The role of analytical techniques in the diagnosis of asbestos-associated disease

Our plain-English summary of The role of analytical techniques in the diagnosis of asbestos-associated disease, by V. Vallyathan, F.H. Green (Critical Reviews in Clinical Laboratory Sciences, 1985).

The study

• Authors: V. Vallyathan, F.H. Green
• Journal: Critical Reviews in Clinical Laboratory Sciences
• Published: 1985;22(1):1-42
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

There is increasing concern over the adverse health effects resulting from asbestos exposure. The mineralogy of asbestos and the pathology of asbestos-associated diseases is briefly reviewed. Techniques for tissue sampling, histopathological diagnostic criteria and the role of light microscopy (LM), scanning electron microscopy (SEM), transmission electron microscopy (TEM), selected area electron diffraction (SAED), and X-ray diffractometry (XRD)--in the identification and quantitation of asbestos bodies and fibers in the lung tissue samples--are discussed. The value of a systematic quantitative approach is emphasized in order to differentiate the dose relationships and disease patterns.

In plain English

This article was a review of asbestos mineralogy, uses, sources of exposure and the pathology of asbestos-associated diseases. It also reviewed how light and electron microscopy, X-ray energy spectrometry, electron diffraction and X-ray diffractometry identify asbestos bodies and fibers in lung tissue, including the authors' own laboratory methods. The authors stated that the pathological diagnosis of asbestosis can only be made by light microscopy. They also stated that microanalytical techniques alone cannot be used to diagnose asbestos-associated disease, partly because almost all people have asbestos bodies and fibers in their lungs and laboratory methods are not standardized. Summarizing other studies, the review reported that people without known occupational exposure usually had 0 to 500 asbestos bodies per gram of lung, while occupationally exposed workers usually had more than 500. It reported that mesothelioma patients as a group had a greatly increased lung asbestos burden, but a sizeable number had fiber counts within the general-population range. The authors concluded that microanalysis can aid diagnosis by providing exposure information when clinical features are nonspecific or no exposure history can be obtained.

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: Review of mineralogy, pathology and laboratory analytical techniques, including a description of the authors' own laboratory procedures
• Who was studied: No study population of its own; the review draws on published studies of the general population, occupationally exposed workers and patients with asbestos-associated disease
• Exposure: Asbestos in general: chrysotile (serpentine) and the amphiboles amosite, actinolite, tremolite, anthophyllite and crocidolite; occupational, avocational and environmental exposure
• Main results:
  • The authors stated that the pathological diagnosis of asbestosis can only be made by light microscopy; advanced techniques provide supportive evidence about type and degree of exposure.
  • The authors stated that microanalytical techniques alone cannot be used to diagnose asbestos-associated disease.
  • Among the reasons the authors gave: almost all individuals, whatever their occupation, have asbestos bodies and fibers in their lungs.
  • Reviewed studies: in patients without known occupational exposure, asbestos body counts usually lay within 0 to 500 bodies per gram of lung.
  • Reviewed studies: in workers occupationally exposed to asbestos, counts were usually in excess of 500 asbestos bodies per gram of lung.
  • Mesothelioma patients as a group had a greatly increased lung asbestos burden, but the review reported considerable variation between patients, with a sizeable number having fiber counts in the general-population range.
  • Fiber counts based on light microscopy greatly underestimate total fiber burden compared with electron microscopy.
  • The authors described selected area electron diffraction as probably the most valuable technique for identifying asbestos fibers in tissue samples.
• The authors' conclusion: The authors concluded that in patients whose clinical or radiological features are nonspecific, or who have no obtainable history of asbestos exposure, microanalytical techniques will aid diagnosis by providing information on exposure.
• Limitations the authors state:
  • Because fibers are slowly cleared from the lung, microanalytical studies tend to reflect more recent exposures.
  • Analytic techniques have not been adequately standardized between laboratories, so comparing values from different laboratories may be misleading.
  • Because asbestos distribution within the lung varies widely, studies of lung asbestos burden need cautious interpretation, especially with small biopsies.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mineralogy, Pathology, Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Selected Area Electron Diffraction (SAED), Asbestos Bodies.

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• Mesothelin family proteins and diagnosis of mesothelioma: analytical evaluation of an automated immunoassay and preliminary clinical results — F. Di Serio, A. Fontana, et al. (2007)
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