Asbestosis and small cell lung cancer in a clutch refabricator

Objectives-To present a case of asbestosis and small cell lung cancer cause d by asbestos in a clutch refabricator, Methods-Exposed surfaces of used clutches similar to those refabricated in the worker's workplace were rinsed, and the filtrate analysed by analytical transmission electron microscopy. Tissue samples were also analysed by thi s technique. Results-Numerous chrysotile fibres of respirable dimensions and sufficient length to form ferruginous bodies (FBs) were detected from rinsed filtrates of the clutch. Bronchoalveolar lavage fluid contained many FBs, characteri stic of asbestos bodies. Necropsy lung tissue showed grade 4 asbestosis and a small cell carcinomaa in the right pulmonary hilum. Tissue analysis by l ight and analytical electron microscopy showed tissue burdens of coated and uncoated asbestos fibres greatly exceeding reported environmental concentr ations (3810 FBs/g dry weight and 2 080 000 structures greater than or equa l to 0.5 mu m/g dry weight respectively). 72% Of the cores were identified as chrysotile. Conclusions-Clutch refabrication may lead to exposure to asbestos of suffic ient magnitude to cause asbestosis and lung cancer.