title: Utility of Bronchoalveolar Lavage for the Diagnosis of Asbestos-Related Diseases.
abstract: BACKGROUND
  Bronchoalveolar lavage (BAL) analysis has been proposed as an objective technique for confirming asbestos exposure. However, the reliability and diagnostic yield of this procedure has not been studied in Spain. The aim of this study was to assess the usefulness of the analysis of asbestos bodies (AB) in bronchoalveolar lavage (BAL) for the diagnosis of asbestos-related diseases (ARD).
  
  
  METHODS
  BAL samples from 72 patients (66 male, mean age 66 years) undergoing bronchoscopy were analyzed. Lung tissue from 23 of these patients was also analyzed. Asbestos exposure was assessed by anamnesis and a review of the patient's medical records. BAL and lung samples were processed and AB count was determined by light microscopy. The accepted threshold value to diagnose asbestos-related diseases was 1 AB/ml BAL or 1000 AB/gr dry tissue.
  
  
  RESULTS
  Thirty-nine patients reported exposure to asbestos. Of these, 13 (33%) presented AB values above 1 AB/ml BAL. In the 33 non-exposed patients, 5 (15%) presented AB values above 1 AB/ml BAL. There was a significant difference between the AB levels of exposed and non-exposed patients (P=.006). The ROC curve showed that a value of 0.5 AB/ml BAL achieved the most satisfactory sensitivity, 46%, and a specificity of 83%. The correlation between AB levels in BAL and lung was 0.633 (P=.002).
  
  
  CONCLUSIONS
  BAL study provides objective evidence of exposure to asbestos. The good correlation between the AB counts in BAL and lung tissue indicates that both techniques are valid for the analysis of asbestos content.
authors.affiliation: Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España.
authors.forename: María Jesús
authors.initials: MJ
authors.lastname: Cruz
authors.affiliation: Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España.
authors.forename: Victor
authors.initials: V
authors.lastname: Curull
authors.affiliation: Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España.
authors.forename: Lara
authors.initials: L
authors.lastname: Pijuan
authors.affiliation: Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Álvarez-Simón
authors.affiliation: Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España; Servicio de Neumología, Hospital del Mar, IMIM, Barcelona, España.
authors.forename: Albert
authors.initials: A
authors.lastname: Sánchez-Font
authors.affiliation: Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España.
authors.forename: Javier
authors.initials: J
authors.lastname: de Gracia
authors.affiliation: Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España.
authors.forename: Mario
authors.initials: M
authors.lastname: Culebras
authors.affiliation: Servicio de Neumología, Hospital Universitario Vall d'Hebron, Barcelona, España; Ciber Enfermedades Respiratorias (CibeRes), Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, España. Electronic address: jjferrer@vhebron.net.
authors.forename: Jaume
authors.initials: J
authors.lastname: Ferrer
mesh_terms: D000368:Aged; D001194:Asbestos / Q000009:adverse effects / Q000032:analysis*; D001195:Asbestosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D001992:Bronchoalveolar Lavage Fluid / Q000737:chemistry*; D001999:Bronchoscopy; D002277:Carcinoma / Q000737:chemistry / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D008175:Lung Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008654:Mesothelioma / Q000737:chemistry / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D008875:Middle Aged; D019016:Mineral Fibers / Q000032:analysis*; D009790:Occupations; D010997:Pleural Neoplasms / Q000737:chemistry / Q000175:diagnosis / Q000209:etiology / Q000473:pathology; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D019016:Mineral Fibers; D001194:Asbestos
keywords: Asbestos bodies; Asbestosis; Cuerpos de amianto; Cáncer de pulmón; Lung cancer; Mesotelioma; Mesothelioma