Asbestos Bodies in Bronchoalveolar Lavage Fluid and in Lung Parenchyma

Abstract

Numerical concentrations of asbestos bodies (AB) were measured by light microscopy both in samples of bronchoalveolar lavage (BAL) fluid and in samples of lung parenchyma from 69 patients with suspected asbestos-related diseases who had had lavages and later open lung biopsies or autopsies. Objectives were to study the recovery of pulmonary AB by BAL and the ability of BAL concentrations to predict parenchymal concentrations. BAL and parenchymal concentrations were both spread over 6 orders of magnitude and were positively correlated (r = 0.74 between logarithmic values). It is believed that, by a process of progressive elution, AB firmly adherent to the alveolar wall become suspended in BAL fluid; such suspended bodies represent roughly 2% of all the bodies stored in the portion of lung lavaged. Recovery is associated with great interindividual variations. When a measured BAL concentration exceeds 1 AB/ml, it can be quite confidently predicted, however, that the parenchymal concentration is in excess of 1,000 AB/g and that the patient has experienced a nontrivial asbestos exposure.

Biopersistence of nonfibrous mineral particles in the respiratory tracts of subjects following occupational exposure.

“…A previous study did not find any significant differences in any of the particles analyzed, except for fly ash (excess in BALF, p < 0.05), nor was there any significant correlation between the absolute number of particles in BALF and lavaged lung tissue (20), as was previously observed for asbestos bodies (7). However, this study was performed on a small series of subjects without previously known occupational exposure to NFMP.…”

“…Many studies performed on fibrous partides in humans have demonstrated that the concentration of asbestos bodies in BALF is correlated with the parenchymal concentration (7). Characterization and quantification of asbestos bodies (using optical microscopy) or of fibers (using electron microscopy) in BALF or lung tissue is very useful in interstitial diseases, pulmonary malignancies, and mesothelioma (7)(8)(9)(10)(11). These markers provide a good estimate ofprevious exposure to asbestos even long after exposure has ceased, as asbestos fibers remain in the lungs for a long period.…”

Guidelines for mineral fibre analyses in biological samples: report of the ERS Working Group. European Respiratory Society

“…BAL is much less invasive than thoracoscopy or biopsy and is therefore often performed to evaluate lung fibre burden. A BAL fluid sample can be accepted if it meets the following criteria: it should be performed preferentially in the right middle lobe or in the lingula; the site opposite to the tumour should be sampled, as the tumour may affect injection and recovery; 3×50 mL or 5×20 mL of saline must be instilled; recovery must be at least 30%; recovery fluid must not be filtered through gauze; cytological analysis should confirm the alveolar origin of the sample; and analysis should be performed on at least 10 mL, preferably of the second or third fraction as these fractions contain the highest concentration of AB [5].…”

“…Counting AB in iron-stained tissue sections and counting AB in digested LT samples are the methods that are most frequently applied to assess the AB content of the lungs. Values >1000 AB·g -1 dry LT and 1-2 AB·tissue section -1 are usually considered as indicative of nontrivial (usually occupational) exposure [5,15,[32][33][34]. The corresponding limits may be somewhat higher in areas where exposure to long amphiboles is common, e.g.…”

Air Pollution with Asbestos in Several Cities in Romania

“…They have been classified as markers of exposure, markers of effect, and markers of susceptibility (NAS/NRC 1989). Principal biomarkers of exposure to asbestos fibers include the detection and counting of fibers or asbestos bodies in bronchoalveolar lavage fluid samples (De Vuyst et al 1982, 1997Dumortier et al 1990Dumortier et al , 1998Roggli et al 1994a;Sebastien et al 1988a;Teschler et al 1994;, Tuomi et al 1991b),sputum samples (McDonald et al 1988(McDonald et al , 1992Sebastien et al 1988b), or in autopsied or surgically resected lung tissue samples (Case 1994;Churg 1982;Churg and Warnock 1981;Churg and Wright,1994;Churg et al 1993;de Klerk et al 1996;Dodson et al,1999;Dufresne et al 1995Dufresne et al , 1996aDufresne et al , 1996bSebastien et al 1989). Asbestos bodies are collections of fibers (usually of length >8 μm) with a protein -iron coating (also known as ferruginous bodies) that, when observed in lung tissue sections in conjunction with fibrosis, have been proposed to be used in the diagnosis of asbestosis (Churg 1989;.…”