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Asbestosis

Asbestosis

Asbestosis, also known as diffuse pulmonary fibrosis, is a chronic lung condition that can develop years after exposure to asbestos. After inhalation or ingestion, the asbestos fibers can become stuck in the lung tissue and cause inflammation and scarring over time, which can develop into asbestosis. While asbestosis itself is not a type of cancer, over time, the condition can become more severe and present a higher risk of developing into an asbestos cancer like mesothelioma or lung cancer.

Diagnosing the Symptoms of Asbestosis

Like other asbestos-related diseases, it can take many years for asbestosis to develop and begin to show symptoms. On average, the latency period can range from 10 – 30 years after asbestos exposure.

Similarly, many of the symptoms may be attributed to other conditions and can be difficult to diagnose. Typically, shortness of breath is the first sign of asbestosis. It may begin as a struggle to catch your breath after some exertion, but difficulty with breathing may also become apparent even during periods of rest.

Common Asbestosis Symptoms
  • Shortness of breath
  • Persistent cough
  • A crackling sound in the lungs when breathing
  • Chest pain and tightness
  • Decrease in appetite and weight loss
  • Fatigue

In more advanced cases, asbestosis patients may experience other, more severe symptoms. One of the common symptoms in more severe cases is clubbing of the fingers, meaning they become rounder and wider, with the nails curving around the fingertips. Digital clubbing is often a sign of low oxygen in the blood and can be linked to several lung and heart diseases, which is indicative that the asbestosis is leading to even more health complications.

High blood pressure, or pulmonary hypertension, can also be a symptom of advanced asbestosis. Scar tissue buildup makes the arteries have to work harder to pump blood from the heart to the lungs. Since this added pressure makes the heart work harder, asbestosis patients can be at a high risk for heart disease or coronary artery disease.

Asbestosis is often diagnosed with a chest X-ray or a CT scan, which can show scarring and damage to the lungs. Diagnosis can be challenging, and, as with other asbestos-related diseases, Asbestosis can be confused for other types of lung disease, especially if the patient has a history of smoking. It’s also important for doctors to differentiate asbestosis from other forms of pneumoconiosis specifically, which are lung diseases caused by inhalation of toxic dust. Occasionally, a biopsy of lung tissue may also be necessary to make a definitive diagnosis.

Once properly diagnosed, patients will also likely undergo breathing or lung function tests to better assess the extent of the damage to the lungs. These tests will measure how well the lungs are working, the oxygen and carbon dioxide levels in the blood, and may also focus on how the lungs work during periods of exercise and sleep. The imaging tests and lung function tests together will better enable a doctor to come up with the appropriate treatment plan.

Treatment for Asbestosis

Unlike asbestos cancers like mesothelioma, asbestosis treatment plans largely rely on combinations of medications rather than more aggressive options like surgery or chemotherapy. Again, asbestosis is not a cancer, so there aren’t tumors to be targeted with these kinds of treatments. Instead, treatment is more about disease management.

There is no cure for asbestosis since it’s impossible to reverse the damage to the lungs and the alveoli. There are limited treatment advancements and no clinical trials for patients to consider. However, unlike other asbestos cancers like mesothelioma that have a very poor prognosis, many asbestosis patients are able to live with the condition for many years. Asbestosis can be effectively managed with some treatments and procedures that can help slow the progression of the disease, alleviate symptoms and enable patients to have a better quality of life.

Common Treatments for Asbestosis
  • Bronchodilators or inhalers can increase airflow to the lungs
  • Supplemental oxygen can bring more oxygen to the lungs and improve breathing
  • Antibiotics can thin lung secretions to alleviate chest pain and improve breathing
  • Postural drainage, getting into a position that helps drain fluid out of the lungs
  • Chest percussion, or chest physical therapy, also helps drain fluid from the lungs
  • Pulmonary rehabilitation, exercise and lifestyle changes designed for patients with chronic lung conditions

In more advanced cases where lung function is extremely poor, some patients may undergo surgery to remove some of the scar tissue and hopefully improve breathing. In very rare cases where asbestosis is also connected with another severe condition, like emphysema, medical professionals may consider a lung transplant. With long waiting lists and extensive testing required to determine eligibility for such an invasive procedure, this treatment option is often considered to be a last resort.

Living with Asbestosis

Patients can expect to be ill more often when diagnosed with asbestosis. For this reason, it is important to receive the flu vaccine to avoid additional respiratory infections. In general, patients and their family members will need to develop a daily routine that can make it easier for the asbestosis patient to enjoy better quality of life without always struggling to breathe. Treatment options including inhalers, supplemental oxygen with an oxygen tank, and a healthy diet and exercise routine can enable asbestosis patients to live more comfortably.

Although more easily managed than other asbestos diseases, asbestosis is still attributed to around 1,200 deaths in the United States each year. It’s important for asbestosis patients to monitor their condition and have regular scans and checkups to ensure the disease doesn’t continue to progress.

Without the right treatment plan and lifestyle changes, it is possible for the scarring and inflammation to develop into tumors. Patients with a history of smoking or prolonged asbestos exposure are more at risk of their asbestosis developing into malignant mesothelioma or other asbestos-related cancers.

Sources

MayoClinic.com - Asbestosis - Definition
http://www.mayoclinic.com/health/asbestosis/DS00482

emedicine.com from Web MD - Asbestosis
http://emedicine.medscape.com/article/295966-overview

Roggli V, Gibbs A, et al. Pathology of Asbestosis—An Update of the Diagnostic Criteria: Report of the Asbestosis Committee of the College of American Pathologists and Pulmonary Pathology Society. Archives of Pathology andLaboratory Medicine. March 2010. 134(3).

American Lung Association. Living with Asbestosis.

Kishimoto T, Kato K, et al. Clinical, Radiological, and Pathological Investigation of Asbestosis. International Journal of Environmental Research and Public Health. 2011 Mar; 8(3): 899–912. doi: 10.3390/ijerph8030899

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