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PubMedDate not supplied

Screening and pathological diagnosis of asbestosis and mesothelioma: a review.

X-ray screenings of workers employed in asbestos manufacturing in Hungary revealed 255 cases of asbestosis and 3 cases of malignant mesothelioma. The pathological diagnosis of asbestosis is not very difficult. The diagnosis of mesothelioma, however, is fraught with problems. To identify mesothelioma we use histochemical reactions with PAS diastase digestion and immunohistochemical reactions for cytokeratin, vimentin, and CEA. The PAS and CEA reactions are negative but the vimentin and cytokeratin are positive in mesothelioma. Cytogenetic and molecular genetic studies may contribute to the better understanding of the pathogenesis and, thus, open new perspectives in our understanding of mesotheliomas.

Asbestosis↗

PubMedDate not supplied

[An unusual exposure to asbestosis risk in a bag manufacturing plant: observations on 22 cases].

Although the risks connected with occupational exposure to asbestos and its numerous industrial uses are widely known, it still happens that instances of exposure with high potential risk are discovered. A detailed study of a worker suffering from silicosis and asbestosis who had worked for many years in a firm dealing with the recovery and re-use of used jute sacks also containing asbestos, revealed the existence of a real asbestosis risk in the firm, with the result that other workers in the same firm were studied. A total of 22 subjects were studied, 17 of whom also underwent bronchoalveolar lavage (BAL) and determination of the cellular composition of the recovery liquid in order to establish the presence of asbestous alveolitis. The age of the subjects ranged between 39 and 75 years (x = 56.36), length of service in the firm ranged between 2 and 18 years (x = 9.27), time between start of exposure and clinical examination varied between 29 and 50 years (x = 40.27). The 22 subjects were divided into 3 groups on the basis of the radiological examinations: 1) 8 cases were negative (36.36%); 2) 8 cases had pleural alterations only (36.36%); 3) 6 cases had interstitial lung disease (with and without pleural lesions) (27.27%). Of the 17 subjects who underwent BAL, 7 were in the first group, 7 in the second and 3 in the third. Among these 17 subjects BAL showed absence of alveolitis in all subjects of the first group, diagnosis of alveolitis in only some of the second group, and in all of the third group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1978

Angiotensin-converting enzyme and lysozyme in silicosis and asbestosis.

Serum angiotensin-converting enzyme (ACE) activity and lysozyme (LZM) concentration in 22 silicosis and 18 asbestosis patients were studied. These patients were compared with 57 untreated and 36 treated sarcoidosis patients. In all groups significantly raised ACE and LZM mean values were noted. Untreated sarcoidosis patients had the highest values. Raised ACE activity in silicosis and asbestosis has not been reported before, and weakens the differential diagnostic value of this enzyme determination for sarcoidosis. The similar patterns of increased ACE and LZM mean values in all three diseases suggest that these enzymes have a common source.

Adult↗

PubMed1989

[An autopsy case of pulmonary asbestosis with synchronous multiprimary lung cancers, early gastric cancer and atypical mycobacteriosis].

An autopsy case of pulmonary asbestosis with synchronous multiprimary lung cancers, gastric cancer and atypical mycobacteriosis of a 64-year-old asbestos textile worker was reported. Chest X-ray film on the first admission showed a coin lesion on the left upper lung field, and on the second admission showed a progressively enlarging shadows in the left hilum. Chemotherapy showed almost no effect and the patient died of respiratory failure. Autopsy revealed moderate asbestosis, with triple lung cancers (squamous cell carcinoma, adenocarcinoma and small cell carcinoma) in the left upper lobe, gastric cancer (signet-ring cell carcinoma) and atypical mycobacteriosis. So far as we know, no case with such complex lesions has ever been reported.

Adenocarcinoma↗

PubMed1989

Excessive accumulation of asbestos fibre in the bronchoalveolar space may be a marker of individual susceptibility to developing asbestosis: experimental evidence.

Earlier studies have shown that only 60% of sheep exposed to a given chrysotile exposure developed asbestosis. Analyses of lung lavage (BAL) fibre content early in the disease showed that, despite identical injected doses, the subset of sheep with interstitial lung disease had significantly more fibre retention. To determine if the fibre retention preceded or followed early disease, 15 were exposed at 10 day intervals to 100 mg chrysotile by intratracheal injection. Animals were studied at three month intervals by chest radiograph (CR) and BAL. At month 15, 10 sheep had definitely abnormal CR (group B) and five had normal CR (group A). Fibre analyses of BAL reproduced earlier finding of a higher level of fibre retention early in the disease, month 15: 92 +/- 2 f/microliter in group B v 35 +/- 19 in group A. Moreover, at month 3, when no disease was detectable, group B already had a significantly higher fibre retention level: 84 +/- 2 in group B v 52 +/- 3 in group A (p less than 0.05). These data clearly imply that high alveolar dust retention precedes the disease process and that alveolar dust clearance capacity may be a major determinant of asbestosis.

Animals↗

PubMed1985

[Pleural involvement and functional effect of asbestosis in 380 exposed patients].

