Correlation of bronchoalveolar lavage and clinical and functional findings in asbestosis

Respiratory clinical, radiographic, and functional findings were assessed and correlated with bronchoalveolar lavage (BAL) cellular changes in 52 asbestos workers (27 with and 25 without asbestosis) and in 15 control subjects without asbestos exposure. Subjects with asbestosis had a moderate neutrophilic alveolitis (7.8 +/- 5%) compared with the other groups (p less than 0.001) that was correlated with the presence of crackles (p = 0.03) and PaO2 (p less than 0.05) and AaPO2 at rest (p less than 0.05) values. Asbestos bodies (AB) in BAL were quantitated in 34 of the 52 asbestos workers (21 with and 13 without asbestosis) and in the control group. They were present in 83% of asbestos workers but they were absent in the latter. No significant differences were observed in the number of AB between those asbestos workers with and without lung disease. We conclude that crackles on auscultation and PaO2 and AaPO2 values may well be good indicators of the staging of neutrophilic alveolitis in asbestosis. In contrast, the amount of AB in BAL is not a reliable marker of asbestos lung fibrosis.