Chest pain in asbestos-exposed individuals with benign pleural and parenchymal disease

Many asbestos-exposed individuals complain of chest pain for which there is no clear explanation. To determine whether chest pain is associated with t he presence of benign pleural or parenchymal disease on chest radiograph, w e studied 1,280 subjects undergoing surveillance because of prior asbestos exposure at Wittenoom, Western Australia. All subjects completed the Rose q uestionnaire on chest pain and this revealed 556 subjects (43%) who experie nced some chest pain. A posterior-anterior chest radiograph was performed a t the same clinic visit and was subsequently graded independently by two ex perienced readers for diffuse parenchymal disease and pleural disease. Logi stic regression models adjusted for sex, age, and cumulative asbestos expos ure indicated that the presence of chest pain was significantly associated with the presence of both benign pleural disease and diffuse parenchymal di sease. Further analysis after stratification of chest pain into nonanginal and anginal pain showed that there was a significant association between an ginal pain and the presence of pleural and parenchymal asbestos-induced rad iologic abnormalities and an association of nonanginal pain with parenchyma l disease. We conclude that radiographic evidence of either parenchymal or pleural disease in subjects exposed to asbestos is significantly related to the presence of chest pain, particularly anginal pain.