Assessment of prognosis in asbestosis

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Auditorium 10 of Oulu University Hospital

Topic of the dissertation

Assessment of prognosis in asbestosis

Doctoral candidate

Licentiate of Medicine Eerika Keskitalo

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Research Unit of Biomedicine and Internal Medicine

Subject of study

Medicine

Opponent

Docent Hille Suojalehto, Finnish Institute of Occupational Health

Custos

Professor Riitta Kaarteenaho, University of Oulu, Oulu University Hospital

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Assessment of prognosis in asbestosis

Asbestosis is a lung disease caused by asbestos, in which scar tissue, that is fibrosis, is formed in the lungs. Asbestosis is classified as an interstitial lung disease (ILD), and it is one form of pulmonary fibrosis. In ILDs, inflammation or fibrosis occur mainly between pulmonary alveoli and capillaries. The use of asbestos was banned in Finland in 1994. Asbestosis still occurs in Finland, because the time between exposure and the development of the disease is long. Asbestos is still used in some countries. Asbestosis is an important differential diagnostic disease in diagnostics of ILDs. Previous research on prognosis-associated factors in asbestosis has been sparse.

The aim of the research was to investigate asbestosis from the perspective of ILDs. We investigated comorbidities, causes of death, lung function test results and bronchoalveolar lavage (BAL) fluid findings and their association with survival in asbestosis patients treated in Oulu University Hospital during the years 1996–2015.

Asbestosis patients had a high percentage of neutrophils in BAL and decreased lung function test results. Patients had several comorbidities of which cardiovascular and respiratory comorbidities were common. The most common underlying cause of death was asbestosis/lung fibrosis and the most common immediate cause of death was pneumonia. BAL findings and diffusion capacity were useful in the evaluation of survival. In addition, risk predicting models, i.e., gender, age and physiologic variables (GAP) and composite physiologic index (CPI), determined on the basis of lung function results, were useful in the evaluation of prognosis. Coronary artery disease and lung cancer associated with shortened survival.

The information of the clinical features of asbestosis observed in our study could be utilised in differential diagnostics of ILDs. Several novel factors were observed which may be useful in evaluating the prognosis of asbestosis patients.

Last updated: 23.1.2024