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The French mesothelioma register has three objectives. The first, collection of morbidity data could not be achieved since the data collected are not exhaustive. The second, the collection of histological material for establishing diagnostic criteria, has provided interesting data; and the third, etiological research, may constitute the basis for well-defined studies.

Two different methods have been tested for assessing retrospectively occupational exposure to asbestos dust in 80 cases with suspected asbestos-related thoracic diseases: 1) Occupational history was recorded by an interviewer using a standardized questionnaire. The patients were divided into three groups: those obviously exposed (E), those obviously not exposed (NE) and those with an inconclusive questionnaire (IQ). 2) Ferruginous bodies were isolated from lung washing fluid and counted under the light microscope. In the questionnaire groups, the proportions positive for ferruginous bodies in lung washing fluid were as follows: E, 29/33; NE, 1/7; IQ, 17/40. In cases positive for ferruginous bodies in lung washing fluid, the median numbers of bodies per ml of fluid were: E, 11.7 (range, 0.05-31,250); NE, 0.06; IQ, 1.1 (range, 0.06-350) Since the data provided by the two methods were in good agreement (P less than 0.001) for the E and NE questionnaire groups, the presence of ferruginous bodies in lung washing fluid is considered to be a good indicator of past exposure. In the IQ group, the monitoring of ferruginous bodies in lung washing fluid demonstrated exposure to asbestos in 43% of cases.

The relationship was studied between the presence in X-rays of one or several regions of straightness on the diaphragm, which interrupt or replace its normal curve, and the intensity, length and latency of asbestos exposure. Subjects were four groups in whom intensity of exposure, assessed by questionnaire and by ferruginous body counts, increased progressively. Diaphragmatic straightness increased with increasing intensity but not with length or latency of asbestos exposure.

Different lung function tests have been studied in a group of 39 spray workers, with exposure of a few months to 20 years, in order to determine early impairments in ventilatory or gaseous exchange parameters. Lung function was assessed by conventional spirometric tests, plethysmographic measurement of lung volume, determination of arterial oxygen tension at rest and on exercise and measurement of single-breath diffusion of carbon monoxide. Asbestos exposure was assessed using a standardized questionnaire administered by an interviewer to determine length of exposure, and light microscopic examination to ascertain the number of ferruginous bodies in one sputum sample or in lung washing fluid. The results of the functional tests are expressed with respect either to duration of working exposure or to the number of ferruginous bodies. Restrictive ventilatory impairment with decrease in diffusion of carbon monoxide and increase in the oxygen alveolar-arterial difference on exercise was observed both in the group with 1-50 ferruginous bodies and in workers exposed for more than five years. The decrease in lung volume was approximately 10% when the length of asbestos exposure varied from 0-5 to 10-15 years, and 15% between those with no ferruginous bodies and those with more than 50. No obstructive profile was observed, even in heavy smokers. All function tests were altered equally. Plethysmography therefore appears to be a suitable technique for the follow-up of asbestos workers.

Three groups of people working in buildings with insufficient protection against sources of asbestos (ceilings, lagging, cupboards, etc.) have been compared by clinical and radiological examinations. The first group, G1 (n = 160), comprised people working in direct contact with sources of asbestos; the second one, G2 (n = 277), comprised people who had worked for at least 10 years in buildings with little protection; and the third one, G3 (n = 157), may be considered a control group, since the only period of exposure was while the buildings were being constructed. The prevalence of lung abnormalities (clinical, functional and radiological) was higher in G1 than in G3; G2 was closer to G1 for some signs, but closer to G3 for most. These differences are no explained by obvious possible confounding factors (such as age, sex or tobacco consumption). They were analysed taking the number of years of presence in the buildings into account.