Pleural abnormalities in the Framingham Heart Study: Prevalence and CT image features

Tetsuro Araki, Masahiro Yanagawa, Fangui Jenny Sun, v. Dupuis, Mizuki Nishino, Yoshitake Yamada, George R. Washko, David C. Christiani, Noriyuki Tomiyama, George T. O'Connor, Gary M. Hunninghake, Hiroto Hatabu

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Abstract

Background The prevalence of pleural abnormalities in the general population is an epidemiologically important index of asbestos exposure, which has not been investigated since a radiography-based study in 1980. Methods We examined 2633 chest CT scans (mean 59.2 years, 50% female) from the Framingham Heart Study (FHS) for the presence and image characteristics of pleural plaques and diffuse pleural thickening. Demographics and pulmonary function were stratified by the presence of pleural abnormalities in association with interstitial lung abnormalities. Results Pleural abnormalities were present in 1.5% (95% CI 1.1% to 2.1%). Pleural lesions were most commonly bilateral (90.0%), multiple (77.5%), calcified (97.5%) and commonly involved posterior (lower: 92.5%, middle: 87.5%), anterior (upper: 77.5%, middle: 77.5%) and diaphragmatic areas (72.5%). Participants with pleural abnormalities were significantly older (75.7 years, p <0.0001), male (92.5%, p <0.0001), former or current smokers (80.0%, p <0.001) with higher packyears (33.3, p <0.0001). No significant reduction was noted in pulmonary function measures (p=0.07-0.94) when adjusted for the associated covariates, likely due to small number of cases with pleural abnormalities. Information about prior history of asbestos exposure and occupation was not available. Conclusions Pleural plaques and diffuse pleural thickening are present on CT in 1.5% of the FHS cohort. The current prevalence of the pleural abnormalities is smaller than that reported in the previous populationbased study using chest radiography, likely representing lower asbestos exposure in recent decades. The posterior portion of the pleura is most frequently involved but the anterior portion is also commonly involved.

Original languageEnglish
JournalOccupational and Environmental Medicine
DOIs
Publication statusAccepted/In press - 2017 Mar 3

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Asbestos
Cross-Sectional Studies
Radiography
Lung
Thorax
Pleura
Occupations
Cohort Studies
Demography
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Pleural abnormalities in the Framingham Heart Study : Prevalence and CT image features. / Araki, Tetsuro; Yanagawa, Masahiro; Sun, Fangui Jenny; Dupuis, v.; Nishino, Mizuki; Yamada, Yoshitake; Washko, George R.; Christiani, David C.; Tomiyama, Noriyuki; O'Connor, George T.; Hunninghake, Gary M.; Hatabu, Hiroto.

In: Occupational and Environmental Medicine, 03.03.2017.

Research output: Contribution to journalArticle

Araki, T, Yanagawa, M, Sun, FJ, Dupuis, V, Nishino, M, Yamada, Y, Washko, GR, Christiani, DC, Tomiyama, N, O'Connor, GT, Hunninghake, GM & Hatabu, H 2017, 'Pleural abnormalities in the Framingham Heart Study: Prevalence and CT image features', Occupational and Environmental Medicine. https://doi.org/10.1136/oemed-2016-104178
Araki, Tetsuro ; Yanagawa, Masahiro ; Sun, Fangui Jenny ; Dupuis, v. ; Nishino, Mizuki ; Yamada, Yoshitake ; Washko, George R. ; Christiani, David C. ; Tomiyama, Noriyuki ; O'Connor, George T. ; Hunninghake, Gary M. ; Hatabu, Hiroto. / Pleural abnormalities in the Framingham Heart Study : Prevalence and CT image features. In: Occupational and Environmental Medicine. 2017.
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abstract = "Background The prevalence of pleural abnormalities in the general population is an epidemiologically important index of asbestos exposure, which has not been investigated since a radiography-based study in 1980. Methods We examined 2633 chest CT scans (mean 59.2 years, 50{\%} female) from the Framingham Heart Study (FHS) for the presence and image characteristics of pleural plaques and diffuse pleural thickening. Demographics and pulmonary function were stratified by the presence of pleural abnormalities in association with interstitial lung abnormalities. Results Pleural abnormalities were present in 1.5{\%} (95{\%} CI 1.1{\%} to 2.1{\%}). Pleural lesions were most commonly bilateral (90.0{\%}), multiple (77.5{\%}), calcified (97.5{\%}) and commonly involved posterior (lower: 92.5{\%}, middle: 87.5{\%}), anterior (upper: 77.5{\%}, middle: 77.5{\%}) and diaphragmatic areas (72.5{\%}). Participants with pleural abnormalities were significantly older (75.7 years, p <0.0001), male (92.5{\%}, p <0.0001), former or current smokers (80.0{\%}, p <0.001) with higher packyears (33.3, p <0.0001). No significant reduction was noted in pulmonary function measures (p=0.07-0.94) when adjusted for the associated covariates, likely due to small number of cases with pleural abnormalities. Information about prior history of asbestos exposure and occupation was not available. Conclusions Pleural plaques and diffuse pleural thickening are present on CT in 1.5{\%} of the FHS cohort. The current prevalence of the pleural abnormalities is smaller than that reported in the previous populationbased study using chest radiography, likely representing lower asbestos exposure in recent decades. The posterior portion of the pleura is most frequently involved but the anterior portion is also commonly involved.",
author = "Tetsuro Araki and Masahiro Yanagawa and Sun, {Fangui Jenny} and v. Dupuis and Mizuki Nishino and Yoshitake Yamada and Washko, {George R.} and Christiani, {David C.} and Noriyuki Tomiyama and O'Connor, {George T.} and Hunninghake, {Gary M.} and Hiroto Hatabu",
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T1 - Pleural abnormalities in the Framingham Heart Study

