ORIGINAL PAPER
Analysis of changes in radiographic lung image and lung ventilation disorders
in workers occupationally exposed to chrysotile in the past
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1
Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu, Oddział Jelenia Góra / Regional Centre of Occupational Medicine,
Jelenia Góra Department, Wrocław, Poland
(Dyrektor Oddziału / Head of the Department)
2
Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Insttitute of Occupational Medicine, Łódź, Poland
(Zakład Epidemiologii Środowiskowej / Department of Environmental Epidemiology)
3
Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu / Regional Centre of Occupational Medicine, Wrocław, Poland
(Dyrektor Ośrodka / Head of the Centre)
Online publication date: 2017-03-17
Corresponding author
Elżbieta Cwynar
Dolnośląski Wojewódzki Ośrodek Medycyny Pracy
we Wrocławiu, Oddział Jelenia Góra, ul. Groszowa 1, 58-500 Jelenia Góra
Med Pr Work Health Saf. 2017;68(2):247-58
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ABSTRACT
Background: The adverse health effects of occupational exposure to asbestos dust may occur several years after first exposure.
The objective of the study was to assess the relationship between lesions in the respiratory system and the factors contributing to
occupational exposure to asbestos described in the first medical examination as well as to analyze the factors responsible for the
progression of these changes in further medical tests. Material and Methods: The study group comprised 591 former workers
of asbestos processing plant “Gambit” in Lubawka. The results of medical examinations carried out in 2001–2012 were assessed.
Statistical inference was performed based on bilateral significance tests at the 0.05 level of significance. Results: A higher risk of
interstitial lung changes along with an increase in the cumulative concentration of asbestos was indicated; for the employees with
the highest exposure, the adjusted odds ratio (OR) was 1.63 (95% confidence interval (CI): 0.99–2.71), while for changes with the
severity degree qualifying for asbestosis diagnosis, the risk was significantly increased, over fivefold higher, compared to subjects
employed in the lowest exposure. The analysis of the relationship between the progression of interstitial changes and the exposure
to asbestos dust showed a fourfold higher risk of the progression in workers employed in the highest exposure. Mean values
of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity), FEV1/FVC (forced expiratory volume in 1 s to forced vital
capacity) were significantly lower in the subjects working in a higher asbestos exposure. The effect of tobacco smoking on the
occurrence of interstitial lung changes and their progression was also confirmed. Conclusions: The results of prophylactic medical examinations of the health status of workers formerly employed in the plants using chrysotile indicate the importance
andthe need for a long-term clinical follow-up and the promotion of anti-smoking prevention in this group of former employees.
Med Pr 2017;68(2):247–258