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Record W4230135610 · doi:10.5271/sjweh.635

Association between pleural plaques and coronary heart disease

2001· letter· en· W4230135610 on OpenAlexaboutno aff
Bengt Sjögren

Bibliographic record

VenueScandinavian Journal of Work Environment & Health · 2001
Typeletter
Languageen
FieldMedicine
TopicOccupational and environmental lung diseases
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineCohortAsbestosCause of deathMortality rateStandardized mortality ratioCohort studyRisk factorChrysotileInternal medicineDiseaseCardiologySurgery

Abstract

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Ossi Korhola and his co-workers presented an interesting relationship between the occurrence of calcified pleural plaques and coronary heart disease (1). They discussed infection as one possible etiologic factor associated with both conditions. They also emphasized that asbestos exposure is the most important, if not the only, known etiologic factor for pleural plaques. An increased mortality due to diseases of the circulatory system [code 400-468 of the International Classification of Diseases, 7th revision (ICD 7)] was found among white male textile workers exposed to chrysotile in the United States [standardized mortality ratio (SMR) 1.25, P<0.05] (2). The smoking habits were about the same as in a reference group of men in the United States. Some years later, Enterline and his co-workers reported the mortality experience of 1074 white men who retired from an asbestos company in the United States during 1941-1967 (3). The participants were exposed during production or maintenance and followed until 1980. Increased mortality due to coronary heart disease (ICD 7, 420) was observed (SMR 1.12, P<0.05) when the cohort was compared with national death rates in the United States. A cohort of 3211 men first employed between 1933 and 1974 at a Rockdale asbestos textile factory were followed until 1983 (4). A small but not significant increase in mortality due to circulatory disease was observed when the death rate of the cohort was compared with the death rates for England and Wales (SMR 1.15) and the death rates for Rockdale (SMR 1.18). A cohort of 952 workers first employed between 1930 and 1965 in a chrysotile asbestos mine in northern Italy was followed until 1975 (5). Increased mortality due to cardiovascular diseases (ICD 7, 400-468) was recorded (SMR 1.48, P<0.01) when the cohort was compared with Italian national death rates. A cohort of some 11 000 men born in 1891-1920 and employed for at least 1 month in the chrysotile mines and mills of Quebec was followed until 1988 (6). Ischemic heart disease was more common among those exposed to 300 million or more particles per cubic foot × years (SMR 1.24) compared with those exposed to less than 30 million particles per cubic foot (SMR 0.92). One part of this large cohort comprising 4559 men was followed for radiological findings (7). Uncalcified pleural changes were associated with an increased mortality risk regarding diseases of the heart (ICD 7, 400-443) [relative risk (RR) 1.54, P<0.005]. Pleural calcifications were also associated with a somewhat increased risk of the same disease (RR 1.34, P<0.10). A total of 1106 workers was selected from the workforce of the asbestos industry in Western Australia (8). These workers were exposed to crocidolite, and pleural thickening was a risk factor for death from other causes [RR 1.5, 95% confidence interval (95% CI) 1.3-1.8]. Ischemic heart disease formed the largest proportion of deaths from other causes. Ischemic heart disease (IHD) was studied in a cohort of 1725 Swedish male shipyard workers exposed to asbestos (9). Men with pleural plaques had a slightly increased risk of IHD when compared with men without pleural plaques (RR 1.3, 95% CI 0.8-2.0) after stratification for age and smoking habits. However, men with asbestosis or suspected asbestosis had a significantly higher risk (RR 3.1, 95% CI 1.5-6.4) of dying from IHD than did men without asbestosis, after stratification for age and smoking habits. When the deaths of workers exposed to asbestos are compared with death rates from a national population, such a comparison is most often regarded as an underestimation of the true risk as the general population includes sick and disabled people unable to work. This underestimation is well known as the healthy worker effect (10). However, several studies show a relationship between asbestos exposure and coronary heart disease despite this biased comparison. Some studies also show a relationship between the occurrence of pleural plaques and coronary heart disease, and one investigation shows a relation between asbestosis and coronary heart disease. Does a possible mechanistic link exist between asbestos exposure and coronary heart disease? Human pulmonary epithelial cells cultured in the presence of asbestos crocidolite produced a dose-dependent increase in the secretion of interleukin-6 (11). Interleukin-6 is known to stimulate hepatocytes to produce and secrete fibrinogen (12). A high plasma level of fibrinogen is an established risk factor for coronary heart disease (13). A general hypothesis has linked the inhalation of particles and fibers to the occurrence of IHD in the following way. Air pollutants retained in the lungs after inhalation will hypothetically create low-grade inflammation in association with an increase in plasma fibrinogen. The high concentration of fibrinogen increases the likelihood for blood clotting and thereby the risk for myocardial infarction and IHD (14, 15). Thus it seems as if asbestos exposure by itself could explain an increased risk of IHD. However, I agree with Korhola and his co-workers (1) that an infectious agent may be a contributing cause in a series of events creating an inflammatory response.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.245
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.018
GPT teacher head0.263
Teacher spread0.245 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations6
Published2001
Admission routes1
Has abstractyes

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