Pairon J C, Martinon L, Iwatsubo Y, Vallentin F, Billon-Galland M A, Bignon J, Brochard P
INSERM Unité 139, Hôpital Henri Mondor, Créteil, France.
Am J Ind Med. 1994 Jun;25(6):793-804. doi: 10.1002/ajim.4700250604.
Examination of asbestos bodies (AB) retained in the lungs is a useful way of assessing past occupational exposure to this material. AB retention has been extensively studied in workers directly exposed to asbestos, but less so in those end users, such as welders, who use asbestos-containing products. We therefore retrospectively studied AB retention in 211 welders, for whom biological testing procedures had been requested by a chest physician, between 1988 and 1991. Optical microscopy of AB was performed on samples of sputum (40 subjects), bronchoalveolar lavage fluid (BAL) (147 subjects), and lung tissue obtained after thoracotomy (38 subjects). Information on previous jobs and exposure was obtained using a questionnaire (the mean duration of welding activities was 16.6 years). Eighty-two subjects (38.9%) had elevated lung retention of AB in all the samples studied. Significant AB retention occurred in only 30% of sputum samples, but in 40.1% of BAL samples and 39.5% of lung tissue samples. The duration of welding activities correlated with the density of AB in BAL or lung tissue (r = 0.31, p < 0.01 and r = 0.49, p < 0.05, respectively). On the basis of the questionnaire, only two of the welders with significant AB retention had other occupational exposure to asbestos. Our findings suggest that welding activities may increase lung retention of AB, and consequently might produce higher risks of fibrotic and/or malignant pulmonary diseases. These potential risks need to be brought to the attention of doctors; a longitudinal follow-up may also be warranted in such populations, even after individuals have ceased their welding jobs.
检查留存于肺部的石棉小体(AB)是评估过去职业性接触该物质情况的一种有用方法。在直接接触石棉的工人中,对AB留存情况已有广泛研究,但在诸如焊工等使用含石棉产品的终端用户中研究较少。因此,我们对1988年至1991年间211名焊工的AB留存情况进行了回顾性研究,这些焊工均由胸科医生要求进行生物学检测程序。对痰液样本(40名受试者)、支气管肺泡灌洗液(BAL)样本(147名受试者)以及开胸术后获取的肺组织样本(38名受试者)进行了AB的光学显微镜检查。通过问卷调查获取了既往工作及接触情况的信息(焊接活动的平均时长为16.6年)。在所有研究样本中,82名受试者(38.9%)的肺部AB留存量升高。仅30%的痰液样本出现显著的AB留存,但BAL样本中有40.1%,肺组织样本中有39.5%出现显著留存。焊接活动时长与BAL或肺组织中AB的密度相关(分别为r = 0.31,p < 0.01和r = 0.49,p < 0.05)。根据问卷调查,在AB留存显著的焊工中,只有两人有其他职业性石棉接触史。我们的研究结果表明,焊接活动可能会增加肺部AB的留存,进而可能产生更高的纤维化和/或恶性肺部疾病风险。这些潜在风险需要引起医生的关注;即使个体已停止焊接工作,对此类人群也可能有必要进行纵向随访。