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PubMed1977

[Problems and experiences with computerized coding of radiological findings in pneumoconioses (author's transl)].

For medical surveillance of dust workers, correlation of anatomical and radiological findings in silicosis and asbestosis is an assumption for computerized application of the ILO U/C 1971 classification of pneumoconiosis. The new regulations of insurance companies for preventive examinations in workers exposed to asbestos are described, and their results presented. Practicability and preliminary data suggest important information for the future.

Asbestosis↗
PubMed1988

Evaluation of the pathological changes progress in people of long-term exposure to asbestos dust during 5-year observation.

In order to evaluate the dynamics of the pathological changes in the respiratory system of the workers exposed to asbestos dust in the industrial plants of Gdańk-Sopot-Gdynia, after the first series of examinations in 1981/82 the tests were repeated in 1986/87 comprising 340 persons i.e. 85.4% of previously examined. Minimal employment period was 10 years. After 5 years the state of health of the subjects got worse. The number of the chronic nonspecific lung diseases and the rate of ventilatory disorders increased. The number of the people with irregular small opacities present in the radiological picture of the lungs also got higher. After the period of 5 years more than a doubled increase of asbestosis was found. These changes were much more often in women. The author suggests that the exposure to asbestos longer than 10 years induces changes in the respiratory system of a progress that in the group observed proved to be distinct and quite rapid.

Adult↗
PubMed1977

[Application of modern methods to clinical autopsy].

Among the numerous modern methods at the disposal of pathologists, four techniques and their applications are demonstrated: 1. An enzymatic stain for macroscopic diagnosis of early myocardial infarcts. 2. Immuno-histochemistry in juvenile diabetes. 3. Electron microscopy in pulmonary hypertension in relationship with the intake of slimming pills. 4. X-ray micro-analysis in the the diagnosis of asbestosis. These various techniques are of great interest but can only be performed on fresh necropsy specimens taken early after death.

Asbestos↗
PubMedDate not supplied

Cardiopulmonary exercise testing to assess respiratory impairment in occupational lung disease.

Exercise testing can answer several pertinent questions for the physician. It can determine whether a worker's aerobic performance is limited by respiratory or by other factors. It can also help decide whether an individual can perform a job without undue physiologic limitations and fatigue. Exercise testing has its limitations. It cannot determine the etiology of the impairment nor can it make a specific diagnosis except in rare cases. Interpretation of exercise data is not always precise, especially when the VO2max is normal but several physiologic measurements are abnormal. The VO2max achieved under laboratory conditions is probably too simplistic an estimate of the complex energy requirements of any occupation. Future research is needed to develop portable devices to assess both aerobic and anaerobic potentials of workers on the job to better determine job-specific impairment and disability. Patients who have unexplained symptoms or abnormal, but not severely reduced, static pulmonary function tests benefit most from exercise testing. For now, the AMA criteria for impairment as defined by static and exercise pulmonary function testing are the most appropriate to follow. Exercise testing has provided valuable data for epidemiologic research. Descriptive and case-control studies have documented minor physiologic abnormalities and rare respiratory limitations in workers with asbestos exposure and simple coal worker's pneumoconiosis. Additional studies are necessary to further elucidate pathophysiologic findings in patients with asbestosis and other occupationally induced pulmonary diseases.

Asbestosis↗
PubMedDate not supplied

Asbestos bodies in bronchoalveolar lavage fluid. A study of 20 asbestos-exposed individuals and comparison to patients with other chronic interstitial lung diseases.

We studied the asbestos body (AB) content of bronchoalveolar lavage fluid from 20 patients with a history of occupational asbestos exposure, 31 patients with sarcoidosis and 5 patients with idiopathic pulmonary fibrosis. The cellular lavage pellet was digested in sodium hypochlorite and filtered onto Nuclepore filters for AB quantification by light microscopy. ABs were found in 15 of 20 asbestos-exposed individuals, 9 of 31 sarcoidosis cases and 2 of 5 patients with idiopathic pulmonary fibrosis. There was a statistically significant difference in the number of ABs per million cells recovered or per milliliter of recovered lavage fluid in the asbestos-exposed group as compared to the other categories of chronic interstitial lung disease. The highest levels occurred in patients with asbestosis. Large numbers of asbestos bodies in the lavage fluid (greater than 1 AB/10(6) cells) were indicative of considerable occupational asbestos exposure, whereas occasional bodies were a nonspecific finding.

