Am. J. Respir. Crit. Care Med., Vol 149, No. 3, Mar 1994, 641-645.
Asbestos fibers in bronchoalveolar lavage and lung tissue of former asbestos workers
H Teschler, KH Friedrichs, GB Hoheisel, G Wick, U Soltner, AB Thompson, N Konietzko and U Costabel
Ruhrlandklinik, Department of Allergy, University of Essen, Germany.
Bronchoalveolar lavage (BAL) provides a simple method of sampling inhaled
particles deposited in the lower respiratory tract. We hypothesized that
BAL could be used to measure the quantity and quality of lung asbestos
burden. This would be true if BAL fluid asbestos fiber content reflected
the total content as well as the size distribution of both uncoated and
coated asbestos fibers in lung parenchyma. Therefore, we analyzed the
asbestos fiber counts of 23 individual sample pairs in both BAL fluid and
lung tissue samples obtained from 20 patients with occupational asbestos
exposure using transmission electron microscopy (TEM). In addition, fiber
type, fiber size, and aspect ratio were compared. Coated asbestos fibers
were found in 10 of 23 BAL samples and 16 of 23 biopsies. The mean
concentrations of coated asbestos fibers (i.e., asbestos bodies) in BAL and
lung parenchyma showed a positive correlation (r = 0.75, p < 0.001).
Likewise, the mean amphibole fiber concentrations correlated positively (r
= 0.55, p < 0.01). However, there was no relationship between the mean
chrysotile fiber counts in BAL and lung parenchyma (r = 0.18, p = 0.40).
Asbestos fibers in lung tissue were significantly longer (8.2 +/- 0.5
versus 4.8 +/- 0.6 microns; p < 0.001) but had the same width (0.12 +/-
0.27 versus 0.11 +/- 0.15 microns; p = 0.24) when compared with those
retrieved by BAL from the airspace compartment. The aspect ratio (dividing
fiber length by width) was much higher in lung tissue than in BAL fluid
(66.4 +/- 0.4 versus 42.9 +/- 0.5; p < 0.001).(ABSTRACT TRUNCATED AT 250
WORDS)
