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Original article
Asbestos bodies in bronchoalveolar lavage in the 21st century: a time-trend analysis in a clinical population
  1. Valerie Nuyts1,
  2. Hadewijch Vanhooren1,
  3. Sarah Begyn1,
  4. Kristiaan Nackaerts2,
  5. Benoit Nemery1,2
  1. 1Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
  2. 2Department of Respiratory Diseases, University Hospitals Leuven, University of Leuven, Leuven, Belgium
  1. Correspondence to Professor Benoit Nemery, Laboratory of Pneumology, Herestraat 49 (O&N1 706), Leuven B-3000, Belgium; ben.nemery{at}kuleuven.be

Abstract

Objectives Asbestos bodies (AB) in bronchoalveolar lavage (BAL) can be detected by light microscopy and their concentration is indicative of past cumulative asbestos exposure. We assessed clinical and exposure characteristics, as well as possible time trends, among patients in whom AB had been quantified in BAL.

Methods BAL samples obtained from 578 participants between January 1997 and December 2014 were available for analysis. The processing of samples and the microscopic analysis were performed by a single expert and 76% of samples came from a single tertiary care hospital, allowing clinical and exposure data to be extracted from patient files.

Results The study population (95% males) had a mean age of 62.5 (±12.4) years. AB were detected in 55.2% of the samples, giving a median concentration of 0.5 AB/mL (95th centile: 23.6 AB/mL; highest value: 164.5 AB/mL). The AB concentration exceeded 1 AB/mL in 39.4% and 5 AB/mL in 17.8%. A significant decrease from a geometric mean of 0.93 AB/mL in 1997 to 0.2 AB/mL in 2014 was apparent. High AB concentrations generally corresponded with occupations with (presumed) high asbestos exposure. AB concentrations were higher among patients with asbestosis and pleural plaques, when compared with other disease groups. Nevertheless, a substantial proportion of participants with likely exposure to asbestos did not exhibit high AB counts.

Conclusions This retrospective study of a large clinical population supports the value of counting AB in BAL as a complementary approach to assess past exposure to asbestos.

  • Bronchoalveolar Lavage
  • Occupational exposure
  • Asbestos Bodies
  • Asbestos-related diseases

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Footnotes

  • Contributors VN searched for the diseases and the occupations of the patients, did all the statistical tests, wrote the article and made all conclusions in collaboration with BN. HV performed all the technical analysis (processing and counting of asbestos bodies under the light microscope). SB collaborated in the clinical assessment of patients. KN checked the writing and the ideas behind the article. BN conceived the study, checked the writing of the article and made all the conclusions in collaboration with VN.

  • Funding This research received financial support from the Foundation against Cancer, Belgium (Project 2012-222).

  • Competing interests None declared.

  • Ethics approval The Medical Ethical Committee of University Hospital KU Leuven (UZ Leuven).

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