Induced sputum in occupational lung diseases

Abstract

Key pointsBAL, an important tool in assessing occupational lung diseases, is an invasive technique and thus unsuitable for screening programmes, the evaluation of exposure and the monitoring of hazardous dust.Examination of induced sputum is a noninvasive method to directly study particulate burden and inflammatory processes in the lung.The correlation between cells retrieved by BAL and induced sputum shows different proportions of leukocytes, but similar eosinophil cell counts and qualitative/quantitative analyses of particles.Many accumulating lines of evidence have shown that the eosinophil count is a useful marker for monitoring OA.Educational aimsTo introduce induced sputum methodology in the field of occupational lung diseases.To describe the eosinophil count as a method of monitoring occupational asthma.To explain how to use quantitative and qualitative analysis of inhaled particles in hazardous dust exposure.SummaryInduced sputum is a particularly promising procedure, since it provides specific information on both the cellular and molecular constituents in inflammation. In the period 1950–1970, sputum cells were examined on stained smears in both research and clinical settings. After their recovery by spontaneous coughing, the cells were used to study lung cancer and respiratory infections, and, later on, to diagnosePneumocystis cariniipneumonia in patients infected with HIV. The method was widely improved upon by the induction of sputum with aerosol of hypertonic saline, and then extended to become part of the assessment of airway inflammation in bronchial asthma and COPD. However, less attention was given to the use of induced sputum in occupational exposures. This review analyses the value of induced sputum and presents its applications in pulmonary occupational and environmental medicine.

A Novel Alternative to Environmental Monitoring to Detect Workers at Risk for Beryllium Exposure-Related Health Effects

“…In contrast with the findings of previous studies, (18) the current results did not reveal any differences in the CD4/CD8 ratio between the study groups in showing that a high variability in CD4/CD8 T lymphocyte may be present in CBD, as in sarcoidosis. (28) Although the change in CD4/CD8 ratio was also not significant after follow-up, a clear accumulation of CD4 T lymphocytes in IS samples was observed over time for all individuals tested.…”

Induced sputum in interstitial lung diseases

“…By virtue of it being a safe and simple procedure, induced sputum was investigated for its ability to assess occupational exposures [32 ]. Several investigators showed the relevance of asbestos bodies present in spontaneous sputum compared with BAL.…”

Use of exhaled breath condensate to investigate occupational lung diseases

“…Such pathophysiological processes can be identified by means of a wide range of diagnostic tools, which still represent the gold standard in epidemiological and clinical settings, including bronchoscopy or bronchoalveolar lavage (BAL), or less invasive induced sputum, to sample particulate burden and assess the involvement of inflammatory and structural cells. However, they cannot be extensively applied in routine clinical practice because of their relative invasiveness, which hampers their use in screening programs, exposure monitoring or the follow-up of workers exposed to hazardous pollutants [2].…”