Adult↗
PubMed1987

[Radioscintigraphic correlation in interstitial pneumopathy. Case presentations].

Radiological and scintigraphic findings in 82 patients (58 male, 24 female) were compared. The patients were hospitalised in 1981-86 with sarcoidosis (43 cases), silicosis (26), asbestosis (9) extrinsic allergic alveolitis (3), lung disease caused by hard metals (1). Gallium scintigraphy was positive in 61 patients (74.39%). More precisely, the response was positive in 57 cases in both analogic and quantitative terms and in 4 only quantitatively. The radiological (radiography and stratigraphy) finding was significant in 42 of the 61 gallium-positive cases and negative in the remaining 19. In the 21 gallium-negative cases (25.61%) the radiological finding was significant in 9, negative in 12. The study confirms the real value of gallium scintigraphy in the diagnosis and follow-up of interstitial lung disease in line with views presented in the recent literature.

Adult↗
PubMed1985

[The diagnostic value of asbestos bodies in mesotheliomas].

The exposure of asbestos was studied in 31 cases of mesothelioma from case histories and by microscopic mineralogical analysis of the broncho-alveolar lavage fluid (BAL) (31 cases) and of pulmonary tissue (5 cases). When definite exposure had occurred the lavage contained asbestos bodies in every case, except one patient with severe airflow obstruction. The most positive lavages, probably reflecting exposure to industrial amphiboles, were found in patients presenting with radiological evidence of asbestosis. Two patients had positive lavages 50 years after exposure had ceased. The lavage confirmed exposure in 6 out of 11 suspected cases and revealed contamination by asbestos in a further 4 cases, in a group of 6 not known to have been exposed. In 19.3% of cases there was a low concentration of asbestos bodies (less than 1AB/ml of BAL), comparable to what is found in 16.2% of controls from an urban population. An analysis of lung tissue confirmed massive exposure (greater than 20 000 AB/g) in two cases and in particular revealed a significant dust load (greater than 250 AB/g) in patients presenting with a weak positive BAL. Thus it seems that all the positive results should be taken into account. Of the 31 cases, 8 had a BAL without asbestos bodies. These were either mesotheliomas not linked to the inhalation of asbestos, or were the result of false negatives on account of artefacts related either to the BAL technique itself or linked to the technique of mineral analysis. Indeed the microscopic counts of asbestos bodies probably underestimate certain exposures, notably environmental exposure to chrysotile.

Adult↗
PubMed1985

Gallium-67 thoracic scan and pleural disease in asbestos workers.

We have recently reported that 67Ga scanning in asbestos workers can document excessive uptake of the marker among workers without sufficient criteria for asbestosis, but in our initial report we could not exclude definitely that 67Ga uptake could be related to pleural disease. To further test this hypothesis, we analyzed the 67Ga thoracic scan in relation to profusion scores of pleural disease on chest roentgenogram and CT scan of the thorax in 171 asbestos workers. We found no significant correlation between the 67Ga lung uptake and the radiographic scores of pleural disease. We concluded that pleural plaques are not an active site of 67Ga accumulation and do not contribute significantly to the thoracic uptake of the marker.

Adult↗
PubMed1985

Lung function in different types of pneumoconiosis.

The results of pulmonary function tests in patients with silicosis, pneumoconiosis in coal miners and arc welders, asbestosis, as well as in persons exposed to asbestos without abnormal x-ray findings of the chest, and in nonexposed healthy control persons and the development after 6 years are compared between each other and with the x-ray findings. There are significant differences between the several groups. There is no correlation (parallelism) between increase of lung function impairment and progression of x-ray findings.

Anthracosilicosis↗
PubMed1986

The patient with asbestos exposure.

