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Diagnostic limitations of lung fiber counts in asbestos-related

Joachim Schneider
1 , Rolf Arhelger 1 , Bernd Brückel 2 , Xaver Baur 3
Institut und Poliklinik für Arbeits- und Sozialmedizin,, 2 Institut und Poliklinik für Arbeits- und Sozialmedizin, 3 European Society for Environmental
and Occupational Medicine,

Keywords: Lung dust analysis, asbestos diseases, ferruginous (asbestos) bodies, chrysotile, crocidolite


Lung dust fibre analyses have been used by some pathologists to estimate past asbestos

exposure in the workplace and its related health risks. Asbestos, however, especially the

predominately applied chrysotile asbestos type, undergoes translocation, clearance and

degradation in the lungs.


We quantified the asbestos fibre and ferruginous (asbestos) body (FB) content in human

tissue with respect to the German asbestos ban in 1993 and the interim period of more

than 20 years in order to evaluate the diagnostic evidence of these analyses for

asbestos-related diseases (ARD).


Lung dust analyses have been used in empirical assessments of ARD since 1982. Tissue

samples of about 2 cm
3 were used and processed in standardized manner. FB was
analysed by light microscopy and asbestos fibres by scanning transmission electron

microscopy (STEM).


Chrysotile and amphibole fibre concentrations in the lung tissue depend roughly on the

cumulative asbestos exposure levels in the workplace.

However, the concentration of lung asbestos fibre and FB depends on the year of

examination and especially on the interim period. As the interim period increases, the

asbestos fibre burden decreases. There is no relationship between FB and chrysotile

asbestos fibre concentrations and only a weak correlation between FB and crocidolite

fibre concentrations.

There was no significant difference in chrysotile and amphibole fibre concentrations as

well as in FB counts between the different ARD.


Due to the length of interim periods, a past exposure to chrysotile or amphibole asbestos

can no longer be detected with FB or asbestos fibre measurement in lung tissue. This

means that negative results of such measurements cannot disprove a qualified

occupational case history of asbestos exposures and the related health risks due to the

fibrogenic and carcinogenic potential of asbestos.