Billon-Galland M-A
Laboratoire d'étude des particules inhalées (LEPI), DASES, département de Paris, 11 rue George-Eastman, Paris, France.
Rev Mal Respir. 2012 Apr;29(4):521-8. doi: 10.1016/j.rmr.2012.03.001. Epub 2012 Apr 5.
The aim of mineralogical analysis of lung tissue, bronchoalveolar lavage (BAL) and sputum is to characterize individuals' exposure to asbestos fibres by identifying markers of this; asbestos bodies (AB) and uncoated fibres. The techniques of mineralogical analysis, habitually used to identify AB and uncoated fibres, are respectively optical microscopy (OM) and analytical electronic microscopy (EM). Correlations between levels of retention of AB in lung tissue, BAL and sputum have been established and validated threshold values indicating a high probability of significant exposure exist. These results must be interpreted in the context of clinical and occupational information. Mineralogical analysis is not suitable for use in routine medical screening but it can be considered when a source of exposure is not evident from the questionnaire since a positive analysis of BAL or of sputum is highly specific and thus useful to confirm an important retention of asbestos in the lung, which justifies medical follow-up. A negative result does not exclude previous significant asbestos exposure (frequent false negatives occur especially in sputum and biopersistence of chrysotile is lower than for amphiboles). Thus it can be a complementary tool for the assessment of asbestos exposure but its use imposes conditions for the collection and handling of samples.
对肺组织、支气管肺泡灌洗(BAL)液和痰液进行矿物学分析的目的是,通过识别石棉纤维的标志物——石棉小体(AB)和未包裹的纤维,来确定个体接触石棉纤维的情况。矿物学分析技术,通常用于识别AB和未包裹的纤维,分别是光学显微镜(OM)和分析电子显微镜(EM)。已经建立了肺组织、BAL液和痰液中AB留存水平之间的相关性,并且存在表明高概率显著接触的验证阈值。这些结果必须结合临床和职业信息来解读。矿物学分析不适用于常规医学筛查,但当问卷调查中未明确暴露源时可予以考虑,因为BAL液或痰液的阳性分析具有高度特异性,因此有助于确认肺部有重要的石棉留存,这为医学随访提供了依据。阴性结果并不排除既往有显著的石棉接触(尤其是在痰液中经常出现假阴性,且温石棉的生物持久性低于闪石类)。因此,它可以作为评估石棉接触的补充工具,但其使用对样本的采集和处理有一定条件要求。