Asbestos and airflow limitation.

To assess the effect of asbestos on the airways, researchers studied 45 shipyard workers who were lifelong nonsmokers and had asbestos-related abnormalities seen on their chest roentgenograms. Patients with interstitial lung disease, bronchial asthma prior to asbestos exposure, recurrent pneumonias, or significant cardiovascular disease were excluded from the study. In addition to chest films, they had spirometry performed before and after bronchodilator inhalation, lung volumes, diffusing capacity, and arterial blood gases. Forced vital capacity and forced expired volume in one second were normal in all patients. Maximum midexpiratory flow rates (MMFR) were abnormal (MMFR less than 75% of predicted) in 13 patients (29%). Therefore, 29% of lifetime nonsmokers with asbestos exposure exhibited evidence of small airways dysfunction. An abnormal MMFR in these workers may be due, in part, to asbestos exposure and could conceivably indicate a population at risk for pulmonary fibrosis and/or obstructive airways disease.