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Medicine and Health

Determining -the damage caused by asbestos

   
 
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Clean-up work on a building containing an excessive amount of asbestos.
Is it possible to determine with certainty the links between various pulmonary pathologies and the patient's exposure to asbestos in the past? Up to now it has been difficult to compare the results obtained by various laboratories carrying out lung tissue sample analyses. Thanks to a European research project - the first of its kind in the world - considerable advances on this sensitive public health issue are guaranteed. The accumulation of several thousand reference samples will provide the metrological tools needed to determine the origin of these pathologies.

 

Our knowledge of the serious lung symptoms attributable to asbestos fibres goes back some time and, while increasingly strict preventive measures banning this material have now been adopted, it has nevertheless continued to be used for too long and without proper precautions in the construction industry and other industrial applications. Essentially, the damage caused by the inhalation of asbestos fibres can be classified under four types of pathology. Asbestosis, a generalised lung fibrosis, which was very widespread in the past as a result of major cumulative exposure to asbestos, is now becoming rarer - at least in its advanced form - thanks to the obligatory precautions now taken in the industries handling this material. Mesothelioma, a tumour of the pleura or the peritoneum caused specifically by asbestos may become apparent only decades after the original exposure. Diffuse or localised fibrosis (pleural plaques) of the pleura, less serious than the preceding pathology, is also a disease closely linked to the inhalation of asbestos. Finally, bronchial cancer may be induced by the inhalation of asbestos - but may also result from many other causes - the commonest of which is smoking.

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Lung tissue samples, dried and homogenised, used as certified reference materials (seen under a scanning electron microscopy)

Objective presence?
Nowadays, these diseases are recognised as occupational diseases, and the victims are joining forces to claim compensation for the damage they have suffered. But how are the merits of their claims to be backed up? "Apart from carrying out an occupational case study, from which it is often difficult to produce tangible evidence, the only way of actually assessing the existence and magnitude of exposure to asbestos - and, where appropriate, establishing a link with pathologies currently present - consists in finding objective evidence of the presence of fibres in pulmonary samples taken from the patients concerned," explains Pascal Dumortier, of the Erasmus Hospital (Brussels), one of the partners in the European project that has set about tackling this problem.

In Europe, some 30 or so specialised laboratories are carrying out such biometrological analyses. "The problem," adds Dr Dumortier, "is that their work is based on totally non-standardised procedures, thereby ruling out valid comparisons and any semblance of a common approach."

The need for reference
materials As a direct result of this deficiency, a research project was launched in 1995 under the Standards, Measurements and Testing programme with the aim of producing a range of "certified reference materials" (CRMs), - biological or physico-chemical samples(1) with a defined composition serving as a standard for validating analyses. In the case in point, the CRMs are in fact lung tissue samples which were taken during autopsies on patients who had suffered exposure to asbestos and which were duly calibrated according to their fibre content. "In the case of asbestos pathologies," continues Dr Dumortier, "it is essential, for the purposes of expert medical and legal reports and other scientific work, that we are able to compare the results obtained on lung tissue samples in terms of fibre concentration and granulometry." From now on the CRMs will serve as standards to be supplied to laboratories, enabling them to adopt a common language when reporting on, and interpreting, analytical results.

From feasibility to
practice During the initial phase, five European laboratories, with the Finnish Institute of Occupational Health (Helsinki) acting as coordinator, conducted a feasibility study on the production of a CRM for the analysis of asbestos in lung tissue. This study has shown that it is possible to produce high-precision measurements based on lung tissue samples that are sufficiently dry and homogeneous.

The second phase of the project brings eight EU laboratories together with the task of producing a range of operational CRMs which will be used to supply all the European centres involved in these analyses. The development of these CRMs - several thousand reference samples will be distributed - will provide the metrological tools needed to diagnose whether or not a pathology is attributable to exposure to asbestos, according to harmonised European standards.

The result of this research is of interest not merely to the analysis laboratories. Instrument manufacturers also require CRMs to check the precision of their equipment, notably in the electron microscopy sector. Furthermore, the international distribution of these standardised samples - which have no equivalent in other parts of the world, especially the United States - represents a genuine scientific and economic endeavour.

(1) There are some 400 certified reference materials in Europe in a wide variety of areas (biomedical, environment, water and food microbiology, agriculture and physico-chemical properties of industrial materials).

 

 

Project Title:  
Certification of reference materials for the analysis of asbestos fibres in lung tissues

Programmes:
Standards, measurements and testing

Contract Reference: SMT4- CT96-2054

CORDIS databaseFor more information on this project,
go to the Cordis database Record

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