Attention to the hazards of asbestos has aroused concern among many healthy persons who have been exposed at some time to one of the world's most versatile materials. Present standards for exposure to asbestos, however, may not fully protect workers from asbestos-induced pulmonary malignancy. To evaluate the patient who has had some asbestos exposure, the physician should focus on the pulmonary system, take a thorough occupational history, conduct a physical examination and pulmonary function studies, and obtain chest films. In managing the patient with asbestosis, removal from further occupational exposure is advisable. For workers with only pleural changes, it is unclear whether removal from the work place is of any value.

Asbestos↗
PubMed1986

Simultaneous determination of trace elements in lavage fluids from human bronchial alveoli by energy-dispersive x-ray fluorescence. 2: Determination of abnormal lavage contents and verification of the results.

We applied energy-dispersive x-ray fluorescence to the determination of abnormally present elements or abnormal concentrations of elements in human broncho-alveolar lavage fluids. The low detection limits and the ability to perform multi-elemental analysis permit one to establish or confirm occupational exposure of workers. We also describe different methods used to check our method and our results. We report examples of abnormal compositions of broncho-alveolar lavages containing W, Ce, La, Nd, I, Fe, or Ni. We discuss the limits of the method for characterizing silicosis or asbestosis.

Asbestosis↗
PubMed1986

Cigarette smoke increases the penetration of asbestos fibers into airway walls.

For study of the penetration of asbestos fibers into airway walls, guinea pigs were given amosite asbestos by intratracheal instillation. Half of the animals were also exposed to cigarette smoke. Animals were sacrificed at 1 week and 1 month, and numbers of fibers in airway walls were counted in histologic sections. In both smoke-exposed and nonexposed groups, numbers of fibers per square millimeter of airway wall increased from 1 week to 1 month in the respiratory bronchioles. At each time period, smoke-exposed animals had significantly higher numbers of fibers in the airway walls, compared with nonexposed animals. It is concluded that 1) continued transport of fibers into interstitial tissues may be the reason that asbestosis can progress after cessation of exposure; 2) cigarette smoke increases the penetration of fibers into airway walls. This effect may play a role in the increased incidence of disease seen in smoking, compared with nonsmoking, asbestos workers.

Animals↗
PubMed1985

Inhaled asbestos activates a complement-dependent chemoattractant for macrophages.

Pulmonary macrophages migrate to the sites where inhaled chrysotile asbestos fibers initially are deposited (i.e., surfaces of alveolar duct bifurcations). These macrophages have been shown to form a major component of an early asbestos-induced interstitial lesion in rats. In this report, we describe a potential mechanism by which macrophages are attached to these sites of fiber deposition. Chrysotile asbestos fibers used in vitro activate complement proteins in peripheral blood serum and in lavaged cell-free lung proteins. After brief inhalation of chrysotile asbestos, fluids lavaged from the lungs of exposed rats contain substantial chemotactic activity for macrophages compared to fluids from sham-exposed animals (p less than 0.01). We hypothesize that this chemotactic activity is derived from complement activated by inhaled asbestos on alveolar surfaces. This contention is supported by the following observations. Production of chemotactic activity by asbestos in vitro in serum or in lavaged lung fluids was blocked by complement inhibitors. Fractionation, by molecular sieve chromatography, of serum proteins and concentrated proteins lavaged from the lungs of asbestos-exposed rats showed that chemotactic activity was detected in the 14,000- to 18,000-dalton range. This fractionation profile is similar to C5a, the chemotactic product of complement activation. Rats treated with cobra venom factor to deplete circulating complement as well as complement-deficient mice demonstrated significantly depressed macrophage accumulation at sites of asbestos deposition. Pulmonary macrophages are the cells that form the initial inflammatory response to asbestos inhalation. Our findings support the hypothesis that asbestos fibers, and possibly other inhaled particulates, activate complement-derived chemotactic activity on alveolar surfaces. Consequently, macrophages are attracted to the alveolar duct bifurcations where inhaled asbestos fibers are deposited, and this is where the initial lesion of asbestosis is manifested.

Animals↗
PubMed1974

The spectrum of asbestos-related diseases.

