Bronchoalveolar lavage results are independent of season, age, gender and collection site

PLoS One. 2012;7(8):e43644. doi: 10.1371/journal.pone.0043644. Epub 2012 Aug 31.


Background: Clinical interpretation of bronchoalveolar lavage fluid results is dependent on the availability of reference values for healthy individuals. Only a few studies have published such reference values and the applicability of results is restricted by small sample sizes and the limited representativeness of the study population. We aim to investigate the influence of age, gender, collection site and season on bronchoalveolar lavage fluid results and to establish reference values for use in clinical practice.

Methodology/principal findings: Bronchoalveolar lavage fluid data from 295 healthy never-smoking volunteers, investigated during 1990-2009, were analyzed retrospectively. 47 volunteers had 2-5 repeat lavages during the course of several years. Fluid recovery, total number of cells, cell concentration, and differential cell counts on cytospin prepared slides were recorded. Reference values, as represented by the 5(th) to the 95(th) percentile, were 72-96% for macrophages, 2-26% for lymphocytes, 0-4% for neutrophils and 0-1% for eosinophils. Basophils and mast cells were rare. When repeat lavages were performed, there was a relatively large intra-individual variability, mainly for macrophages and lymphocytes. An age dependent decrease of lavage fluid return was present, but there was no age dependent correlation with any of the other BALF parameters. The BALF cell parameters were independent of gender, season and site (lingula vs. middle lobe).

Conclusions/significance: Our data show that bronchoalveolar lavage fluid cell differential count is independent of age, gender, season and collection site (RML or lingua). It therefore seems acceptable to use the same reference values for all never-smoking individuals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Bronchoalveolar Lavage Fluid / cytology*
  • Cell Count
  • Female
  • Humans
  • Male
  • Middle Aged
  • Seasons*
  • Sex Factors
  • Specimen Handling / methods*
  • Young Adult

Grants and funding

JG and AE received financial support from AstraZeneca to be able to pay a statistician and a BMA for a shorter time helping in putting data together. Funding was also received from The Swedish Heart and Lung Foundation, The Swedish Medical Research Council and Stockholm County Council. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.