The relationship of pulmonary function to exposure to asbestos and radiogra
phic abnormalities has been controversial, especially when smoking is prese
nt as a confounder. The aim of the study was to provide further understandi
ng on the radiographic-physiologic associations in nonsmoking and smoking a
sbestos workers. Radiographic asbestosis, pleural lesion, and pulmonary fun
ction were studied in 269 Chinese asbestos workers, with average exposure y
ears of 23 for male workers and 18 for female workers. Their functional dat
a were compared with those of 274 controls without exposure to dust. Althou
gh most of the male workers were smokers, none of the female workers smoked
. In comparison with controls, asbestos workers had significantly lower lun
g volume and diffusing capacity, irrespective of gender. Female workers and
smoking male workers had lower measurements of forced expiratory volume in
1 second and instantaneous forced expiratory flow at 50% and 25% of forced
vital capacity. After adjustment for relevant covariates, asbestos exposur
e, asbestosis, and pleural abnormalities were associated with decreased par
ameters of pulmonary function, including lung volume, diffusing capacity, a
nd airway flow. These data indicate that asbestos-related functional defect
s manifested by lung restriction and mild airway obstruction correlate with
exposure to asbestos and with parenchymal and pleural abnormalities, indep
endent of smoking.