PT - JOURNAL ARTICLE AU - J L Levin AU - M F O'Sullivan AU - C J Corn AU - M G Williams AU - R F Dodson TI - Asbestosis and small cell lung cancer in a clutch refabricator. AID - 10.1136/oem.56.9.602 DP - 1999 Sep 01 TA - Occupational and Environmental Medicine PG - 602--605 VI - 56 IP - 9 4099 - http://oem.bmj.com/content/56/9/602.short 4100 - http://oem.bmj.com/content/56/9/602.full SO - Occup Environ Med1999 Sep 01; 56 AB - OBJECTIVES: To present a case of asbestosis and small cell lung cancer caused by asbestos in a clutch refabricator. METHODS: Exposed surfaces of used clutches similar to those refabricated in the worker's workplace were rinsed, and the filtrate analysed by analytical transmission electron microscopy. Tissue samples were also analysed by this technique. RESULTS: Numerous chrysotile fibres of respirable dimensions and sufficient length to form ferruginous bodies (FBs) were detected from rinsed filtrates of the clutch. Bronchoalveolar lavage fluid contained many FBs, characteristic of asbestos bodies. Necropsy lung tissue showed grade 4 asbestosis and a small cell carcinoma in the right pulmonary hilum. Tissue analysis by light and analytical electron microscopy showed tissue burdens of coated and uncoated asbestos fibres greatly exceeding reported environmental concentrations (3810 FBs/g dry weight and 2,080,000 structures > or = 0.5 micron/g dry weight respectively). 72% Of the cores were identified as chrysotile. CONCLUSIONS: Clutch refabrication may lead to exposure to asbestos of sufficient magnitude to cause asbestosis and lung cancer.