Assessment of past asbestos exposure in patients: occupational questionnaire versus monitoring in broncho-alveolar lavage

Our plain-English summary of Assessment of past asbestos exposure in patients: occupational questionnaire versus monitoring in broncho-alveolar lavage, by L. Di Menza, A. Hirsch, P. Sebastien, et al (1980).

The study

• Authors: L. Di Menza, A. Hirsch, P. Sebastien, A. Gaudichet, J. Bignon
• Published: pp. 609-611; conference proceedings (volume not named on these pages); Institut de Recherches sur l'Environnement, ERA CNRS No. 846, Créteil, France (1980)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This French study compared two ways of finding out whether hospital patients had been exposed to asbestos in the past. The authors studied 80 consecutive patients admitted to a hospital chest disease department for suspected asbestos-related thoracic disease. An interviewer gave each patient an occupational questionnaire. Separately, ferruginous bodies were counted under a light microscope in fluid recovered by broncho-alveolar lavage, a lung washing procedure. The article does not name any asbestos fiber types. The questionnaire gave inconclusive results for half of the patients. Ferruginous bodies were found in 29 of 33 patients judged clearly exposed, in 1 of 7 judged clearly not exposed, and in 17 of 40 whose questionnaire was inconclusive. The authors described that last figure as exposure shown in 43% of the inconclusive group. Agreement between the two methods in the clearly exposed and clearly unexposed groups was reported as P less than 0.001. The authors concluded that ferruginous bodies in lung washing fluid are a good indicator of past exposure, and that this monitoring might be helpful when the questionnaire is negative or inconclusive. They noted that lung lavage is an invasive technique.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Comparison of two methods of assessing past asbestos exposure (an interviewer-administered occupational questionnaire versus counting ferruginous bodies in broncho-alveolar lavage fluid) in the same group of hospital patients
• Who was studied: 80 consecutive patients hospitalized for suspected asbestos-related thoracic disease in a hospital chest disease department (authors based in Créteil and Paris, France); dates not given
• Exposure: Past occupational exposure to asbestos dust, assessed by questionnaire and by ferruginous bodies counted under the light microscope in 5-20 ml of lung washing fluid; no fiber types named
• Main results:
  • The questionnaire was inconclusive for half of the 80 patients (40 patients)
  • Ferruginous bodies were present in lung washing fluid in 29/33 patients judged obviously exposed (E), 1/7 judged obviously not exposed (NE), and 17/40 with an inconclusive questionnaire (IQ)
  • Agreement between the two methods in the E and NE questionnaire groups was reported with P < 0.001
  • Among patients with ferruginous bodies present, the median number of bodies per ml was 0.06 in the NE group and 1.1 (range 0.06-350) in the IQ group; the range in the E group was 0.05-31,250
  • In the inconclusive-questionnaire group, ferruginous body monitoring showed asbestos exposure in 43% of subjects
  • The authors reported that concentrations as low as 0.1 ferruginous bodies per ml seemed to be significantly related to exposure as judged from the questionnaire
• The authors' conclusion: The authors concluded that in cases with a negative or inconclusive questionnaire, monitoring ferruginous bodies in lung washing fluid might be helpful, and that the presence of these bodies is a good indicator of past exposure
• Limitations the authors state:
  • The authors note that this kind of biological monitoring cannot be done on a large scale for epidemiological studies, partly because broncho-alveolar lavage is invasive
  • The authors note that ferruginous bodies in inconclusive-questionnaire cases could reflect either failure of the questionnaire to detect occupational exposure or environmental exposure the questionnaire did not detect

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Ferruginous body.

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