Occupational cancer. Cytology in industrial applications.
Occupational safety and health symposia 1979. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 80-139, 1980 Jun; :31-37
Cytologic screening for lung cancer in industrial workers was reported. Specimen cells for microscopic examination should be obtained from early morning deep cough sputum. For the patient who can not cough, aerosol induction was advised. The expectorate should be kept in a jar half filled with a mixture of 50 percent alcohol and 2 percent carbowax (Saccomanno fixative). Previous studies had shown that the cancer detection rate was about 40 percent with one specimen and increased to 90 percent for five specimens. Screening program data indicated that sputum analysis was successfully used in detecting cancer among uranium and asbestos workers, and in heavy cigarette smokers. The cited 0.4 to 0.5 percent incidence rate corresponded to the current lung cancer mortality rate of 38 per 100,000. Squamous metaplasia was represented by groups of generally angular cells which were larger than bronchial basal cells. With increasing degrees of atypical metaplasia, there was increased nuclear hyperchromasia, irregular nuclear shapes, irregular chromatin distribution and occasionally very dense nuclei. The cytoplasm was usually eosinophilic or orangeophilic; it also might have been basophilic. In the most advanced, in-situ atypia cells were more likely to occur singly. Cells of invasive squamous cell carcinoma occurred singly for the most part and usually revealed considerable variation and irregularity in size and shape. In addition to squamous cell carcinoma, the adenosquamous carcinoma also occurred in as much as 50 percent of the lung tumors. Large cell and small cell undifferentiated carcinomas were two major types of bronchogenic carcinomas. The author concluded that cytodiagnosis in sputum was readily applicable to industrial screening.
NIOSH-Contract; Contract-210-79-0009; Lung-cancer; Cytopathology; Lung-cells; Cell-alteration; Microscopic-analysis; Occupational-diseases; Industrial-medicine; In-vivo-studies
DHHS (NIOSH) Publication No. 80-139
Occupational safety and health symposia 1979