A large number of pleural abnormalities was detected by radiological and functional monitoring of 380 persons (mean age: 47 years) working in an asbestos processing factory. There were 127 cases of parietal pleura thickening (after 22 1/2 years' exposure), 11 cases of pleural calcifications (after 26 years' exposure) and 29 cases of obliteration of the costophrenic angle. Fourteen images of pulmonary asbestosis were encountered, 7 of which were associated with pleural effusion; they occurred at a mean age of 50 years, after 22 years' exposure. Pleural lesions had a restrictive influence on respiratory function in 24% of the cases and were sometimes painful. Small airway obstruction was detected by flow-volume loops in 9% non-smokers with pleural thickening, which suggests that intra-radiological lung lesions exist in asbestosis.

Asbestosis↗

PubMed1987

[Respiratory functional decline after 5 years in patients with silicosis and asbestosis].

A retrospective study of 561 patients with silicosis and 234 with asbestosis was performed to assess whether lung function decline in five years is related to the type (restrictive or obstructive) and/or to the degree of initial damage. Based on lung function tests, three groups of patients were identified: NC with normal lung function tests, CR with restrictive impairment and CO with airway obstruction. The degree of impairment was classified as mild, moderate and severe. Patients were considered worse if five years later they presented a higher degree of impairment. The prevalence of CR was significantly higher in asbestosis, that of NC and CO in silicosis (p less than 0.01). Among subjects with normal starting lung function, 9% only developed CR or CO 5 years later. The prevalence of subjects with worsened lung function in the CR groups was significantly higher (p less than 0.001) in asbestotics (36%) than in silicotics (14%) and was closely related to starting functional impairment. In the CO group the prevalence of worsened subjects was significantly higher than in CR (p less than 0.001), similar in the two diseases and independent of starting lung impairment.

Adult↗

PubMed1987

[Value of modern study methods in the early diagnosis and assessment of asbestosis].

Results of examinations among 31 asbestos-workers with pleural hyalinosis are presented. The hyalinosis was ascertained by means of pleuroscopy and computed tomography. The value of both methods and special function tests in asbestosis is discussed. Diagnostic and expertising of early signs in asbestosis should not rely on x-ray of thorax but include selected and suitable function tests.

Asbestosis↗

PubMed1986

NK cell activity in asbestosis.

Natural killer (NK) cell activity was studied in 40 asbestos workers with chest roentgenographic signs of asbestosis and 54 sex- and age-matched healthy controls. NK cell activity in asbestosis was 32.3 +/- 18.2%, significantly higher than that in healthy controls (17.4 +/- 12.2%). We also examined the relationship between NK cell activity and the duration of exposure, and that between NK cell activity and the ILO U/C classification of radiographs. NK cell activity tended to decrease relatively in the presence of lung cancer.

Adenocarcinoma↗

PubMed1979

[Pleural asbestosis in dock workers].

During the last three years 29 patients with asbestosis of the pleura were examined. 21 of them were exposed to dust on wharfs as joiners, locksmiths, transport workers, isolators and in other trades. The beginning of the exposition was at least 15 years age, the duration of the exposition was 5 to 25 years. Two bronchial carcinomas and one mesothelioma of the pleura among our patients emphasize the increased risk for malignoma of the patients with asbestosis. For this reasons an early recognition and a regular medical control of the patients as well as a reducthe long time of latency between the beginning of the exposition and the appearance of morphologic changes it is recommended to employ older colleagues in the working places with dust exposition.

Adult↗

PubMed1982

Correlation of asbestos bodies and fibers in lungs of subjects with and without asbestosis.

We compared the numbers of asbestos bodies in 2 histologic sections of lung from 25 subjects showing a wide range of total asbestos burden with the numbers of asbestos bodies and fibers (analyzed by electron diffraction and x-ray spectroscopy) extracted from the lung. We also compared the numbers of extracted asbestos bodies with the numbers of fibers in 24 other subjects. Histologic and extracted asbestos bodies were correlated best with total asbestos fibers and with amosite and crocidolite fibers, and not at all with chrysotile fibers. Nevertheless, the total fiber count could not be reliably estimated from the count of either histologic or extracted bodies. Although asbestos bodies appeared to be fairly uniformly distributed in these lungs, detection of early fibrosis or asbestosis required careful examination of all portions of the parenchyma. When we defined asbestos histologically as clusters of 3 or more asbestos bodies adjacent to areas of fibrosis, we found that subjects with asbestosis had more than 240,000 asbestos fibers/g of wet lung. The nature of the disease in lungs showing fibrosis and more than 240,000 fibers/g, but only isolated asbestos bodies, is uncertain.

Adult↗

PubMed1980

The prognosis following certification with asbestosis in the United Kingdom.

Men who were first awarded compensation for asbestosis by the Cardiff, London or Swansea Pneumoconiosis Medical Panels in the period 1952 to 1976 have been followed up. Out of a total of 665 men, 283 have died: 36% of the deaths were due to lung cancer, 9% to mesothelioma and 20% to asbestosis. Compared with the death rates for England and Wales, the rate for all deaths was 2.6 times that expected and that for lung cancer 8.5 times that expected. Mortality was related to the rate of compensation awarded but was still high for all of the above three causes for those awarded the lowest rates. The excess death rates were apparent in the first year after certification and were still operating after 10 years in those who survived until then.

