Increased body mass index is related to apparent circumscribed pleural thickening on plain chest radiographs

Am J Ind Med. 2001 Jan;39(1):112-6. doi: 10.1002/1097-0274(200101)39:1<112::aid-ajim11>;2-g.


Background: Diffuse pleural thickening and pleural plaques are the commonest radiological manifestations of asbestos exposure. Differentiation between subpleural fat and non-calcified pleural plaques is important clinically and medico-legally. This study aims to determine if apparent circumscribed pleural thickening on chest radiographs is related with obesity.

Methods: Surveillance chest x-rays of 693 former asbestos workers were read with the ILO classification. Subjects with costophrenic angle obliteration (n = 57) were analyzed separately. The remaining subjects were subdivided according to their body mass index (BMI): Group 1 < 26 kg/m(2); Group 2 26-30 kg/m(2); Group 3 > 30 kg/m(2).

Results: Baseline characteristics, asbestos exposure, and profusion scores were evenly distributed. BMI of > 30 kg/m(2) was associated with a higher prevalence of pleural thickening on CXR (Gp1 = 8.5%; Gp2 = 9.3%; Gp3 = 18.3%). This relationship was strongest in the subgroups with 25-50% of the lateral chest wall involved and pleural thickness of < 10 mm.

Conclusions: Obesity (BMI > 30 kg/m(2)) is related to apparent circumscribed pleural thickening on CXR, especially thin (< 1 cm) shadows covering 25-50% of the lateral chest wall.

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Asbestosis / diagnostic imaging
  • Body Mass Index*
  • Chi-Square Distribution
  • Diagnosis, Differential
  • Female
  • Humans
  • Male
  • Middle Aged
  • Obesity / diagnostic imaging*
  • Occupational Exposure
  • Pleura / diagnostic imaging*
  • Pleural Diseases / diagnostic imaging
  • Population Surveillance
  • Prevalence
  • Radiography, Thoracic*
  • Thorax
  • Western Australia