Investigation of asbestos concentration in ambient and lavage fluids of patients referred for bronchoscopy, Ahvaz

Abstract

Introduction: The amount of fibers in the lungs is considered to reflect the cumulative intensity of past asbestos exposure, and bronchoalveolar lavage (BAL) has been proposed to be a good indicator of the presence and quantity of asbestos particles in the lungs. This study evaluated the asbestos concentration in BAL fluids of asbestos-exposed and unexposed pulmonary patients and the environment of Ahvaz city.

Methods: This prospective study was conducted on 80 patients underwent diagnostic fiberoptic bronchoscopy referred to Imam Khomeini Hospital in Ahvaz, Iran, in 2019. Patients with Lung diseases were divided into three groups based on CT scan results: normal (n = 32), lung cancer (n = 40) and Interstitial lung disease (n = 8). The analysis of asbestos fiber concentration in BAL fluid was carried out by Scanning Electron Microscope (SEM).

Results: The positive asbestos test was detected in 69% of all subjects, including 64% of whom had asbestos-related jobs and 74.5% of those with non-related jobs (p = 0.240). The concentrations of asbestos fiber in the BAL in normal patients, lung cancer and interstitial fibrosis (ILD) were 8.13 ± 5.38, 9.66 ± 7.30 and 6.31 ± 1.98 f/ml, respectively (P = 0.492). There was no significant difference between the asbestos levels and exposure history (P = 0.877). The mean concentration of asbestos in the ambient air during the current year was 2.69 ± 0.57 f/ml (2.26-3.70), and the correlation between asbestos levels in BAL and the air was not significant (r = 0.147; P = 0.243).

Conclusions: The exposure of different occupational and non-occupational groups to this carcinogenic substance indicates the need for environmental and individual control measures to reduce and prevent asbestos exposure.

Keywords: Asbestos; Lung cancer; Pulmonary disease, Bronchoalveolar lavage.