Occupational and environmental exposure to asbestos increases one’s risk of lung damage and asbestosis, a kind of pulmonary fibrosis. Asbestosis is a lung disease caused by inhalation of asbestos fibers. It is characterized by inflammation and scarring of the lungs, resulting in chest tightness and shortness of breath. Over time, asbestosis can lead to complications of heart disease, cancer, and respiratory failure.
Making an Asbestosis Diagnosis: Step 1
In making a diagnosis of asbestosis, a doctor first considers an individual’s risk factors for the disease as well as their symptoms.
Risk factors for asbestosis include
- Occupational and environmental exposure: occupational exposure is the greatest risk factor for asbestosis, especially within the fields of construction, demolition, manufacturing, mining, milling, automobile repair, and firefighting.
- Prolonged exposure: asbestosis is a dose-dependent disease, meaning greater cumulative exposure to asbestos increases one’s risk for the disease.
- Smoking history: smoking is an additional risk factor for asbestosis.
Usually, it takes 10 to 40 years after exposure for symptoms of an asbestos-related disease to develop.1
Hallmark symptoms of asbestosis include
- Shortness of breath on exertion
Additional symptoms of asbestosis may include
- Chest tightness or pain
Making an Asbestosis Diagnosis: Step 2
Next, the doctor will perform a physical exam to assess for signs of the disease.
Clinical signs of asbestosis include
- Lung crackles
- Nail clubbing, or curvature of the fingernails and toenails
Making an Asbestosis Diagnosis: Step 3
Lastly, the doctor will order tests to confirm or refute their clinical suspicion for asbestosis.
Diagnostic tests for asbestosis include
- Chest x-ray
- Pulmonary function tests
In some cases, a doctor will need to order more tests to make a diagnosis.
Additional diagnostic tests may include
- Chest CT scan
- Lung biopsy
- Bronchial lavage
If asbestosis is diagnosed, a follow-up appointment will be made to discuss the diagnosis and treatment options. Asbestosis can be treated, but, unfortunately, there is no known cure for the disease. Treatment focuses on symptom management and may include
- Drug therapy: oral steroids may help to reduce symptoms.
- Oxygenation: supplemental oxygen and pulmonary rehabilitation can help to reduce symptoms, maintain one’s activity level, prevent some heart and lung complications, and improve quality of life.
- Smoking cessation: quitting smoking can help improve prognosis.
- Surgery: surgical intervention can help to prevent lung collapse in severe cases of the disease.
- Lung transplantation: when all other treatments have failed to provide symptom relief, lung transplantation may be an option.
Although asbestosis cannot be cured, it can be prevented by avoiding exposure to asbestos. Unfortunately, once an individual is exposed to asbestos, there is no known way to prevent the disease from developing. Maximum survival after symptom onset is about 4 years.2
Complications of Asbestosis
Complications of asbestosis may arise, including
- Heart disease: heart failure may develop secondary to scarring and compression of pulmonary vessels.
- Cancer: asbestosis is associated with the development of lung cancer and malignant pleural mesothelioma, one of the deadliest diseases attributed to asbestos exposure.
- Respiratory failure: as lung scarring worsens, lung expansion and oxygen diffusion are hindered, ultimately resulting in oxygen-deficient respiratory failure.
A trusted team of specialists composed of cardiologists, pulmonologists, and oncologists can be invaluable in managing asbestosis complications.