Diseases caused by exposure to asbestos are prime examples of environmentally-related illnesses. Asbestos produces asbestosis from large exposures over short latent periods; it acts as a carcinogen from small exposures over long latent periods; and it induces mesothelioma with minute exposures. Its presence as the magic mineral is ubiquitous in our modern society.

Asbestos↗
PubMed1979

[Importance of the work environment for the respiratory system].

In the working process a great number of dusts, gases and smokes affect on the respiratory organs which may lead to fibrogenic, irritative, toxic, cancerogenic or allergic reactions, when the norms of industrial hygiene are not observed. In addition to this come still infective agents. Also communal surroundings, habits of life and medicaments are able to impair the respiratory organ with concurrent noxae. Among the professional diseases which are annually acknowledged about 1,200 (10%) concern the respiratory organ. Apart from the classical professional diseases silicosis and asbestosis unspecific diseases of the respiratory organ, carcinomas and allergoses come into the foreground of interest. The report needs special knowledge in the field of professional medicine and an analysis of the working conditions. The observation of the MAK-values is the prerequisite for the prophylaxis and prevention. For noxae with biologic long-term effects the life-long control of the exposed persons is necessary.

Air Pollutants↗
PubMed1983

[Pulmonary fibrosis and inorganic particles].

Biological data acquired in recent years has thrown new light on the pathogenesis of pulmonary fibrosis. The key element in the genesis of fibrosis may be the alveolar macrophage which, under the influence of different stimuli, secretes numerous factors, attracting polymorphonuclear leukocytes and eosinophils, stimulating fibroblasts and activating lymphocytes. Pulmonary fibrosis induced by inhalation of inorganic particles seems to proceed by identical mechanisms, with certain differences relating to the nature of each mineral. The morphological, cytological and immunological characteristics which defend the lung from silicosis and asbestosis are particularly discussed. The in vitro reactivity of several cell types (alveolar macrophages, mesothelial cells in culture, fibroblasts) equally has revealed differences between quartz and chrysotile. Nevertheless this in vitro response is difficult to interpret compared to an in vivo response: they vary according to the cellular system used and the physico-chemical state of the particular mineral (chrysotile and leached chrysotile by oxalic acid for example). The fibrosing action of other particles (talc, metals) is also reviewed. As opposed to an inflammatory granuloma secondary to the stimulation of alveolar macrophages which represents the usual response to mineral particles, there is also an immunological granuloma of the sarcoid type which may lead to secondary fibrosis: beryllium and talc in certain circumstances may act by this mechanism.

Animals↗
PubMed1984

Asbestos exposure in Israel: findings, issues and needs.

In Israel, since the 1950s, at least several thousand workers, their wives and children, and possibly many others, have been or still may be exposed to hazardous amounts of airborne asbestos fibers. These are found both in asbestos-based industries (asbestos cement, textiles and brake linings) and trades with asbestos exposure (construction, shipyard repair, boiler maintenance, insulation work). These people are at increased risk for disability or illness, or for premature death from asbestosis, from lung cancer, from exacerbation of preexisting respiratory disease (especially if they smoke), from mesothelioma, from gastrointestinal cancer, and from other malignancies. Although there has been progress, much still has to be done in the areas of legislation, standard setting, exposure control, technology, surveillance, smoking cessation, and medical care and follow-up. Compensation is needed to care for those workers currently or previously exposed, as well as for their families and others at risk. A national policy for protecting and caring for those formerly or currently exposed is indicated by the review of the situation in Israel.

Asbestos↗
PubMed1980

The effect of differing concepts of the criteria that should be used for the diagnosis of asbestos disease.

The work of the Society for the Prevention of Asbestosis and Industrial Disease suggests that arbitrary rules, operated for the purpose of deciding which cases may benefit from employment insurance schemes, are adding to the recognized problems connected with the diagnosis of asbestos disease. As a result, statistics are unrealistic and do not include cases which show not only that workers in th asbestos manufacturing industry are at risk, but that asbestos, including chrysotile, affects the health of the community.

Asbestosis↗