Biopersistence of respirable synthetic fibers and minerals: point of view of the chest physician

Our plain-English summary of Biopersistence of respirable synthetic fibers and minerals: point of view of the chest physician, by P. De Vuyst (Environmental Health Perspectives, 1994).

The study

• Author: P. De Vuyst
• Journal: Environmental Health Perspectives
• Published: 1994;102 Suppl 5(Suppl 5):7-9
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Problems of diagnosis related to the presence or absence of particles in lung and pleural tissues are discussed from the clinician's viewpoint. The advantage of applying mineralogical analytical techniques is considered.

In plain English

This was a viewpoint paper, presented at a 1992 workshop in Lyon, France, in which a Brussels chest physician discussed how the persistence of inhaled fibers and minerals in the lung bears on the causes, diagnosis and outlook of dust-related diseases. It did not report an original study of a defined group. As illustrations, the author described a man who had worked with crocidolite for a few months during World War II and, 47 years later, had pleural plaques and a pleural effusion, with more than 7 million crocidolite fibers per gram of dry lung tissue. The author also described a Turkish migrant never exposed to asbestos at work whose lavage fluid held more than 1500 asbestos bodies per milliliter, all tremolite. The author stated that finding durable particles is not in itself proof that they caused a disease, although high concentrations make a link appear more probable to the clinician. Because chrysotile does not persist in the lung, the author suggested that such mineral analysis may be of diminishing diagnostic interest now that chrysotile is virtually the only asbestos used.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Viewpoint (commentary) paper presented at a scientific workshop, illustrated with clinical observations; not an original study
• Who was studied: No defined study population. The author gave individual clinical illustrations: a former crocidolite worker, a Turkish migrant from central Anatolia (previously reported, reference 10), and a diamond polisher exposed to cobalt dust. The author also referred to earlier lavage studies of brake lining and asbestos-cement workers (reference 12).
• Exposure: Persistent fibers (crocidolite, amosite, tremolite, erionite), chrysotile, man-made mineral fibers (glass fibers, rockwool, slagwool), and cobalt dust from diamond-cobalt polishing discs
• Main results:
  • One patient had worked with crocidolite for a few months during World War II. Forty-seven years later he had pleural plaques and a left pleural effusion, and his lung biopsy showed more than 7 million crocidolite fibers per gram of dry lung tissue. This supported a diagnosis of benign asbestos effusion.
  • A Turkish migrant from central Anatolia, never occupationally exposed to asbestos, had lung fibrosis with pleural thickening and calcification. His lavage fluid yielded more than 1500 asbestos bodies per milliliter, all tremolite, and a clinical diagnosis of environmental asbestosis was made (this case is cited to an earlier report, reference 10).
  • In brake lining workers exposed only to chrysotile (earlier work, reference 12), chrysotile asbestos body concentrations during or soon after exposure were comparable to amphibole asbestos body concentrations in asbestos-cement workers. In one patient tested again three years after exposure, a very significant decrease was recorded.
  • A diamond polisher exposed to cobalt dust died from severe lung fibrosis 8 years after exposure ended, yet his lung tissue showed only traces of cobalt. The author took this as showing that even nondurable particles may lead to fibrosis.
  • The author noted that in asbestos-exposed workers, fibrosis found without asbestos bodies would not be given a preliminary diagnosis of asbestosis.
  • The author stated that malignant mesothelioma can occur with lung asbestos fiber concentrations no higher than in unexposed subjects.
• The authors' conclusion: The author's view was that durable particles in a sample do not by themselves prove causation, but high mineral concentrations make a cause-effect relationship appear more probable to the clinician. The author also considered that mineralogical analysis may be of diminishing diagnostic interest now that chrysotile, which does not persist, is virtually the only asbestos used.

Topics

Medical terms in this study, explained in our Lexicon: biopersistence.

Related studies

• Biopersistence of respirable synthetic fibers and minerals: the point of view of the epidemiologist — P. Boffetta (1994)
• An experimental approach to the evaluation of the biopersistence of respirable synthetic fibers and minerals — D.M. Bernstein, R. Mast, et al. (1994)
• Introduction: INSERM-IARC-CNRS workshop on biopersistence of respirable synthetic fibers and minerals — J. Bignon, R. Saracci, et al. (1994)
• Patterns of histopathological change determined by the point counting method and its application for the hazard assessment of respirable dust — A. Ogami, Y. Morimoto, et al. (2004)
• Lung dust analysis in the assessment of past exposure of man-made mineral fibre workers — J.C. McDonald, B.W. Case, et al. (1990)
• Metsovo lung: pleural calcification and restrictive lung function in northwestern Greece. Environmental exposure to mineral fiber as etiology — S.H. Constantopoulos, J.A. Goudevenos, et al. (1985)

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