Grand Rounds: Asbestos-Related Pericarditis in a Boiler Operator

Details

• Personal Author:
  Abejie BA ; Chung EH ; Kales SN ; Nesto RW
• Description:
  Context: Occupational and environmental exposures to asbestos remain a public health problem even in developed countries. Because of the long latency in asbestos-related pathology, past asbestos exposure continues to contribute to incident disease. Asbestos most commonly produces pulmonary pathology, with asbestos-related pleural disease as the most common manifestation. Although the pleurae and pericardium share certain histologic characteristics, asbestos-related pericarditis is rarely reported. Case presentation: We present a 59-year-old man who worked around boilers for almost 30 years and was eventually determined to have calcific, constrictive pericarditis. He initially presented with an infectious exacerbation of chronic bronchitis. Chest radiographs demonstrated pleural and pericardial calcifications. Further evaluation with cardiac catheterization showed a hemodynamic picture consistent with constrictive pericarditis. A high-resolution computerized tomography scan of the chest demonstrated dense calcification in the pericardium, right pleural thickening and nodularity, right pleural plaque without calcification, and density in the right middle lobe. Pulmonary function testing showed mild obstruction and borderline low diffusing capacity. Discussion: Based on the patient's occupational history, the presence of pleural pathology consistent with asbestos, previous evidence that asbestos can affect the pericardium, and absence of other likely explanations, we concluded that his pericarditis was asbestos-related. Relevance to clinical practice: Similar to pleural thickening and plaque formation, asbestos may cause progressive fibrosis of the pericardium. [Description provided by NIOSH]
• Subjects:
  Asbestos Environmental Exposure Inorganic Chemicals Lung Diseases Occupational Health Pathology Public Health Radiation Respiratory Tract Diseases Safety
• Keywords:
  Author Keywords: Asbestos Boiler Operators Calcific Pericarditis Constrictive Pericarditis Diseases Environmental Exposure Extrapulmonary Public Health Pulmonary System Disorders Radiography Respiratory System Disorders

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• ISSN:
  0091-6765
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  86-89
• Volume:
  116
• Issue:
  1
• NIOSHTIC Number:
  nn:20060418
• Citation:
  Environ Health Perspect 2008 Jan; 116(1):86-89
• Contact Point Address:
  S.N. Kales, The Cambridge Health Alliance, Macht Building, Room 427, 1493 Cambridge St., Cambridge, MA 02139
• Email:
  skales@challiance.org
• CAS Registry Number:
  Asbestos (CAS RN 1332-21-4)
• Federal Fiscal Year:
  2008
• Performing Organization:
  Harvard School of Public Health
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Environmental Health Perspectives
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e139928f7870fd43081ceb1584c090a3b8b7cd754483b635a3cf46d683dac6c8f6a095247950894c00b02d09fc69f58b7d3bb94ec1eee0e7695dd617d103a68d
• Download URL:
  https://stacks.cdc.gov/view/cdc/224321/cdc_224321_DS1.pdf
• File Type:
  [PDF - 121.24 KB ]