Lung function and nervous system involvement in asbestosis

Our plain-English summary of Lung function and nervous system involvement in asbestosis, by O. Korhonen, J. Juntunen, M. Huuskonen (European Journal of Applied Physiology and Occupational Physiology, 1983).

The study

• Authors: O. Korhonen, J. Juntunen, M. Huuskonen
• Journal: European Journal of Applied Physiology and Occupational Physiology
• Published: 1983;50(2):207-12
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001716).

Abstract

A group of 115 patients with asbestosis of the lungs was tested in detail for neurological functions and lung functions in order that any possible impaired pulmonary function and neurological signs (especially peripheral neuropathy) could be discovered. Attention was also paid to finding out whether peripheral neuropathy, which is frequently encountered among asbestosis patients, had any role in decreased pulmonary function. A slight trend towards lowered spirometrical values (vital capacity, forced expiratory volume in one second, maximal mid-expiratory flow and maximal expiratory flow at 25% of vital capacity) was found for the group of patients with peripheral neuropathy. No differences in diffusing capacity were found between the groups of patients either with or without peripheral neuropathy. We concluded that the spirometrical findings are more indicative of a parallel phenomenon than a causal factor. Nor was the involvement of the central nervous system associated with decreased pulmonary function. In short, the pulmonary dysfunction of our asbestosis patients did not appreciably contribute to the occurrence of nervous system involvement, whether central or peripheral.

In plain English

This Finnish study asked whether poor lung function was linked to nervous system problems in patients with asbestosis. The authors studied 115 asbestosis patients followed at Helsinki's Institute of Occupational Health. A neurologist grouped them: 19 with both central and peripheral nervous system involvement, 19 with central nervous system involvement, 25 with peripheral neuropathy (damage to nerves outside the brain and spinal cord), and 52 with normal findings. Lung function was measured by spirometry and diffusing capacity in 1977 and 1980. In 13 matched pairs with and without neuropathy, lung function did not differ. In these pairs, diffusing capacity fell more over three years in the neuropathy group, but the authors judged this single statistically significant result most likely due to chance. In a larger comparison of 27 patients with and 39 without peripheral neuropathy, no significant differences were found, though spirometry values tended to be lower in the neuropathy group. Central nervous system involvement was not linked to lung function. The authors concluded that lung impairment did not appreciably contribute to the patients' nervous system involvement. Arterial blood oxygen was not measured.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Clinical comparison study of asbestosis patients grouped by neurological findings. It included matched pairs with and without peripheral neuropathy, and lung function measured twice, three years apart (1977 and 1980).
• Who was studied: 115 patients followed for 3-5 years for asbestosis at the Department of Occupational Medicine, Institute of Occupational Health, Helsinki, Finland. By neurological examination, 19 had combined central and peripheral nervous system involvement, 19 had central nervous system involvement, 25 had peripheral neuropathy and 52 had normal neurologic status. The 63 with some nervous system involvement had a mean age of 59 years (range 34-75) and were 58 men and five women. Thirteen matched pairs with and without neuropathy were formed.
• Exposure: Occupational asbestos exposure; fiber types are not stated. The 63 patients with nervous system involvement had been exposed for a mean of 23 years (range 5-44 years). Detailed exposure data are given in another report.
• Main results:
  • In the 13 matched pairs of asbestosis patients with and without peripheral neuropathy, lung function measured at the time of neurological evaluation did not differ between groups.
  • In the matched pairs, comparing 1977 with 1980, the group with peripheral neuropathy showed a more pronounced decrease in diffusing capacity.
  • The authors judged this one statistically significant difference (marked p < 0.005 in the table) most likely due to chance, because no other part of the analysis showed statistically significant differences.
  • In the larger comparison the authors call 'all of the material' (tables list 27 patients with and 39 without peripheral neuropathy), no significant difference was observed between the groups.
  • When the material was divided into quartiles by diffusing capacity in 1980, or by its change from 1977 to 1980, patients with and without peripheral neuropathy were equally distributed.
  • There was an overall tendency toward lower spirometric values (VC, FEV1.0, MMEF and MEF25) in patients with peripheral neuropathy, in both the matched-pair and the larger comparison.
  • Groups defined by central nervous system dysfunction did not differ in lung function.
• The authors' conclusion: The authors concluded that their patients' lung impairment did not appreciably contribute to nervous system involvement. Lowered spirometric values tended to coincide with peripheral neuropathy, but no definite conclusions could be drawn; the authors saw this more as a parallel phenomenon than a cause.
• Limitations the authors state:
  • Oxygen tension in arterial blood was not measured, which the authors said would have been more illustrative.
  • MEF25 was not measured in 1977, only in 1980.
  • Different instruments were used for diffusing capacity in 1977 and 1980; a small systematic difference between methods was found and corrected.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Diffusing Capacity (DLCO).

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