• Clinical science

Asbestosis

Abstract

Asbestosis is a type of pneumoconiosis caused by the inhalation of asbestos fibers that occurs primarily as a result of occupational exposure. This condition exhibits nonspecific symptoms after a long latency period, e.g. coughing and dyspnea, which are caused by fibrotic changes in the lungs. Diagnosis is established based on history of occupational exposure (such as working with textiles, cement, ship-building, insulation) and characteristic changes noted on chest x-ray (reticular opacities and pleural plaques). Long-term exposure to asbestos can lead to complications like fibrosis, respiratory failure, and malignancy (especially bronchogenic carcinoma, and mesothelioma). Pleural effusion may be the first sign of a malignant mesothelioma. Currently, there exists no curative treatment for asbestosis. Supplementary measures like oxygen therapy, prompt antimicrobial treatment of respiratory infections, cessation of exposure, and immunization against influenza and pneumococcal pneumonia make up the management of these cases. A combination of chemotherapy, surgery, and/or radiation therapy is used to manage malignant mesothelioma. However, prognosis is poor with the mean survival time being ∼ 1 year.

Etiology

  • Type of pneumoconiosis caused by inhalation of asbestos fibers
  • Risk factors
    • Occupations involving the manufacture or demolition of ships, plumbing, roofing, insulators, heat-resistant clothing, and brake-lining
    • Smoking

References:[1]

Pathophysiology

  • Inhalation of airborne asbestos fibers into alveoli
  • inflammation and fibrosis of pleural parenchyma
  • → risk of carcinogenic effects

A high cumulative dose of asbestos is associated with a higher incidence of asbestosis, while those who smoke have an increased progression of disease (impaired mucociliary clearance)!

References:[1]

Clinical features

References:[1]

Diagnostics

References:[1]

Treatment

  • No specific treatment exists
  • Palliative care if advanced

References:[1]

Complications

Mesothelioma

Other

The most common malignancy associated with asbestosis is bronchogenic carcinoma, not mesothelioma!

References:[2][3]

We list the most important complications. The selection is not exhaustive.

Prevention

  • The use of asbestos in the US is restricted
  • The following products are banned: any new uses of asbestos, corrugated paper, rollboard, commercial or specialty paper, and felt flooring

References:[4]