Bronchoalveolar Lavage In Asymptomatic Underground Coal Miners

Pulmonary responses to coal mine dust exposure were investigated by analysis of bronchoalveolar lavage specimens from non-smoking coal miners (n-12, mean age-43 ± 2 years, mean underground exposure-17 ± 2 years) and from non-smoking normal volunteers (n-18, mean age-43 ± 2 years). Spirometric and diffusion capacity indices were monitored as part of a physical exam. Lavage was performed in a subsegment of the right middle lobe by instillation of 200 ml of warmed saline solution in 50 ml aliquots and recovery by gentle suction. Specimens were centrifuged at 500g for 5 minutes at 2°C. Total and differential cell counts were recorded. Secretion of oxidants measured by chemiluminescence, surface morphology (spreading and ruffling), and lymphocyte parameters were determined. Lavage fluid was analyzed for the presence and quantity of acute phase reactants and immunoglobulins. Pulmonary function measurements as well as recovered lavage volume, total lavagable cells, and differential cell counts were similar in both miners and controls. Both resting and phorbol myristate acetate-stimulated chemiluminescence were also similar in miners and controls. In contrast, particle-stimulated chemiluminescence was significantly decreased in the alveolar macrophages from the miners (48% of control values). Morphometric analysis of scanning electron micrographs indicate that phagocyte surface spreading was similar in miners and controls. However, surface ruffling was 127% greater in the miners compared to controls. Lymphocyte subpopulations were similar in miners and controls. Protein analysis of the lavage fluid revealed lower total protein content in the lavage fluid of miners. However, the concentration of albumin, IgG, and IgA were similar in miners and controls. We conclude that most indices were normal in underground miners working under the current dust standard of 2 mg/m3. The decrease in particlestimulated chemiluminescence and the increase in surface ruffling in miners may suggest the beginnings of particle overload and activation of the macrophages. In addition, a decrease in total protein was noted in lavage fluid from miners.