Contenido pulmonar de amianto en trabajadores de los astilleros de Ferrol / Asbestos pulmonary content in workers of Ferrol shipyards, Spain

Fundamento y objetivo: Desde hace unos años se está llevando a cabo el estudio de los trabajadores expuestos a amianto en los astilleros de Ferrol con la finalidad de llegar al diagnóstico de las enfermedades derivadas de la exposición. El objetivo del presente estudio fue conocer el contenido pulmonar de amianto en esta población. Material y método Se obtuvieron muestras pulmonares necrópsicas correspondientes a individuos que habían trabajado en los astilleros de Ferrol. En la mayoría de los casos se analizaron muestras de los 2 pulmones. Tras eliminar la materia orgánica pulmonar con hipoclorito sódico, el residuo inorgánico fue analizado mediante microscopia óptica. Los resultados se expresaron como cuerpos de amianto (CA) por gramo de tejido seco. Se consideraron niveles causantes de enfermedad aquellos que superaron los 1.000 CA/g. Resultados Se estudiaron 30 pacientes varones, con una edad media de 67 años (extremos 56-89 años). Veintiséis sujetos eran fumadores o ex fumadores, mientras que 4 no habían fumado. Todos tenían una enfermedad pulmonar, pleural o peritoneal relacionada con la exposición a amianto (16 cáncer de pulmón, 6 mesotelioma, 25 enfermedad pleural benigna). Solo en 6 de los 16 casos de cáncer de pulmón existía asbestosis concomitante. La mediana (intervalo) de CA observados fue de 6.171 (249-4.660.059) CA/g. El 97% de individuos presentaron valores superiores a los 1.000 CA/g. Se encontró correlación entre los CA y la edad del sujeto (r=0,5676; p=0,0011).Conclusiones Los trabajadores de los astilleros de Ferrol analizados tienen valores pulmonares de amianto elevados. Se debe aumentar la sospecha clínica del amianto como factor potencialmente causante de enfermedad pulmonar en este colectivo (AU)

Background and objective: In the last years, a study is being conducted about exposure to asbestos among shipyards workers in order to know the diagnosis of the diseases associated with the exposure. Our goal was to know the asbestos pulmonary contents in this population. Material and methods: We obtained autopsy pulmonary samples from individuals who had worked in Ferrol shipyards. We analyzed samples from both lungs in most cases. After removing the lung organic matter with sodium hypochlorite, the inorganic residue was analyzed with optic microscopy. Results were expressed as asbestos bodies (AB) per gram of dry tissue. We considered as disease causative levels those above 1,000 AB/g. Results: We studied 30 males, with a mean age of 67 years (r: 56-89 years). Twenty-six were smokers or former smokers, and 4 had never smoked. All had a lung, pleural or peritoneal disease related to asbestos exposure (16 lung cancer, 6 mesothelioma, 25 benign pleural disease). Only in 6 out of the 16 lung cancercases there was coexisting asbestosis. The median (interval) of AB was 6,171 (249-4,660,059) AB/g. Ninety-seven per cent of individuals had levels above 1,000 AB/g. There was a correlation between A Band age (r = .5676; P = .0011).Conclusions: Workers from Ferrol shipyards who were analyzed had increased pulmonary levels of asbestos. It is essential to raise clinical suspicion of asbestos as a factor that can potentially cause lungdisease in this group (AU)

[Asbestos pulmonary content in workers of Ferrol shipyards, Spain]. / Contenido pulmonar de amianto en trabajadores de los astilleros de Ferrol.

BACKGROUND AND OBJECTIVE: In the last years, a study is being conducted about exposure to asbestos among shipyards workers in order to know the diagnosis of the diseases associated with the exposure. Our goal was to know the asbestos pulmonary contents in this population. MATERIAL AND METHODS: We obtained autopsy pulmonary samples from individuals who had worked in Ferrol shipyards. We analyzed samples from both lungs in most cases. After removing the lung organic matter with sodium hypochlorite, the inorganic residue was analyzed with optic microscopy. Results were expressed as asbestos bodies (AB) per gram of dry tissue. We considered as disease causative levels those above 1,000 AB/g. RESULTS: We studied 30 males, with a mean age of 67 years (r: 56-89 years). Twenty-six were smokers or former smokers, and 4 had never smoked. All had a lung, pleural or peritoneal disease related to asbestos exposure (16 lung cancer, 6 mesothelioma, 25 benign pleural disease). Only in 6 out of the 16 lung cancer cases there was coexisting asbestosis. The median (interval) of AB was 6,171 (249-4,660,059) AB/g. Ninety-seven per cent of individuals had levels above 1,000 AB/g. There was a correlation between AB and age (r=.5676; P=.0011). CONCLUSIONS: Workers from Ferrol shipyards who were analyzed had increased pulmonary levels of asbestos. It is essential to raise clinical suspicion of asbestos as a factor that can potentially cause lung disease in this group.

Reproducibility of asbestos body counts in digestions of autopsy and surgical lung tissue.

