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Asbestos bodies in bronchoalveolar lavage fluid in relation to occupational history
A Karjalainen1, S Anttila, T Mäntylä
1Institute of Occupational Health, Helsinki, Finland.
Abstract:
Concentrations of asbestos bodies (AB) were assessed by optical microscopy of 10 ml iron-stained samples and compared with the exposure history acquired by personal interview for 156 patients. Concentrations equalling or exceeding 1 AB/ml were found in 85% of patients who had been heavily exposed to asbestos and only 7% of those who were unlikely to have been exposed. Elevated AB concentrations were observed among primary asbestos, shipyard and construction workers. Smoking was not found to affect the AB concentrations. The use of Papanicolaou-stained cytological Millipore preparations during routine screening was a less sensitive method for the assessment of AB concentrations than that involving iron-stained preparations. The expression of AB concentration as AB/ml or AB/million cells were found to be equally useful indicators of exposure. The correlation between AB concentration and exposure history was greater than in earlier studies on workers exposed to chrysotile. Concentrations exceeding 1 AB/ml were indicative of a nontrivial exposure to asbestos. Despite the observed correlation between AB concentration and exposure history, the individual variability of AB counts, methodological differences and laboratory-bound reference values are important in the interpretation of AB concentrations in bronchoalveolar lavage (BAL) fluid at individual level.
Insights
Asbestos bodies (AB) in lung fluid can indicate asbestos exposure. High AB concentrations (≥1 AB/ml) were found in 85% of heavily exposed patients, suggesting significant asbestos exposure.
Area of Science:
- Pulmonary Medicine
- Occupational Health
- Toxicology
Background:
- Asbestos bodies (AB) are indicators of asbestos exposure.
- Assessing AB concentrations in bronchoalveolar lavage (BAL) fluid can help quantify exposure.
- Previous studies have explored the correlation between AB levels and occupational history.
Purpose of the Study:
- To assess asbestos body concentrations in BAL fluid.
- To compare AB concentrations with patient exposure histories.
- To evaluate the sensitivity of different staining methods for AB detection.
Main Methods:
- Optical microscopy of iron-stained BAL fluid samples (10 ml).
- Personal interviews to acquire patient exposure history.
- Comparison of Papanicolaou-stained and iron-stained preparations.
- Analysis of 156 patients with varying exposure levels.
Main Results:
- 85% of heavily exposed patients had ≥1 AB/ml, versus 7% of unexposed individuals.
- Elevated AB concentrations were found in asbestos, shipyard, and construction workers.
- Iron-stained preparations were more sensitive than Papanicolaou-stained ones.
- AB/ml and AB/million cells were equally effective exposure indicators.
Conclusions:
- Concentrations ≥1 AB/ml indicate nontrivial asbestos exposure.
- A stronger correlation between AB concentration and exposure history was observed compared to prior studies.
- Individual variability and methodological differences necessitate caution in interpreting AB levels for individual diagnosis.