Asbestosis

Asbestosis is a chronic lung disease characterized by a scarring of lung tissues, which leads to long-term breathing complications. The disease does not have a cure.

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It is caused exclusively by exposure to asbestos, but may not be diagnosed until decades after the exposure occurred.

Asbestosis is linked to chrysotile fibers. Chrysotile is one of the six known types of asbestos. Exposure occurs when someone breathes in the dangerous fibers. Extended exposure can lead to an accumulation of the fibers in lung tissues, setting the stage for long-term fibrosis (scarring). Over time, lung tissues thicken, causing pain and restricting breathing.

Symptoms include labored breathing during routine tasks and exercise, chest pain and coughing. Doctors prescribe breathing treatments, prescription medication and sometimes surgery for people with asbestosis.

The prognosis is often positive. Because asbestosis is not a form of lung cancer or mesothelioma, people can live many years, even decades, with the disease. However, because the condition gets worse over time, patients will require increased treatment as they age.

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DEFINITIONS

  • Alveoli

    the lung's air sacs.

  • Macrophages

    white blood cells found within tissues that stimulate defense mechanisms to boost the immune system.

  • Fibroblast cells

    connective tissue cells that produce the extracellular matrix and collagen.

  • Parenchymal tissue of the lungs

    the tissue that carries out the work of the lungs as compared to connective tissue or tissue which only provides support.

  • Sputum

    mucus secreted from the lungs and expelled through the mouth.

Symptoms

The primary symptoms are decreased tolerance for physical exertion and shortness of breath. The severity of the symptoms is often related to the amount and length of asbestos exposure.

Patients exhibit dry inspiratory crackles, which are clicking or rattling noises made by the lungs during inhalation, and "clubbing" of the fingers, which may include softening of the fingernail beds, bulging of the end of the finger(s) and misshapen nails – all caused by a decrease of oxygenated blood flow to the extremities. Lung cancer can also cause clubbed fingers.

There is always evidence of fibrosis in the lower lung lobes where asbestosis is most prevalent, and more than 50 percent of people develop plaques in the parietal pleura, which is the space between the chest wall and the lungs.

Fast Fact: Asbestosis patients have an 8-10 times higher risk of developing lung cancer than those without asbestosis.

Other symptoms can include:

  • Coughing
  • Chest pain
  • Blood in the sputum
  • Swelling in the neck or face
  • Difficulty swallowing
  • Loss of appetite
  • Weight loss
Learn more about the symptoms of asbestosis.

In severe cases, the drastic reduction in lung function may cause the heart to have to pump at a faster rate than is healthy. It's not uncommon for someone with this disease to die from heart failure, even though asbestosis is the contributing factor.

Fast Fact: Asbestosis can develop fully in as few as seven years. In other cases, it can take 20 years or more before a victim will begin to feel symptoms.

In the later stages of development, other complications may arise, including:

  • High Blood Pressure: Because the disease can destroy the lungs' blood vessels, it may lead to high blood pressure in the arteries near the lungs. A doctor may refer to this complication as pulmonary hypertension.

  • Heart Disease: As the blood pressure increases, the heart will have to work harder to pump blood. Eventually, the heart may weaken and fail.

  • Other Lung Complications: The presence of asbestos fibers in the lungs can cause thickening of lung membranes (pleural membranes), the formation of calcium deposits or plaques, and the accumulation of fluids in the lungs. Although these complications are non-cancerous in nature, they may be accompanied by respiratory difficulty and should be considered a serious threat to your health.

  • Cancers: Asbestosis can elevate the risk of developing serious, related cancers, such as lung cancer and mesothelioma.

Fast Fact: More than 13,000 U.S. asbestosis deaths were recorded from 1995-2004. However, many people who get asbestosis die from a related disease, sometimes lung cancer or mesothelioma.

How Is It Diagnosed?

Recommended diagnostic tools include:

  • Complete physical examination
  • Chest X-ray
  • Lung function tests

A lung biopsy, in which tissue is removed by surgery, is the most reliable way to confirm the presence of microscopic asbestos fibers because X-rays cannot detect them.

