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Albano GD, Rodolico V, Di Franco S, Re GL, Midiri M, Malta G, Cannizzaro E, Argo A, Zerbo S. Asbestos exposure determined 357 days after death through autopsy: a report of a multidisciplinary approach. Forensic Sci Med Pathol 2024:10.1007/s12024-024-00838-z. [PMID: 38806807 DOI: 10.1007/s12024-024-00838-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 05/30/2024]
Abstract
Asbestosis is an interstitial lung disease caused by the inhalation of asbestos fibers and poses a significant risk to individuals working in construction, shipping, mining, and related industries. In a forensic context, postmortem investigations are crucial for accurate diagnosis, for which the gold standard is the histopathological examination. This case report describes the autopsy and related investigations conducted on an 84-year-old man, nearly one year (357 days) after his death. After a post-mortem CT scan, an autoptic investigation was performed, followed by histopathological, immunohistochemical, and scanning electron microscopy examinations. The integration of the evidence from these examinations with previously available personal and clinical information conclusively confirmed the diagnosis of asbestosis. We demonstrated the efficacy and reliability of our diagnostic protocol in detecting asbestosis and asbestos fibers and excluding mesothelioma even in decomposed tissues. According to our findings autopsy remains the diagnostic gold standard in cases of suspected asbestosis within a forensic context, even 1 year after death, therefore it is always highly recommended, even in cases where the body has decomposed.
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Affiliation(s)
- Giuseppe Davide Albano
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy.
| | - Vito Rodolico
- Pathological Anatomy Department, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Simone Di Franco
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
| | - Giuseppe Lo Re
- Radiology Department, Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Mauro Midiri
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
| | - Ginevra Malta
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
| | - Emanuele Cannizzaro
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
| | - Antonina Argo
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
| | - Stefania Zerbo
- Institute of Legal Medicine, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Via del Vespro 129, Palermo, 90100, Italy
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Incharoen P, Hama T, Arsa L, Kamprerasart K, Wongwichai S, Bovornkitti S. Asbestos Bodies Burden in the Autopsy Lung Tissue from General Thai Population. Open Respir Med J 2019; 13:5-10. [PMID: 31929836 PMCID: PMC6935945 DOI: 10.2174/1874306401913010005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/16/2019] [Accepted: 05/05/2019] [Indexed: 11/22/2022] Open
Abstract
Background Chrysotile asbestos has been used in Thailand for over 30 years mainly in asbestos-cement wall and roof tiles. In non-exposed subject, asbestos fiber can contaminate in ambient indoor and outdoor environments. Objective The aim of the present study is to evaluate the current prevalence and volume of AB load in general Thai population. Methods Lung tissues were obtained from 200 autopsy cases. Asbestos Bodies (AB) were identified with light microscopy using the tissue digestion and membrane filtration method. Results are reported as AB/g wet lung tissue. Results AB was identified in 97(48.5%) out of 200 cases. The AB level ranged from 0.19-14.4 AB/g wet lung. Most of the positive cases (99%) have less than 10 AB/g wet lung. Only one case exhibited a high value at 14.4 AB/g wet lung. Age, gender, occupation and hometown were found to have no effect on AB burden in autopsy lung tissue from this study. Conclusion The prevalence of AB in autopsy lung tissue from general Thai population is 48.5% and the AB level ranges from 0-14.4 AB/g wet lung in consistent with non-occupational asbestos exposure level regarding several reference reports.
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Affiliation(s)
- Pimpin Incharoen
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Tuanseeta Hama
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Lalida Arsa
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Kaettipong Kamprerasart
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Sompong Wongwichai
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Sartorelli P, Scancarello G, Romeo R, Marcianò G, Rottoli P, Arcangeli G, Palmi S. Asbestos exposure assessment by mineralogical analysis of bronchoalveolar lavage fluid. J Occup Environ Med 2001; 43:872-81. [PMID: 11665456 DOI: 10.1097/00043764-200110000-00006] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mineralogical analysis of bronchoalveolar lavage fluid (BALF) by electron microscopy can represent the most suitable method for assessing asbestos exposure. However, it has been claimed that no standardized or systematic approach to the subject of mineralogical analysis exists. This study aimed to evaluate BALF mineralogical analysis by transmission electron microscopy as biomarker of asbestos fiber load. BALF was examined in 108 exposed workers and 57 patients who underwent diagnostic fiberoptic bronchoscopy for various clinical purposes. Asbestos bodies in BALF were counted with a phase-contrast microscope. Fibers were counted and analyzed by transmission electron microscopy, which showed a significant difference between the two populations and positive results for all exposed subjects. Only 82.2% of the exposed population tested positive for asbestos bodies. Subjects with long-term exposure had higher concentrations of fibers than did those with more recent exposure, probably because of the higher workplace exposure levels in the past. The results of the study confirm that fiber concentration in BALF can be considered as a reliable biomarker of past asbestos exposure, even many years after the end of exposure.
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Affiliation(s)
- P Sartorelli
- Institute of Occupational Medicine, University of Siena, Italy.
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