Bronchoalveolar lavage and its role in diagnosing cobalt lung disease

• Published in: Science of the Total Environment Vol. 150; no. 1; pp. 173 - 178
• Main Authors: Michetti, G., Mosconi, G., Zanelli, R., Migliori, M., Gaffuri, G., Villa, R., Michetti, L.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Shannon Elsevier B.V 30.06.1994; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Bronchoalveolar lavage; Bronchoalveolar Lavage Fluid - cytology; Chemical and industrial products toxicology. Toxic occupational diseases; Cobalt; Cobalt - adverse effects; Female; Hard metal disease; Humans; Interstitial lung diseaes; Lung Diseases - chemically induced; Lung Diseases - pathology; Male; Medical sciences; Metallurgy; Metals and various inorganic compounds; Middle Aged; Occupational Diseases - chemically induced; Occupational Diseases - pathology; Occupational Exposure - adverse effects; Pneumoconiosis; Toxicology; Interstitial lung diseaes; Pneumoconiosis; Bronchoalveolar lavage; Cobalt; Hard metal disease; Human; Sintered metal; Lung disease; Respiratory disease; Toxicity; Interstitial pneumonitis; Diagnosis
• ISSN: 0048-9697; 1879-1026
• DOI: 10.1016/0048-9697(94)90147-3

The bronchoalveolar lavage (BAL) of two groups of hard metal workers (11 subjects) were examined and compared with BALs of 14 unexposed individuals as controls. The first group of workers included five asymptomatic subjects (2 females and 3 males) with normal lung function tests and chest X-rays. All the workers had been exposed daily to hard metal dust for 5 years before fiberoptic bronchoscopy. The second group of workers included six individuals (1 female and 5 males) with cobalt lung disease at biopsy. The BAL's cytology at the deep lung level is in agreement with a possible immunologic pathogenesis of the lung disease, similar to hypersensitivity pneumonitis (lymphocytosis with helper-suppressor ratio reduction). In order to identify diagnostic key-parameters, the data presented here are compared with data reported in literature for workers with a history of hard metal or cobalt (alone) exposure. Although the BAL can be useful, for a better definition of the reaction at the deep lung level, it seems insufficient per se for the diagnosis of hard metal lung disease.