Learn more about an asbestosis diagnosis.

How Is It Treated?

While there is no cure, treatment options include:

  • Oxygen therapy to relieve shortness of breath
  • Respiratory physiotherapy to remove secretions from the lungs
  • Medications to thin secretions and relieve pain
Find out more about treatment options for patients with asbestosis.

Occupations at Risk

Throughout most of the 20th century, millions of American workers were exposed to asbestos. The greatest risk for contracting the disease has fallen upon those in the asbestos mining and milling trades; those manufacturing asbestos textiles and other products; shipbuilders; and insulation workers in the construction and building trades.

Since the early 1970s, when the use of the mineral declined in the U.S., those individuals most at risk have been demolition workers, drywall removers, asbestos removal workers, firefighters and automobile workers.

Additional factors of how asbestos can affect an individual:

  • Quantity: How much someone was exposed to
  • Duration: How long someone was exposed
  • Type: Which kind of asbestos someone was exposed to
  • Source: Where it came from
Find out more about occupations at risk for asbestos exposure.

Facts

  • The first official diagnosis of asbestosis, described in medical literature, was made in 1924 by an English doctor. The patient was a textile worker named Nellie Kershaw. Her death resulted in the first asbestos-related industry regulations, which began in 1932.

  • Asbestosis is not a cancer, although it can increase the risk of developing either lung cancer or mesothelioma.

  • Asbestosis was identified as the underlying cause of death for more than 9,000 people in the United States from 1968 to 2005, according to the American Public Health Association.

  • An estimated 125 million people in the world today are exposed to asbestos in the workplace, according to the World Health Organizations.

  • Despite active removal efforts throughout the country, an estimated 1.3 million general-industry workers in the United States potentially are exposed each year to asbestos. Many of those are involved in the manipulation during renovation or demolition activities.

Additional Resources

  1. American Thoracic Society. (2004). Diagnosis and Initial Management of Nonmalignant Diseases Related to Asbestos. American Journal of Respiratory and Critical Care Medicine, 170, 691-715. Retrieved from http://www.thoracic.org/statements/resources/eoh/asbestos.pdf
  2. Asbestosis: A Medical Dictionary, Bibliography, and Annotated Research Guide To Internet References. (2004). San Diego, California: Icon Health Publications.
  3. Barbalace, R.C. (2004 October). A Brief History of Asbestos Use and Associated Health Risks. Environmental Chemistry.com. Retrieved from http://EnvironmentalChemistry.com/yogi/environmental/asbestoshistory2004.html
  4. Barnes, J. (2011). Dust-up: Asbestos Litigation and the Failure of Commonsense Policy Reform. Washington, DC: Georgetown University Press.
  5. Becklake M.R., Bagatin E., Neder J.A. (2007, April 11). Asbestos-related diseases of the lungs and pleura: uses, trends and management over the last century. The International Journal of Tuberculosis and Lung Disease 12/7, 356-69. Abstract retrieved from: http://PubMed.gov
  6. Cavalcanti, V., dos Santos, A. (2008 November 18). Asbestosis mortality in the USA: facts and predictions. Occupational and Environmental Medicine, 66, 335-338. Abstract Retrieved from BMJ Journals.
  7. Cooke, W.E. (1924, July 26). Fibrosis of the Lungs Due to Inhalation of Asbestos Dust. British Medical Journal, 2, 147.
  8. National Cancer Institute. (2009, May 01). Asbestos Exposure and Cancer Risk [Fact Sheet]. Retrieved from http://www.cancer.gov/cancertopics/factsheet/Risk/asbestos
  9. National Institute for Occupational Safety and Health Division of Respiratory Disease Studies. (2007). Work-Related Lung Disease Surveillance Report. Retrieved from http://www.cdc.gov/niosh/docs/2008-143/
  10. Webster, P. (2006).White Dust Black Death: the Tragedy of Asbestos Mining at Baryulgil. Indiana: Trafford Publishing.

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