Pleural plaques and interstitial lung abnormalities in AGES-Reykjavik study

Our plain-English summary of Pleural plaques and interstitial lung abnormalities in AGES-Reykjavik study, by Y. Ko, G. Gudmundsson, T. Fukuda, et al (ERJ Open Research, 2026).

The study

• Authors: Y. Ko, G. Gudmundsson, T. Fukuda, Y. Nakamura, H. Bjarnadottir, V. Gudmundsdottir, M. Nishino, V. Gudnason, G.M. Hunninghake, H. Hatabu
• Journal: ERJ Open Research
• Published: 2026;12(5)
• Type of article: Letter
• Read it: PubMed · Publisher · Free full text

Abstract

Pleural plaques are frequent in Iceland and independently associated with interstitial lung abnormalities, highlighting the persistent threat of asbestos-related disease and stressing the urgent need for continued monitoring https://bit.ly/4u4riGW.

Copyright ©The authors 2026.

In plain English

This research letter reported a cross-sectional analysis of chest CT scans from the AGES-Reykjavik study, a community cohort of men and women born in Reykjavik, Iceland, from 1907 to 1935. The authors analysed 5075 of 5496 participants scanned between 2002 and 2006. They looked for pleural plaques and for interstitial lung abnormalities (ILA), which are changes in the lung tissue seen on CT. Individual asbestos exposure was not measured; the authors treated pleural plaques as a marker of prior asbestos exposure. Pleural plaques were found in 400 participants (7.9%), who were more often men and ever-smokers. Among those with plaques, 44 (11.0%) had ILA and 200 (50.0%) had indeterminate ILA. After adjustment for age, sex, smoking and body mass index, plaques were associated with ILA (adjusted odds ratio 2.17, 95% CI 1.49 to 3.13), irrespective of fibrotic changes. The authors concluded that plaques were relatively frequent in Iceland and independently associated with ILA. They added that ILA alongside plaques does not necessarily indicate asbestosis. They noted that the design cannot show cause and that occupational histories were unavailable.

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: Research letter reporting a retrospective, cross-sectional analysis of CT scans in a community-based longitudinal birth cohort
• Who was studied: 5075 of 5496 participants in the AGES-Reykjavik study, a cohort of men and women born in Reykjavik, Iceland, from 1907 to 1935, who had chest CT between 2002 and 2006. 421 were excluded for missing CT images or clinical data.
• Exposure: No direct asbestos exposure data and no fiber types. Pleural plaques seen on CT were used as a marker of prior asbestos exposure.
• Main results:
  • 400 of the 5075 participants (7.9%) had pleural plaques on CT.
  • Participants with pleural plaques were more often male (76.8%) and ever-smokers (75.3%) than those without plaques. Age and body mass index were similar between the groups.
  • Among participants with pleural plaques, 156 (39.0%) had no ILA, 200 (50.0%) had indeterminate ILA and 44 (11.0%) had ILA.
  • After adjustment for age, sex, smoking status, pack-years and body mass index, pleural plaques were associated with ILA: adjusted OR 2.17 (95% CI 1.49 to 3.13), p less than 0.001, irrespective of fibrotic changes.
  • In the table, the adjusted OR for indeterminate ILA among those with pleural plaques was 2.41 (95% CI 1.93 to 3.03).
  • In the table, the adjusted OR was 2.20 (95% CI 1.38 to 3.42) for ILA without fibrosis and 2.11 (95% CI 1.18 to 3.61, p 0.008) for ILA with fibrosis.
  • A second radiologist re-read 300 randomly selected scans. The two readers agreed on pleural plaques in 272 of 300 cases (90.7%); Cohen's kappa was 0.57 (95% CI 0.43 to 0.71), described as moderate agreement.
• The authors' conclusion: The authors concluded that pleural plaques are relatively frequent in the Icelandic population compared with other populations and are independently associated with ILA. They also stated that ILA in people with pleural plaques does not necessarily indicate asbestosis.
• Limitations the authors state:
  • Being retrospective, the study could not include detailed occupational history or clinical information on asbestos exposure.
  • Pleural plaques may also result from non-asbestos-related conditions such as prior illnesses or injuries.
  • The cross-sectional design does not allow any conclusion about cause between pleural plaques and ILA.
  • Long-term outcomes such as pulmonary fibrosis, lung cancer or mesothelioma were not assessed.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Interstitial.

Related studies

• Diagnoses and treatments for participants with interstitial lung abnormalities detected in the Yorkshire Lung Screening Trial — S. Upperton, P. Beirne, et al. (2023)
• Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure — E.J.A. Harris, K.P. Lim, et al. (2021)
• Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age — F. Laurent, I. Benlala, et al. (2021)
• High risk of pleural plaques and parenchymal abnormalities in women living in Biancavilla (Italy) — C. Ledda, C. Loreto, et al. (2016)
• Pleural abnormalities in the Framingham Heart Study: prevalence and CT image features — T. Araki, M. Yanagawa, et al. (2017)
• Author reply: 'Response to: Pleural abnormalities in the Framingham Heart Study: prevalence and CT image features' by Araki et al — T. Araki, G.M. Hunninghake, et al. (2018)

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