function among asbestos-exposed workers. Am J Respir Crit Care Med 150:1243-9
Schwartz, D A; Galvin, J R; Yagla, S J et al. (1993) Restrictive lung function and asbestos-induced pleural fibrosis. A quantitative approach. J Clin Invest 91:2685-92
Pueringer, R J; Schwartz, D A; Dayton, C S et al. (1993) The relationship between alveolar macrophage TNF, IL-1, and PGE2 release, alveolitis, and disease severity in sarcoidosis. Chest 103:832-8
Shih, J F; Hunninghake, G W; Goeken, N E et al. (1993) The relationship between HLA-A, B, DQ, and DR antigens and asbestos-induced lung disease. Chest 104:26-31

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