Purpose: To characterize asbestosis today and to clarify the indications for high-resolution computed tomography (HRCT) in the surveillance of heavily exposed workers.
Methods: Six hundred and twenty-seven workers were screened and HRCT findings were classified and divided in two groups: pulmonary fibrosis (n = 86) and no fibrosis (n = 541).
Results: Most (65/86 = 76%) of the detected fibrosis cases were mild. The magnitude of asbestos exposure showed an unexpected inverse relation with fibrosis. In multivariate analyses, age, forced expiratory volume in 1 s/forced vital capacity ratio, and poor diffusing capacity were associated with HRCT fibrosis, but asbestos exposure was not.
Conclusions: Asbestosis seems to be characterized by mild fibrosis today even in heavily exposed workers. To avoid radiation exposure in HRCT, age and lung function data may be used only to a limited extent to select imaging candidates. Selection and recollection biases may distort the relation between asbestos exposure and fibrosis.
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