McDonald J C
Epidemiological Research Unit, Royal Brompton National Heart and Lung Institute, London, UK.
Environ Health Perspect. 1994 Oct;102 Suppl 5(Suppl 5):221-4. doi: 10.1289/ehp.94102s5221.
For the experimentalist, mineral fiber persistence may provide clues to disease mechanisms, for the epidemiologist, to the measurement of exposure. Qualitatively, this can be valuable when unsuspected exposures have been demonstrated as, for example, MMMF workers exposed to amosite or chrysotile workers to tremolite. Quantitatively, the potential of lung burden analyses to assess lifetime mineral fiber exposure has yet to be achieved with confidence. The difficulties are 2-fold, the first related to sampling and the second to the dynamics of biopersistence. Until some noninvasive method is found to identify and quantify numerically inorganic fibers in human tissue during life, epidemiological studies must depend on lung samples obtained at autopsy or thoracic surgery. This source is inevitably subject to seriously large and indefinable bias of various kinds. Of equal importance is the present uncertain state of knowledge concerning factors that determine what is present in the lung at any time. These determinants clearly include the dimensional features of airborne environmental particulates and characteristics that affect their durability in tissue.
对于实验人员而言，矿物纤维的持久性可能为疾病机制提供线索；对于流行病学家来说，则有助于衡量暴露情况。定性地看，当发现未被怀疑的暴露情况时，这可能很有价值，例如，接触铁石棉的温石棉工人或接触透闪石的温石棉工人。定量方面，肺负荷分析评估终生矿物纤维暴露的潜力尚未得到可靠实现。困难有两方面，一是与采样有关，二是与生物持久性的动态变化有关。在找到某种非侵入性方法来识别并定量活体人类组织中的无机纤维之前，流行病学研究必须依赖于尸检或胸外科手术获取的肺样本。这个来源不可避免地会受到各种严重且难以确定的偏差影响。同样重要的是，目前关于决定肺部随时存在何种物质的因素的知识状态尚不确定。这些决定因素显然包括空气中环境颗粒物的尺寸特征以及影响它们在组织中耐久性的特性。
