CHEST Guidelines-Response_chest

Response_chest_14 (2)

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In a letter to the editor of the CHEST journal, the authors respond to Dr. Miller's comments on their study about the effects of pleural plaques (PP) on lung function in Libby vermiculite miners. They affirm that their study, which utilized high-resolution CT (HRCT) scans, was robust and independently reviewed. Their analysis showed no significant lung function impairment due to PPs alone, aligning with previous research suggesting that observed lung function decrements in asbestos-exposed individuals might be due to coexisting interstitial fibrosis rather than PPs themselves.<br /><br />The authors address Dr. Miller's reference to a study by Black et al., which reported cases of extensive pleural thickening resulting in restrictive impairment. They agree that these findings are consistent with diffuse pleural thickening (DPT), not PPs. Their study found no evidence of DPT among miners who had normal HRCT scans or PPs, arguing that the HRCT method offers a more precise evaluation than chest radiographs used in other studies.<br /><br />Dr. Miller misinterprets their study as including a group of miners with primary DPT. The authors clarify that the observed group, the OCTA, didn't significantly influence study conclusions, and only a minority had DPT. They reinforce that HRCT demonstrates the absence of significant effect from PPs alone on lung function, and note no comparison group in Black et al.'s descriptive study. The authors acknowledge potential conflicts of interest due to their affiliations and funding sources but maintain the integrity of their findings, highlighting that their research provides a more detailed description of lung function impairment than previous studies.

Keywords

pleural plaques

lung function

Libby vermiculite miners

high-resolution CT

interstitial fibrosis

diffuse pleural thickening

Dr. Miller

Black et al.

chest radiographs

conflicts of interest