ABSTRACT
A cross-sectional medical survey including collection of three consecutive sputum samples was carried out among 270 retired workers of a textile and friction materials factory, in order to investigate the relationship between asbestos body identification and asbestos exposure. The individual cumulative asbestos exposure, determined by means of a plant-specific job-exposure matrix based on asbestos air measurements in the workshops, proved to be heavy with a mean cumulative exposure of 217 fibres x mL(-1) x yr. Macrophages and asbestos bodies were identified in sputum samples by light microscopy. The lung origin of the sputum, suggested by the presence of macrophages and/or asbestos bodies, was confirmed in 82.6% of subjects, and 53% of these samples were positive for asbestos bodies. The prevalence of asbestos bodies was not related to sex, smoking status or latency. Conversely, multivariate analysis showed a positive relationship with cumulative exposure, duration and intensity of exposure to asbestos, as well as age and time since retirement. These findings suggest that sputum analysis for asbestos bodies may remain a relevant and noninvasive marker of heavy occupational exposure to asbestos, even years after retirement. Owing to the new perspectives in lung cancer screening, it might contribute to the identification of high-risk subjects.
Subject(s)
Asbestos/analysis , Mineral Fibers/analysis , Occupational Exposure , Sputum/chemistry , Aged , Aged, 80 and over , Air Pollutants, Occupational/analysis , Cross-Sectional Studies , Female , Humans , Logistic Models , Macrophages , Male , Middle Aged , Multivariate Analysis , Odds Ratio , Smoking , Sputum/cytologyABSTRACT
The growing use of asbestos in France like in other industrialized countries since the beginning of the century is the reason of the increase of asbestos-related diseases, which occur after long latency periods. From asymptomatic benign pleural plaques up to malignant mesothelioma of poor prognosis, the fibrogenic and carcinogenic properties of asbestos mainly concern occupationally exposed subjects. The Institut national de la santé et de la recherche médicale (INSERM) expert committee concluded that about 1,950 deaths due to asbestos-related cancers occurred in France in 1996. Reinforcement of French legislation aims at reducing all kinds of asbestos exposure.
