María Jesús Cruz1, Victor Curull2, Lara Pijuan3, Daniel Álvarez-Simón1, Albert Sánchez-Font2, Javier de Gracia1, Mario Culebras1, Jaume Ferrer4. 1. Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España. 2. Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España. 3. Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España. 4. Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: jjferrer@vhebron.net.
Abstract
INTRODUCTION: Bronchoalveolar lavage (BAL) analysis has been proposed as an objective technique for confirming asbestos exposure. However, the reliability and diagnostic yield of this procedure has not been studied in Spain. The aim of this study was to assess the usefulness of the analysis of asbestos bodies (AB) in bronchoalveolar lavage (BAL) for the diagnosis of asbestos-related diseases (ARD). METHODS: BAL samples from 72 patients (66 male, mean age 66 years) undergoing bronchoscopy were analyzed. Lung tissue from 23 of these patients was also analyzed. Asbestos exposure was assessed by anamnesis and a review of the patient's medical records. BAL and lung samples were processed and AB count was determined by light microscopy. The accepted threshold value to diagnose asbestos-related diseases was 1 AB/ml BAL or 1000 AB/gr dry tissue. RESULTS: Thirty-nine patients reported exposure to asbestos. Of these, 13 (33%) presented AB values above 1 AB/ml BAL. In the 33 non-exposed patients, 5 (15%) presented AB values above 1 AB/ml BAL. There was a significant difference between the AB levels of exposed and non-exposed patients (P=.006). The ROC curve showed that a value of 0.5 AB/ml BAL achieved the most satisfactory sensitivity, 46%, and a specificity of 83%. The correlation between AB levels in BAL and lung was 0.633 (P=.002). CONCLUSIONS: BAL study provides objective evidence of exposure to asbestos. The good correlation between the AB counts in BAL and lung tissue indicates that both techniques are valid for the analysis of asbestos content.
INTRODUCTION: Bronchoalveolar lavage (BAL) analysis has been proposed as an objective technique for confirming asbestos exposure. However, the reliability and diagnostic yield of this procedure has not been studied in Spain. The aim of this study was to assess the usefulness of the analysis of asbestos bodies (AB) in bronchoalveolar lavage (BAL) for the diagnosis of asbestos-related diseases (ARD). METHODS: BAL samples from 72 patients (66 male, mean age 66 years) undergoing bronchoscopy were analyzed. Lung tissue from 23 of these patients was also analyzed. Asbestos exposure was assessed by anamnesis and a review of the patient's medical records. BAL and lung samples were processed and AB count was determined by light microscopy. The accepted threshold value to diagnose asbestos-related diseases was 1 AB/ml BAL or 1000 AB/gr dry tissue. RESULTS: Thirty-nine patients reported exposure to asbestos. Of these, 13 (33%) presented AB values above 1 AB/ml BAL. In the 33 non-exposed patients, 5 (15%) presented AB values above 1 AB/ml BAL. There was a significant difference between the AB levels of exposed and non-exposed patients (P=.006). The ROC curve showed that a value of 0.5 AB/ml BAL achieved the most satisfactory sensitivity, 46%, and a specificity of 83%. The correlation between AB levels in BAL and lung was 0.633 (P=.002). CONCLUSIONS: BAL study provides objective evidence of exposure to asbestos. The good correlation between the AB counts in BAL and lung tissue indicates that both techniques are valid for the analysis of asbestos content.
Authors: Jaume Ferrer; Galo Granados; Santos Hernández; María-Jesús Cruz; Júlia Sampol; Daniel Álvarez Simón; José-María Ramada Journal: Int J Environ Res Public Health Date: 2020-12-08 Impact factor: 3.390
Authors: Pietro Sartorelli; Sveva Indini; Francesco Bianchi; Miriana D'Alessandro; Laura Bergantini; Paolo Cameli; Maria Antonietta Mazzei; Giuseppina Scancarello; Lucio Barabesi; Elena Bargagli Journal: Med Lav Date: 2020-10-31 Impact factor: 1.275