Aged↗

PubMed1978

Lymphocyte responses to phytohaemagglutinin in patients with asbestosis and pleural mesothelioma.

Quantitative impairment of lymphocyte responses to phytohaemagglutinin (PHA) has been demonstrated in six (21%) out of twenty-eight patients with asbestos-associated pulmonary fibrosis, in comparison with a group of unexposed normal controls. The impairment tended to occur in patients with fairly severe fibrosis, comparatively short duration of exposure to asbestos dust and with increases in serum immunoglobulin levels. One patient with asbestosis and an associated bronchial carcinoma also had depressed lymphocyte responses to PHA. These findings suggest a relationship between defective T-lymphocyte function and the fibrotic response in asbestosis. Whether it is also linked with the development of lung cancer, occurring either before or at a pre-clinical stage of tumour growth, and is of value in identifying patients especially at risk should now be explored in longitudinal studies. However, eight out of ten patients with asbestos-associated pleural mesothelioma and without lung fibrosis showed no evidence of impaired cellular immunity, either by in vitro testing with PHA or by vivo delayed hypersensitivity skin testing, indicating that impaired T-lymphocyte function is unlikely to be a common finding in all types of asbestos-associated malignancy.

Adult↗

PubMed1983

Pulmonary "mainline" granulomatosis: talcosis secondary to intravenous heroin abuse with characteristic x-ray findings of asbestosis.

A 50-year-old man, a "mainline" heroin abuser for 25 years, with a five-year history of x-ray findings compatible with asbestosis is presented. Multiple open biopsies failed to prove a diagnosis of asbestosis. The microscopic analyses of tissues revealed the presence of granulomatosis, secondary to talc from chronic intravenous heroin abuse. The need for open lung biopsy in establishing a diagnosis is emphasized, as x-ray findings can be and often are misleading. A tissue diagnosis is necessary, particularly in cases in which drug abuse is suspected.

Asbestosis↗

PubMed1983

Asbestosis and the serratus anterior muscle.

Twenty-seven patients with a history of asbestos exposure were reviewed at the UCLA Medical Center in December 1981. All patients were referred by the United States Department of Labor. The patients were told they had asbestosis on the basis of their history of exposure and chest radiographs taken at a local asbestos screening program and initially interpreted by a "B" reader. None of the 27 patients reviewed were found to have evidence of asbestosis either clinically or radiographically. The false-positive radiographic interpretations were due to the extrathoracic musculature (serratus anterior) mimicking intrathoracic disease. Since the study described here was done, an additional 330 patients have had their radiographs reviewed.

Adult↗

PubMed1982

[Evaluation of the size of the population occupationally exposed to asbestos dust and the incidence of asbestosis in Poland 1970-1980].

The analysis was based on the data on occupational exposure to asbestos dust obtained from sanitary--epidemiological stations and cards of occupational diseases certification collected at the Institute of Occupational Medicine in Lódź. The approximate number of those occupationally exposed to asbestos dust in national economy as a whole was about 6400 persons (excluding the data on the Polish State Railways, Ministry of National Defence, Ministry of Internal Affairs) of this--3000 persons worked at concentrations exceeding TLV values for the dust containing asbestos. Approx. 2200 subjects worked at workplaces where no dust concentrations measurements were made. Mostly this work was performed periodically, casually, for varying daily or monthly number of hours. The highest exposure rates were those of the provinces of Lódź, Jelenia Góra and Gdańsk (up to 1980), Warszawa and Katowice. In seventeen provinces there is not a single workplace with asbestos dust. During 1970-1980, 143 cases of asbestosis were found in Poland, of this--49% women. The length of employment in asbestos dust exposure of those with diagnosed asbestosis came, on average, to 20 years (92%) worked more than 10 years, 48% more than 20 years).

Air Pollutants↗

PubMed1994

[Contribution and role of polymorphonuclear leucocytes in inflammatory reactions of asbestosis].

The mechanism of lung fibrosis after asbestos exposure is unknown. Observations suggest that neutrophils may play a role in the development of the lung injury in asbestosis. They are attracted to the lungs by macrophages mediators and there they phagocyte asbestos fibres. A cytotoxic effect of asbestos exerted on polymorphonuclear leucocytes releases proteolytic enzymes such as collagenase and elastase. Besides, asbestos produces highly reactive oxidants in neutrophils responsible for an additional damage of tissues. However, the role of polymorphonuclear leucocytes in pathogenesis of asbestosis still remains controversial.

Animals↗

PubMedDate not supplied

Asbestosis mortality in Italy.

A total of 204 deaths due to asbestosis occurred in Italy in the period 1970-1989, including 24 females; asbestosis death rates (per million) were 0.31 +/- 0.05 among males and 0.4 +/- 0.02 among females. The rates increased a little when comparing 1980-89 with 1970-79. Deaths were concentrated in a limited number of geographical areas where an extensive industrial use of asbestos is known to have occurred and where there were also high rates of mortality due to primary pleural tumours.

Adult↗