In former asbestos-exposed workers TCT findings are more highly correlated to DLCO than to vital capacity

The aim was to determine which of the diagnostic instruments (VC, DLCO, TCT) are relevant for the early detection of asbestos-related pleural and pulmonary fibrosis. The records of 111 formerly asbestos-exposed workers with TCT, VC, DLCO were reviewed; substantial comorbidities (cardiac, malignant) and pulmonary emphysema were excluded. By that, data of 41 males (mean 69.8 years ±6.9) were included. TCT findings for pleural and pulmonary changes were coded according to ICOERD and scores were determined. In all 41 males the VC showed only minor limitations (mean 96.5 ±18.0% pred.), DLCO was slightly reduced (76.4 ±16.6%), DLCO/VA was within reference values (102 ±22%). In the TCT 27 workers showed pleural asbestos-related findings, 24 pulmonary fibrosis. Statistical analysis provided low correlations of VC (ρ = -0.12; 0.10, resp.) and moderate correlations of DLCO (-0.25, -0.23, resp.) with pleural plaque extension and ICOERD-score for pulmonary fibrosis. DLCO had the highest accuracy with 73.2% and Cohens κ with 0.45. DLCO/VA showed no correlations to ICOERD-score. A newly developed score, regarding the extent of pleurovisceral plaques, shows a moderate correlation with DLCO (ρ = -0.35, p Lung function alterations and TCT findings correlated highly and showed highest accuracy using DLCO and ICOERD-score considering parenchymal ligaments, subpleural curvilinear lines, roundatelectases and pleural effusion in addition to pleural plaque extension, also in regard to pulmonary findings. VC showed only weaker correlations. Besides TCT, the determination of VC and DLCO is mandatory for the early detection and assessment of functional asbestos-related deficiencies.