T2 - Prevalence and CT image features

AU - Araki, Tetsuro

AU - Yanagawa, Masahiro

AU - Sun, Fangui Jenny

AU - Dupuis, v.

AU - Nishino, Mizuki

AU - Yamada, Yoshitake

AU - Washko, George R.

AU - Christiani, David C.

AU - Tomiyama, Noriyuki

AU - O'Connor, George T.

AU - Hunninghake, Gary M.

AU - Hatabu, Hiroto

PY - 2017/3/3

Y1 - 2017/3/3

N2 - Background The prevalence of pleural abnormalities in the general population is an epidemiologically important index of asbestos exposure, which has not been investigated since a radiography-based study in 1980. Methods We examined 2633 chest CT scans (mean 59.2 years, 50% female) from the Framingham Heart Study (FHS) for the presence and image characteristics of pleural plaques and diffuse pleural thickening. Demographics and pulmonary function were stratified by the presence of pleural abnormalities in association with interstitial lung abnormalities. Results Pleural abnormalities were present in 1.5% (95% CI 1.1% to 2.1%). Pleural lesions were most commonly bilateral (90.0%), multiple (77.5%), calcified (97.5%) and commonly involved posterior (lower: 92.5%, middle: 87.5%), anterior (upper: 77.5%, middle: 77.5%) and diaphragmatic areas (72.5%). Participants with pleural abnormalities were significantly older (75.7 years, p <0.0001), male (92.5%, p <0.0001), former or current smokers (80.0%, p <0.001) with higher packyears (33.3, p <0.0001). No significant reduction was noted in pulmonary function measures (p=0.07-0.94) when adjusted for the associated covariates, likely due to small number of cases with pleural abnormalities. Information about prior history of asbestos exposure and occupation was not available. Conclusions Pleural plaques and diffuse pleural thickening are present on CT in 1.5% of the FHS cohort. The current prevalence of the pleural abnormalities is smaller than that reported in the previous populationbased study using chest radiography, likely representing lower asbestos exposure in recent decades. The posterior portion of the pleura is most frequently involved but the anterior portion is also commonly involved.

AB - Background The prevalence of pleural abnormalities in the general population is an epidemiologically important index of asbestos exposure, which has not been investigated since a radiography-based study in 1980. Methods We examined 2633 chest CT scans (mean 59.2 years, 50% female) from the Framingham Heart Study (FHS) for the presence and image characteristics of pleural plaques and diffuse pleural thickening. Demographics and pulmonary function were stratified by the presence of pleural abnormalities in association with interstitial lung abnormalities. Results Pleural abnormalities were present in 1.5% (95% CI 1.1% to 2.1%). Pleural lesions were most commonly bilateral (90.0%), multiple (77.5%), calcified (97.5%) and commonly involved posterior (lower: 92.5%, middle: 87.5%), anterior (upper: 77.5%, middle: 77.5%) and diaphragmatic areas (72.5%). Participants with pleural abnormalities were significantly older (75.7 years, p <0.0001), male (92.5%, p <0.0001), former or current smokers (80.0%, p <0.001) with higher packyears (33.3, p <0.0001). No significant reduction was noted in pulmonary function measures (p=0.07-0.94) when adjusted for the associated covariates, likely due to small number of cases with pleural abnormalities. Information about prior history of asbestos exposure and occupation was not available. Conclusions Pleural plaques and diffuse pleural thickening are present on CT in 1.5% of the FHS cohort. The current prevalence of the pleural abnormalities is smaller than that reported in the previous populationbased study using chest radiography, likely representing lower asbestos exposure in recent decades. The posterior portion of the pleura is most frequently involved but the anterior portion is also commonly involved.

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U2 - 10.1136/oemed-2016-104178

DO - 10.1136/oemed-2016-104178

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