The usefulness of bronchoalveolar lavage in identifying past occupational exposure to asbestos: A light and electron microscopy study

Abstract

Fiberoptic bronchoscopy has permitted the development of lavage procedures for the collection of lung washes. In certain disease states this material may contain large numbers of phagocytic cells (macrophages and neutrophils). Since these phagocytes are the predominant "dust scavenger cells" in the lung, the assessment of their particulate burden as well as that of the overall lavage material has been suggested as a potentially important diagnostic tool. The studies to date have shown that the presence of ferruginous bodies is an indication of past occupational exposure. In the present study, a digestion procedure was carried out on bronchoalveolar lavage material collected from individuals who were occupationally exposed to asbestos and from samples obtained from the general population. The parameters used for distinguishing the source of these samples included both light microscopy assessment of the filters for the presence of ferruginous bodies and electron microscopic screening for the presence of uncoated fibers.

Airflow obstruction in nonsmoking, asbestos-and mixed dust-exposed workers

“…The presence of ferruginous or asbestos bodies (ABs) in BAL fluid was quantitated by light microscopy [19,23]. The BAL cells were quantified, bleach digested, and filtered through 0.2 micron pore size polycarbonate filters (Nucleopore; Nucleopore Corp., Pleasanton, Calif.).…”

“…The number of AB was estimated by a manual count of the whole filter, or a fraction of the filter was used for assessing uncoated fiber burden. The number of AB was standardized to milliliters of BAL fluid recovered and 10 6 recovered alveolar macrophages (AM) [19,23]. In addition to light microscopy, analysis of the filter was carried out by transmission electron microscopy (Jeol 100cx analytical electron microscope) with energy-dispersive analysis (TN 2000 XEDS; Noran Instruments, Inc., Middletown, WI) as described previously [19,23].…”

“…The number of AB was standardized to milliliters of BAL fluid recovered and 10 6 recovered alveolar macrophages (AM) [19,23]. In addition to light microscopy, analysis of the filter was carried out by transmission electron microscopy (Jeol 100cx analytical electron microscope) with energy-dispersive analysis (TN 2000 XEDS; Noran Instruments, Inc., Middletown, WI) as described previously [19,23]. This technique allows analysis and quantitation of uncoated asbestos fibers recovered by BAL and was analyzed over a 0.8-mm z surface area of the filter.…”

“…Structure/function analysis of occupationally exposed populations is difficult. Bronchoalveolar lavage (BAL), in this setting, can provide a potentially useful objective measure of alveolar inflammation, inorganic dust exposure, and tissue dust burden [I, 13,17,18,19,25,34,35]. We, therefore, performed BAL in 30 nonsmoking and 30 cigarette smoking employees of a glass manufacturing plant who had incidental asbestos and mixed dust exposure.…”

Asbestos bodies in bronchoalveolar lavage fluid in relation to occupational history

“…This finding probably reflects three methodological problems [Schwartz et al, 1991[Schwartz et al, , 1992De Vuyst et al, 19921. First, ABs represent only a small and individually varying fraction of the total fiber burden of the lung [Dodson et al, 1985[Dodson et al, , 1991Warnock and Wolery, 19871. Second, chrysotile asbestos fibers are less likely to form ABs than amphibole asbestos fibers [Pooley, 1972;Albin et al, 19901.…”