Evaluation of low-level asbestos exposure by transbronchial lung biopsy with analytical electron microscopy

To improve diagnostic sensitivity for detecting low-level asbestos exposure (AEx) in patients, a new method was developed using an analytical transmission electron microscope (ATEM) for specimens of transbronchial lung biopsy (TBLB). The TBLB specimens from 28 patients were examined and the results were: 1) In cases with long-term AEx, the present method detected a large amount of asbestos fibers (AF) as well as asbestos bodies (AB) showing a good agreement with the results of light microscope (LM) which detected definite amounts of ferruginous bodies (FB). 2) In cases with short-term or suspected AEx, the LM failed to detect FB in some cases, but an appreciable amount of AF was detected using the present method, and AEx was disclosed through a second close interview. 3) Neither AB nor AF were detected in most of the cases without any dust exposure. Although small amounts of chrysotile fibers were observed in some cases, this might simply reflect the exposure level of urban dwellers. These results show that the ATEM applied to the TBLB specimens promises to confirm low-level AEx in such small specimens even if the patients were unaware of their past AEx.