NYC-WTC_000195068

NYC 9/11 Public Portal Document

ASBESTOS MEDITEXT ® - Medical Management Page 1 of 4

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ASBESTOS MEDITEXT ®. Medical Management

4.0 MEDICAL SURVEILLANCE/LABORATORY 4.1 MONITORING PARAMETERS/LEVELS

4.1.1 SUMMARY

A. Chest X-ray and pulmonary function tests should be monitored in asbestos-exposed patients.

4.1.2 SERUM/BLOOD

A. BLOOD/SERUM CHEMISTRY 1. SERUM PEPTIDE LEVELS - Serum type IH procollagen peptide (PIUP; a lung structural protein precursor) concentrations were shown to be significantly higher among 36 asbestos-exposed workers, compared to 13 healthy controls; the levels were significantly related to duration of asbestos exposure (Cavalieri et al, 1988). This potential diagnostic tool has yet to be validated.

4.1.5 OTHER

A. MONITORING 1. PULMONARY FUNCTION TESTS - After correcting for smoking, age, and other confounders, a restrictive pattern of pulmonary dysfunction with preserved diffusing capacity is expected in patients with asbestosis, unless severity impairs diffusion as well (ATSDR, 1990; Demers et al, 1990; Jones et al, 1988; Kilburn & Warshaw, 1990, 1990a; Mossman & Gee, 1989; Robins & Green, 1988; Schwartz et al, 1990, 1990a; Siracusa et al, 1988). a. Nonsmoking patients with asbestosis typically have spirometric changes indicative of small airway disease and restrictive defects; smokers with asbestosis may have a combined obstructive/restrictive pattern (ATSDR, 1990; Mossman & Gee, 1989). b. Smoking-adjusted forced vital capacity (FVC) and forced expiratory volume at one second (FEVl) decreased with increasing years of work as boilermakers (Demers et al, 1990). These respiratory function changes were also noted among other asbestos exposed workers (Robins & Green, 1988; Siracusa et al, 1988). Cessation of asbestos exposure for about 10 years did not arrest lung function decline (Siracusa et al, 1988). c. Linear multivariate regression analysis which controlled for potential confounders showed that asbestos-induced circumscribed plaques and diffuse pleural thickening were independently associated with decrements in FVC, but not with decrements in the FEVl/FVC ratio (Schwartz et al, 1990). d. Of 24 nonsmoking sheet metal workers, all had normal parenchyma on chest x-ray

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