Lung function in asbestos-exposed workers, a systematic review and meta-analysis

MEDLINE was searched from its inception up to April 2010. We included studies that assessed lung function parameters in asbestos exposed workers and stratified subjects according to radiological findings. Estimates of VC, FEV1 and FEV1/VC with their dispersion measures were extracted and pooled.Our meta-analysis with data from 9,921 workers exposed to asbestos demonstrates a statistically significant reduction in VC, FEV1 and FEV1/VC, even in those workers without radiological changes. Less severe lung function impairments are detected if the diagnoses are based on (high resolution) computed tomography rather than the less sensitive X-ray images. The degree of lung function impairment was partly related to the proportion of smokers included in the studies.Asbestos exposure is related to restrictive and obstructive lung function impairment. Even in the absence of radiological evidence of parenchymal or pleural diseases there is a trend for functional impairment.Asbestos fibres are one of the most pervasive environmental hazards because of their worldwide use in the last 100 years as a cheap and effective thermal, sound and electrical insulation material, especially in the construction, shipping and textile industries. The general public is also exposed to asbestos, mainly from deterioration and reconstruction or destruction of asbestos contaminated buildings, worn vehicle brake linings and from the deterioration of asbestos-containing products. In spite of outright bans or restrictions in nearly all industrialised countries nowadays, approximately 125 million workers are occupationally exposed to asbestos worldwide [1] and it is estimated that at least 100,000 die annually from complications of asbestos exposure [2]. In addition to mesothelioma, lung and laryngeal cancer, asbestos has long been known to cause non-malignant pleural fibrosis, (i.e. circumscript pleural plaques (PP), or diffuse pleural thickening (DPT)), pleural effusions, rounded atelectasis and lung f