BACKGROUND: Asbestos body (AB) counting by a single observer is the most commonly used objective technique to demonstrate asbestos deposition in the lung. In this study, the accuracy and reliability of this procedure is analyzed by evaluating the degree of agreement between two experienced readers. METHODS: Lung tissue specimens from 66 individuals, most of whom had not been exposed to asbestos, were studied: 35 were obtained in postmortem studies (upper, middle, and lower lung) and 31 were from patients who underwent surgery for lung cancer. Overall, 167 samples were analyzed. Lung tissue sections weighing 0.5 g were obtained prospectively and processed, and the inorganic residue was analyzed by light microscopy at 400× magnification by two experienced readers. Results were expressed as AB/g of dry lung tissue. Interobserver variability was analyzed using the Spearman correlation coefficient and agreement was evaluated by the Bland-Altman method and the kappa index. RESULTS: The interobserver correlation was 0.8975: 0.8029 for autopsy samples and 0.9592 for biopsy samples. Bland-Altman plots showed that most values were grouped around the 95% limits of agreement. The kappa index was 0.87 for all samples, and 0.79, 0.65, and 0.54 for upper, middle, and lower lung specimens, respectively. CONCLUSIONS: Asbestos body counting by a single reader is a reliable method, especially at low concentrations of asbestos bodies in lung tissue. Double reading may be indicated in borderline cases with asbestos body levels close to levels of 1 000 AB/g.

Prevalencia y distribución del depósito pulmonar de amianto en población urbana española / Prevalence and Distribution of Asbestos Lung Residue in a Spanish Urban Population

IntroducciónEl objetivo del presente estudio es analizar la prevalencia y distribución de amianto en pulmón de población urbana de Barcelona.Material y métodosSe obtuvieron muestras pulmonares necrópsicas de 35 individuos que habían residido en Barcelona. Se llevó a cabo una entrevista con el familiar más cercano para descartar exposición al amianto. En el acto necrópsico, se obtuvieron muestras de 3 zonas del pulmón derecho: apical del lóbulo superior, apical del lóbulo inferior y base del lóbulo inferior. Las muestras fueron tratadas para la eliminación de la materia orgánica. El residuo inorgánico fue analizado mediante microscopía óptica. Los resultados se expresaron como cuerpos de amianto (CA) por gramo de tejido seco. Se consideraron como niveles potencialmente causantes de patología aquellos que superaron los 1.000CA/g de tejido seco.ResultadosSe detectaron CA en 29 sujetos (83%). El 86% de las muestras analizadas tenían niveles inferiores a 300CA/g. Únicamente un individuo (3%) presentó valores superiores a los 1.000CA/g tejido seco. En 17 individuos (48%), el depósito de amianto era mayor en el lóbulo pulmonar inferior que en el resto, aunque no se observaron diferencias significativas en cuanto al depósito de CA en las 3 zonas pulmonares estudiadas.ConclusionesLos resultados del presente estudio demuestran que la mayoría de la población urbana en nuestro medio tiene niveles de amianto en pulmón que oscilan entre 0–300CA/g tejido seco. En esta población no se han detectado diferencias en el depósito de amianto, según las zonas estudiadas(AU)

IntroductionThe purpose of the present study is to analyse the prevalence and distribution of asbestos lung residue in the Barcelona urban population.Material and methodsLung autopsy samples were obtained from 35 individuals who had lived in Barcelona. The close family were interviewed in order to rule out asbestos exposure. Samples were obtained from three areas of the right lung during the autopsy: upper lobe apex, lower lobe apex, and lower lobe base. The samples were treated to remove organic material. The inorganic residue was analysed using a light microscope. The results were expressed as asbestos bodies (AB) per gram of dry tissue. Levels greater than 1000AB/g of dry tissue were considered as potentially causing disease.ResultsAB were detected in 29(83%) of the subjects, of which 86% had levels less than 300AB/g. Only one individual (3%) had values greater than 1000AB/g dry tissue. The asbestos residue was higher in the lower lung lobe in 17 individuals (48%) than in the rest, although no significant differences were seen as regards AB residue in the three lung areas studied.ConclusionsThe results of this study show that the urban population of Barcelona have asbestos levels in the lung that vary between 0 and 300AB/g dry tissue. No differences in the asbestos residues were detected in the lung areas studied in this population(AU)

[Prevalence and distribution of asbestos lung residue in a Spanish urban population]. / Prevalencia y distribución del depósito pulmonar de amianto en población urbana española.

INTRODUCTION: The purpose of the present study is to analyse the prevalence and distribution of asbestos lung residue in the Barcelona urban population. MATERIAL AND METHODS: Lung autopsy samples were obtained from 35 individuals who had lived in Barcelona. The close family were interviewed in order to rule out asbestos exposure. Samples were obtained from three areas of the right lung during the autopsy: upper lobe apex, lower lobe apex, and lower lobe base. The samples were treated to remove organic material. The inorganic residue was analysed using a light microscope. The results were expressed as asbestos bodies (AB) per gram of dry tissue. Levels greater than 1000AB/g of dry tissue were considered as potentially causing disease. RESULTS: AB were detected in 29(83%) of the subjects, of which 86% had levels less than 300AB/g. Only one individual (3%) had values greater than 1000AB/g dry tissue. The asbestos residue was higher in the lower lung lobe in 17 individuals (48%) than in the rest, although no significant differences were seen as regards AB residue in the three lung areas studied. CONCLUSIONS: The results of this study show that the urban population of Barcelona have asbestos levels in the lung that vary between 0 and 300AB/g dry tissue. No differences in the asbestos residues were detected in the lung areas studied in this population.