• Clinical science

Asbestosis

Summary

Asbestosis is a type of pneumoconiosis caused by the inhalation of asbestos fibers and occurs primarily as a result of occupational exposure. After a long latency period, this condition manifests with nonspecific symptoms, e.g., coughing and dyspnea, which are caused by fibrotic changes in the lungs. The diagnosis is established based on a history of occupational exposure (such as working with textiles, cement, ship-building, insulation) and characteristic changes on chest x-ray (reticular opacities and pleural plaques). Currently, there is no curative treatment for asbestosis. Management consists of measures that provide symptomatic relief like oxygen therapy, prompt antimicrobial treatment of respiratory infections, cessation of exposure, and immunization against influenza and pneumococcal pneumonia. 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. A combination of chemotherapy, surgery, and/or radiation therapy is used to manage malignant mesothelioma. However, the prognosis of patients with malignant mesothelioma 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, insulation, 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. In smokers, the disease progresses more rapidly because mucociliary clearance is impaired.

References:[1]

Clinical features

References:[1]

Diagnostics

References:[1]

Treatment

  • No curative treatment exists.
  • Palliative care in the case of advanced disease

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.