摘要：The permanent existence of large asbestos quantities in many workplaces and the use of asbestos as raw material in different industries expand the number of workers who are occupationally exposed to its noxious effects. Diseases associated with occupational exposure to asbestos are: mesothelioma, lung cancer, asbestosis, and pleural fibrosis/plaques . Aim. The present paper illustrates the possibility of revealing occupational exposures to asbestos dusts through sputum cytological examination. This emphasizes the presence of asbestos fibers and bodies in the sputum samples, and also enhances the effectiveness of sputum cytological examination in early diagnosis of possible pretumoral changes in specific groups of employees. Material and method. The cytological examination was performed on fresh morning sputum samples (3 smears for each patient) from a group of 39 workers occupationally exposed to asbestos dusts (mean age 38.31 ± 7.12 years, mean work length in asbestos industry 13.10 ± 7.03 years) and a control group of 72 subjects, matched by mean age, mean work length and smoking habit, respectively . Results. Asbestos bodies were found in the sputum samples of 29 subjects from the exposed group and, in some of these cases, a high density of free asbestos fibers was also found. According to the Papanicolau classification, the cytological types diagnosed in the samples from the exposed subjects were as follows: 19 cases type I, 16 cases type II, and 4 cases type III. There was a raising tendency (obvious, but statistically not-significant) for the type II inflammatory alterations in those patients from the exposed group with more than 10 years of work length. Related to the smoking habit, an increasing rate (statistically not-significant) of the type II and type III cytology cases appears in the group of the heavy smokers . Conclusions. The presence of asbestos bodies in sputum represents an important indicator for occupational exposure to respirable particles. Sputum cytology screening is a practical, noninvasive and inexpensive approach for the diagnosis and assessment of the occupational exposure to asbestos.
