NIOSH manual of analytical methods, fourth edition - third supplement. Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2003-154, 2003 Mar; :143-166
Fiber-related disease has provided much of the impetus for fiber research in recent years. Asbestos has been the fiber type most commonly associated with disease. The name "asbestos" is a commercial term applied to the fibrous forms of several minerals that have been used for similar purposes and includes chrysotile, amosite, crocidolite, and the fibrous forms of tremolite, anthophyllite, and actinolite. The three primary diseases associated with asbestos exposure are asbestosis, the result of inflammation and collagen formation in lung tissue; lung cancer; and mesothelioma, an otherwise rare form of cancer associated with the lining surrounding the lungs. A current theory describing the toxicity of fibers indicates that fiber dose, fiber dimension, and fiber durability in lung fluid are the three primary factors determining fiber toxicity . The dose, or number of fibers deposited in the lungs, is clearly an important factor in determining the likelihood of disease. Both fiber diameter and length are important in the deposition of fibers in the lungs and how long they are likely to remain in the lungs. Figure 1 indicates some of the factors that determine fiber deposition and removal in the lungs. Fiber length is thought to be important because the macrophages that normally remove particles from the lungs cannot engulf fibers having lengths greater than the macrophage diameter. Thus, longer fibers are more likely to remain in the lungs for an extended period of time. The macrophages die in the process of trying to engulf the fibers and release inflammatory cytokines and other chemicals into the lungs . This and other cellular interactions with the fibers appear to trigger the collagen buildup in the lungs known as fibrosis or asbestosis and, over a longer period, produce cancer as well. Fiber diameter is also important because fiber aerodynamic behavior indicates that only small diameter fibers are likely to reach into and deposit in the airways of the lungs. The smaller the fiber diameter, the greater its likelihood of reaching the gas exchange regions. Finally, fibers that dissolve in lung fluid in a matter of weeks or months, such as certain glass fibers, appear to be somewhat less toxic than more insoluble fibers. The surface properties of fibers are also thought to have an effect on toxicity. Asbestos is one of the most widely studied toxic materials and there have been many symposia dedicated to and reviews of its behavior in humans and animals [4-8]. Several techniques were used for asbestos measurement up until the late 1960s . Earlier than this, it was not widely recognized that the fibrous nature of asbestos was intimately related to its toxicity, so many techniques involved collection of airborne particles and counting all large particles at low magnification by optical microscopy. Thermal precipitators, impactors (konimeters), impingers, and electrostatic precipitators were all used to sample asbestos. Perhaps the primary technique in the United States (US) and the United Kingdom (UK) during this early period was the liquid impinger, in which particles of dust larger than about 1-microm aerodynamic diameter were sampled at 2.7 L/min and impacted into a liquid reservoir . After sampling, an aliquot of the liquid was placed on a slide in a special cell, particles larger than 5-microm size were counted, and the results were reported in millions of particles per cubic foot. Dissatisfaction with this approach stemmed from lack of correlation between measured particle concentration and disease in the workplace. Various indices of exposure have been developed that attempt to relate a portion of the fiber size distribution to the toxic effects. The appropriate indices for each of the asbestos related diseases as a function of fiber length and diameter (Figure 2) were suggested by Lippmann .