Asbestosis

What Is Asbestosis?

Asbestosis is a serious lung condition caused by exposure to asbestos. Many asbestosis cases trace back to consistent exposure to asbestos-containing materials in construction sites, ships and industrial facilities.

Asbestosis is one of many interstitial lung diseases that cause inflammation and scarring in the lungs. Inhaled asbestos fibers can cause scar tissue, known as pulmonary fibrosis, to form within the lungs. When dust from sources such as asbestos cause this type of disease, it is known as pneumoconiosis or occupational lung disease.

There is no cure for asbestosis, but treatment can alleviate symptoms and slow disease progression.

Asbestosis Symptoms

When scar tissue forms around the lungs’ microscopic air sacs, known as alveoli, it gradually becomes harder for them to expand and fill with fresh air. The first symptoms of asbestosis include dry cough and difficulty breathing, accompanied by crackling sounds.

Scarring causes lung tissue to stiffen, which leads to coughing, discomfort and crackling sounds associated with asbestosis. This also results in less oxygen being delivered to the blood, causing shortness of breath. Because the body relies on oxygen for energy, chronic breathing difficulties lead to fatigue and weight loss. Advanced symptoms include pulmonary hypertension and clubbed fingers and toes. 

Pulmonary hypertension is different than the more commonly occurring high blood pressure or systemic hypertension. The formation of scar tissue may constrict arteries and make it harder to pump blood out of the heart and into the lungs, requiring increased pressure to perform the action. Pulmonary hypertension is dangerous because it forces the heart to work harder, potentially leading to problems with coronary artery disease and congestive heart failure.

When the lungs deliver insufficient oxygen to the blood, a symptom called “clubbing” may arise. The tips of the toes and fingers appear wider and rounder than normal. Fingernails and toenails may become deformed because of the lack of oxygen reaching the body’s extremities. This symptom may appear early in disease progression for some patients.

Asbestosis takes less time to develop than asbestos-related cancer, so an asbestosis diagnosis signals a risk of developing lung cancer or mesothelioma in the future. 

Managing Symptoms

Patients can minimize symptoms of asbestosis by taking steps to improve their lifestyle. Eating a well-balanced diet and staying hydrated supplies the body with nutrients necessary to fight chronic disease.

Getting adequate sleep every night and taking short rests during the day helps asbestosis patients regulate their energy. Exercising regularly without overexerting yourself can also improve energy levels and pulmonary function.

Make sure to prevent respiratory infections by getting flu and pneumonia vaccines, washing your hands and avoiding large crowds. Try to avoid air pollution and tobacco smoke.

Asbestosis Causes

The only cause of asbestosis is exposure to asbestos. Other types of pneumoconiosis are caused by different types of dust. For example, silicosis is a form of pneumoconiosis caused by exposure to silica dust. 

Inhalation of asbestos fibers leads to accumulation of the fibers in lung tissue. The immune system recognizes asbestos fibers as foreign invaders and sends macrophages, which are a type of white blood cell, to surround the fiber to break it down and remove it from the body. This works for some fibers, but the body cannot remove all inhaled fibers. 

Over time, asbestos fibers accumulate and cause inflammation and fibrous changes to lung tissue that lead to scarring and restrictive tissue movement. Specifically, asbestos fibers cause inflammation and fibrosis of the interstitium and alveoli air sacs and surrounding tissue.

For an asbestos-related illness to develop, it usually takes years of regular asbestos exposure, followed by a latency period that may last decades before symptoms present. Asbestosis has a shorter latency period of 20 to 30 years compared to asbestos-related cancers, which average 20 to 50 years. 

Asbestosis tends to develop in people who were occupationally exposed to large amounts of asbestos over long periods of time.

Workers most likely to experience this kind of exposure include insulators who installed spray-on asbestos insulation, asbestos miners and millers. Other workers at high risk include pipefitters, mechanics, boiler workers, construction workers, textile mill workers, industrial workers and shipyard workers, according to a 2021 study published in the American Journal of Industrial Medicine.

Risk Factors

Workers in the construction, chemical, plumbing, railroad, automotive and shipbuilding industries are more likely to be at risk for asbestosis.

Another group of at-risk workers includes insulators, drywall removers, firefighters, demolition workers and first responders who assisted at the World Trade Center after the 9/11 attacks. These workers were exposed to asbestos used in the construction of the north tower.

The Occupational Safety and Health Administration developed regulations for asbestos in the workplace based on technological and economic feasibility. These regulations reduce asbestos exposure, but do not eliminate it entirely. As a result, an estimated two deaths from asbestosis per 1,000 people are expected among those working at the permissible exposure limit. 

Prevention

Educating yourself about how to limit and avoid asbestos exposure is the best way to prevent asbestosis. Exposure to asbestos is the only cause of asbestosis. You cannot catch asbestosis because it isn’t a contagious condition. 

If you work in a blue-collar industry, it is important to learn about all the safety measures you can take to prevent asbestos exposure. Talk to your employer about safety protocols and learn more online about occupational asbestos exposure through agencies such as the Occupational Safety and Health Administration. 

