ABSTRACT
The presence of asbestos bodies in the sputum of individuals with known occupational asbestos exposure has been well documented. However, their prevalence and clinical implications in sputum and bronchial washings from patients not clinically known to have asbestos exposure remains controversial. From 1974 to 1979, 31,353 sputum and bronchial washing specimens were processed in the course of evaluating various pulmonary complaints of approximately 11,000 patients from the outpatient clinics and hospitals of the Harris County Hospital District in Houston, Texas. Asbestos bodies were incidentally found in five patients, and, in retrospect, each of them was discovered to have had significant occupational exposure to asbestos dust. Asbestos lung disease was also subsequently proven in four of the five patients and was felt, retrospectively, to have contributed to their presenting complaints and clinical course. It is concluded that asbestos bodies in sputum and bronchial washing specimens are highly specific markers for past asbestos exposure and reflect the presence of a significant asbestos load within the lungs. Sputum cytology is both painless and inexpensive and is recommended as a supplemental procedure to document clinically significant asbestos exposure.
Subject(s)
Asbestosis/diagnosis , Adolescent , Adult , Asbestosis/epidemiology , Environmental Exposure , Humans , Male , Middle Aged , Sputum/cytologyABSTRACT
The Tyler Asbestos Workers Program is a continuing study of 1,105 former amosite asbestos workers. This report includes a study of six former workers, five of whom died and had autopsies, and one who underwent a lobectomy. Five of these men were exposed to asbestos for three months or less. Four had lung cancer, and one a rectal carcinoma. All were cigarette smokers. Ferruginous (asbestos) body content of the upper and lower lobes of the lungs was quantitated by a digestion technic. Tissue sections from upper and lower lobes were independently quantitated for fibrosis and ferruginous bodies, and chest roentgenograms were examined for interstitial fibrosis. (Control lung tissue was obtained from consecutive autopsies of 52 adults who did not have a known occupational exposure to asbestos.) Relatively low ferruginous body counts (less than 700/g lung tissue) were associated with mild degrees of fibrosis, and higher counts (greater than 10,000/g) with moderate to severe fibrosis. Mild to moderate pulmonary fibrosis could be identified on tissue sections before interstitial changes were detectable by chest roentgenograms.
Subject(s)
Asbestos/adverse effects , Carcinoma, Bronchogenic/pathology , Lung Neoplasms/pathology , Lung/analysis , Occupational Diseases/pathology , Pulmonary Fibrosis/pathology , Rectal Neoplasms/pathology , Aged , Humans , Lung/pathology , Male , Middle Aged , Organ Size , Smoking/complications , X-Ray DiffractionABSTRACT
The clinical significance of ferruginous bodies in sputa was examined in a study of 674 former asbestos workers. Data from occupational histories and smoking behavior questionnaires, chest radiographs, spirometric measurements and counts of ferruginous bodies were obtained as part of a five-year surveillance program. Statistical analysis demonstrated that ferruginous bodies found in the sputa were significantly related to radiographic findings of interstitial pulmonary disease and pleural fibrosis and to spirometric findings of restrictive lung disease. Age and cigarette smoking were also found to be related to the presence of ferruginous bodies.
