title: Asbestosis and small cell lung cancer in a clutch refabricator.
abstract: OBJECTIVE
  To present a case of asbestosis and small cell lung cancer caused by asbestos in a clutch refabricator.
  
  
  METHODS
  Exposed surfaces of used clutches similar to those refabricated in the worker's workplace were rinsed, and the filtrate analysed by analytical transmission electron microscopy. Tissue samples were also analysed by this technique.
  
  
  RESULTS
  Numerous chrysotile fibres of respirable dimensions and sufficient length to form ferruginous bodies (FBs) were detected from rinsed filtrates of the clutch. Bronchoalveolar lavage fluid contained many FBs, characteristic of asbestos bodies. Necropsy lung tissue showed grade 4 asbestosis and a small cell carcinoma in the right pulmonary hilum. Tissue analysis by light and analytical electron microscopy showed tissue burdens of coated and uncoated asbestos fibres greatly exceeding reported environmental concentrations (3810 FBs/g dry weight and 2,080,000 structures > or = 0.5 micron/g dry weight respectively). 72% Of the cores were identified as chrysotile.
  
  
  CONCLUSIONS
  Clutch refabrication may lead to exposure to asbestos of sufficient magnitude to cause asbestosis and lung cancer.
authors.affiliation: Department of Occupational Health Sciences, University of Texas Health Center, Tyler 75708-3154, USA. levin@uthct.edu
authors.forename: J L
authors.initials: JL
authors.lastname: Levin
authors.forename: M F
authors.initials: MF
authors.lastname: O'Sullivan
authors.forename: C J
authors.initials: CJ
authors.lastname: Corn
authors.forename: M G
authors.initials: MG
authors.lastname: Williams
authors.forename: R F
authors.initials: RF
authors.lastname: Dodson
mesh_terms: D001194:Asbestos / Q000009:adverse effects; D001195:Asbestosis / Q000209:etiology*; D001336:Automobiles; D018288:Carcinoma, Small Cell / Q000209:etiology*; D017809:Fatal Outcome; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects
chemical_list: D001194:Asbestos