Assessment of Environmental Asbestos Exposure in Turkey by Bronchoalveolar Lavage

Abstract

Environmental or domestic exposure to asbestos fibers originating from local soil is responsible for a high incidence of diseases in large rural areas of Turkey. Bronchoalveolar lavage fluids (BALF) were obtained for 65 Turkish subjects originating from these areas and for 42 Turkish controls. Asbestos bodies (ABs) and uncovered fibers (UFs) were quantified by phase contrast light microscopy. Total fiber burden was determined by transmission electron microscopy. The main asbestos types disclosed were tremolite and to a lesser extent chrysotile. AB and fiber concentrations were higher in environmentally exposed subjects (geometric mean [geometric standard deviation]: 5.20 [6.22] AB/ml, 444 [11.6] tremolite fibers/ml) than in control subjects (0.22 [1.45] AB/ml, 12.0 [15.4] tremolite fibers/ml) (p < 0.001). In subjects environmentally exposed in Turkey, AB burdens on tremolite were in the same range as those on commercial amphiboles in subjects occupationally exposed in Belgium. In Turkish subjects, values above either 1 AB/ml, 3 uncovered fiber/ml in light microscopy, or 300 fibers/ml in electron microscopy indicated usually an abnormal alveolar retention reflecting a significant cumulative exposure from environmental or domestic origin. These observations are probably valid for other areas in the world where diseases associated with environmental exposure to soil- derived asbestos fibers occur and for immigrants originating from these areas.

Environmental Malignant Mesothelioma in Southern Anatolia: A Study of Fifty Cases

“…As shown in Figure 1, among Turkish immigrants living in some other countries have been well documented (4)(5)(6)(7)(11)(12)(13)(14)(15)(16)(17)(18). In Central Anatolian villages, mineralogic analyses performed on lung tissue samples as well as street samples revealed large amounts of zeolite (erionite) fibers, whereas in Karain village, these were mixed with small amounts of tremolite and chrysotile fibers.…”

The role of environmental and occupational exposures in Turkish immigrants with fibre-related disease

“…The probability of environmental exposure was classified as probable or unlikely on the basis of the maps published by Baris [1] and Dumortier et al [12], and information on the geology of Turkey. The probability of occupational asbestos exposure was classified according to the description of the patient9s working life [13].…”

“…Preparation of BALF and determination of asbestos body (AB) and uncovered fibres (UF) w10 mm by light microscopy and of the total fibre burden by electron microscopy have been extensively described previously [12]. Analytical sensitivities were usually v0.1 AB?mL -1 or UF?mL -1 of BALF for light microscopy and v50 fibres (w1mm)?mL -1 of BALF for electron microscopy.…”

“…Analytical sensitivities were usually v0.1 AB?mL -1 or UF?mL -1 of BALF for light microscopy and v50 fibres (w1mm)?mL -1 of BALF for electron microscopy. Results from the present study were compared to those of patients still living in Turkey (residents) [12].…”

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;.…”