Pairon J C, Martinon L, Brochard P
Unité de Pathologie professionnelle, CHI, Créteil.
Rev Mal Respir. 1999 Jan;16 Suppl 2:S9-17.
Several tools are available for the evaluation of the exposure to asbestos, particularly occupational questionnaire and mineralogical analysis of biological samples. These analysis allow quantification of the level of retention of asbestos fibres in the respiratory tract. Two groups of analysis may be used: quantification of asbestos bodies in sputum, bronchoalveolar lavage fluid or lung tissue samples using light microscopy; quantification and identification of asbestos fibres in bronchoalveolar lavage fluid or lung tissue using analytical electron microscopy. Profiles of lung retention of asbestos bodies or asbestos fibres have been described in various asbestos-related disorders, and reference values are available in control populations mainly for asbestos bodies using light microscopy. Mineralogical analysis of biological samples is not required for compensation of occupational asbestos-related diseases. However, this type of analysis may prove to be useful to the chest physician when looking for the etiology of some nonspecific respiratory diseases (interstitial pulmonary fibrosis, lung cancer), particularly when the occupational questionnaire is not contributive. As they are quite easier and less expensive, analysis using light microscopy will be performed first.
有几种工具可用于评估石棉暴露情况，特别是职业调查问卷和生物样本的矿物学分析。这些分析可以量化呼吸道中石棉纤维的留存水平。可以使用两组分析方法：使用光学显微镜对痰液、支气管肺泡灌洗液或肺组织样本中的石棉小体进行定量；使用分析电子显微镜对支气管肺泡灌洗液或肺组织中的石棉纤维进行定量和鉴定。在各种与石棉相关的疾病中，已经描述了石棉小体或石棉纤维在肺部的留存情况，并且在对照人群中主要通过光学显微镜对石棉小体有参考值。职业性石棉相关疾病的赔偿不需要生物样本的矿物学分析。然而，当寻找某些非特异性呼吸道疾病（间质性肺纤维化、肺癌）的病因时，这种类型的分析可能对胸科医生有用，特别是当职业调查问卷没有帮助时。由于光学显微镜分析更容易且成本更低，将首先进行。
