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JOINT WEBSITE OF THE HONG KONG THORACIC SOCIETY AND THE CHEST DELEGATION HONG KONG AND MACAU
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2001

2001 - Retrospective Analysis of a Cohort of Compensable Asbestos Related Disease (CARD) in Hong Kong

Dr. KC Chang, Department of Health

Objective
To describe the characteristics of CARD in Hong Kong.

Setting
Pneumoconiosis Clinic.

Methods
Retrospective analysis of the characteristics and progress of a cohort of CARD patients, whose conditions were confirmed by the Pneumoconiosis Medical Board from 29 May 1986 to 4 January 2001, by review of clinic records from the date of diagnosis until death or 31 March 2001.

Results
The prevalence and incidence of CARD were low. Only eighty-five patients were identified, comprising 67 with asbestosis only, 14 with mesothelioma only, and four with both diseases. The majority had jobs related to ships and dockyards, boilers and pipes, or buildings. They were mostly men and ever-smokers.

Asbestosis patients had typical asbestos exposure duration and a relatively long latency period, which may be related to a lower intensity of asbestos exposure in this locality. The presenting symptoms were modified by a high prevalence of smoking. A significant proportion of patients showed an obstructive airflow pattern. Sputum asbestos bodies were uncommon but its presence was associated with reduction in percentage predicted FEV1. Pleural plaques were common, and its occurrence was related to cumulative asbestos exposure, and a reduced relative risk for clubbing and fine crackles. Most asbestosis patients with lung cancer developed the latter upon presentation. Lung cancer was significantly related to cigarette pack-years and asbestos bodies. Lung cancer and percentage predicted FVC were important mortality risk factors. A two-fold relative risk for tuberculosis was noticed.

Mesothelioma patients had typical asbestos exposure duration and latency. The prognosis was extremely poor with a median survival of 8.5 months, which was typical. A very high relative risk for TB was also found.

Conclusion
Many characteristics of CARD in Hong Kong are comparable with the typical disease pattern and consistent with the current understanding of the diseases. A high risk of tuberculosis was unexpected and further investigation is warranted.

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