Industrial injuries disablement benefit (IIDB) defines asbestos related diffuse pleural thickening (DPT) with obliteration of a costophrenic angle on chest x-ray as eligible for compensation. Previous studies report significant airflow limitation and functional impairment in these patient.

Methods A database search from 08/2005 to 01/2013 for DPT as agreed by a multi-disciplinary team meeting as fulfilling the criteria for a claim. Any IIDB advice given, records of those who applied, smoking history and lung function tests at presentation were interrogated. Lung function was performed by a specialist cardio-pulmonary technician by body plethysomography. Airflow obstruction defined by ARTP/BTS criteria as FEV1/ FVC <70% and severity of airflow obstruction by FEV1 (50–80% predicted as mild, 30–49% predicted as moderate and <30% as severe obstruction respectively).

Results 39/50 male subjects with DPT attended follow-up.

100% were given written advice of their eligibility to claim IIDB.

24/39 (62%) who were followed up applied for IIDB, with disability ranging from 15 - 100%. 2 were recorded as having less than 15% disability. Of 15 who did not apply, 4 patients’ exposure was not work related and 11 chose not to apply.

4/39 (10%) were never smokers and 30/39 (77%) ex-smokers.

Lung function results were available for 43/50 at presentation (table 1).

Conclusions Our group of patients had a significantly high smoking history. Airflow limitation with DPT is the predominant lung function abnormality seen. Despite their disability, patients chose not to apply for IIDB as above.

The airflow limitation may be progressive and hence important to repeat the lung function tests over a time period to see if this deteriorates further contributing to worsening disability.

References

1. Abnormal lung function associated with asbestos disease of the pleura, lung and both; comparitive analysis, Thorax 1991.