For those who live with someone who is at risk of occupational asbestos exposure, it is important to inquire about decontamination procedures. This ensures workers don’t bring asbestos fibers home on their skin, hair, clothes, shoes and tools. 

If you live in an older home or work in an old building, avoid disturbing materials that may contain asbestos. If you suspect asbestos is present, hire a licensed asbestos abatement company to conduct testing and perform any necessary removal projects. 

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Diagnosing Asbestosis

Because this disease is similar to other types of pulmonary fibrosis, diagnosing asbestosis requires thorough medical and occupational histories in addition to medical testing. Most patients diagnosed today were exposed to asbestos decades ago before the U.S. restricted the use of the toxic mineral.

Doctors use imaging scans, lung function tests and medical and occupational histories to diagnose asbestosis. Patients typically go to the doctor with breathing problems and undergo an X-ray or CT scan in addition to lung function tests. Radiologists often diagnose this condition because imaging scans are necessary to identify the fibrosis and scarring of the lungs characterized by asbestosis. 

If signs of scarring appear on image scan results, and the patient has a history of significant asbestos exposure, doctors will consider an asbestosis diagnosis. It is generally challenging to diagnose the disease because there is no simple, quick test for asbestosis. A combination of tests and a history of occupational asbestos exposure is the current diagnostic standard.

A misdiagnosis is possible if patients don’t bring up their history of asbestos exposure. Asbestosis may be misdiagnosed as emphysema, chronic bronchitis or idiopathic pulmonary fibrosis.

Physical Exam

During a physical examination, a doctor will use a stethoscope to listen to your lungs while you breathe. If they hear crackling sounds, they will suspect the presence of lung tissue scarring. They will also look for clubbing of fingers and toes if a form of pneumoconiosis is suspected.

Doctors may not know to suspect asbestosis if the patient doesn’t mention their history of asbestos exposure. If you’ve ever been exposed to asbestos, it is important to tell your primary care physician and any doctor you see for lung or digestive problems. 

Testing for Asbestosis

Pulmonary function tests help to verify how much lung function has been affected by asbestosis, which is a sign of disease progression.

Imaging scans for asbestosis include X-rays and CT scans. CT scans can detect asbestosis sooner than X-rays because they provide more detailed images. Identifying the signs of asbestosis on imaging scans, such as opacities, subpleural accentuation, honeycomb-like changes, “shaggy” cardiac silhouettes and indistinct contours around the diaphragm, is essential to clinically diagnosing the condition. Imaging scans also allow doctors to stage asbestosis, which has three stages of progression.

Another diagnostic procedure is a biopsy through bronchoscopy, which involves inserting a scope down the throat and windpipe and into the airways of the lungs. A biopsy is generally not required when imaging scans reveal signs of asbestosis in patients with heavy asbestos exposure. Discovering asbestos fibers in sputum or biopsy samples can contribute to an asbestosis diagnosis, but that alone is not enough to diagnose the condition. 

Asbestosis vs. Mesothelioma and Lung Cancer

Asbestosis is a type of pulmonary fibrosis involving progressive scarring of lung tissue. Asbestosis is not a cancerous disease, but it does indicate a person was exposed to enough asbestos to be at risk of developing asbestos-related lung cancer or pleural mesothelioma cancer. The chance of developing lung cancer after an asbestosis diagnosis is higher than the risk of developing mesothelioma. 

Mesothelioma is a type of cancer that most commonly develops in the lining of the lungs, known as pleural mesothelioma. It can also develop in the lining of the abdomen, heart and testes. Asbestos-related lung cancer develops in lung tissues.

These conditions are caused by years of occupational asbestos exposure and can damage a type of tissue in the lungs called parenchymal tissue. This delicate tissue is responsible for oxygenating red blood cells.

Asbestosis, lung cancer and mesothelioma begin to develop at least 20 years after asbestos exposure takes place. The conditions share similar symptoms, but are diagnosed and treated differently. People can live longer with asbestosis than lung cancer or mesothelioma. 

Anyone diagnosed with asbestosis should monitor their health for worsening respiratory symptoms and seek cancer screenings per their doctor’s recommendations.

Prognosis for Asbestosis

The medial survival for all patients diagnosed with asbestosis is approximately 10 years. Life expectancy with asbestosis inversely correlates to disease progression, which means that survival time is longest for stage 1 patients and shortest for stage 3 patients. Those diagnosed in stage 1 live about 14 years compared to stage 3 patients, who live an average of 1.75 years.

The outlook for patients with asbestosis depends on how quickly the condition progresses, which is influenced by how much asbestos they were exposed to. Those who endured a high level of exposure will have more severe disease that may progress to a late stage quickly. Patients with a lower level of exposure may develop a mild case that progresses slowly or not at all.

Unfortunately, aside from a lung transplant for asbestosis, there is no way to cure or reverse the scarring caused by asbestos exposure. Asbestosis is the most frequently reported cause of pneumoconiosis deaths, accounting for about 60% of pneumoconiosis deaths recorded from 1999 to 2018.

Can You Live with Asbestosis?

Yes, you can live with asbestosis for years, but there is no cure for this progressive condition. Patients live an average of 10 years with asbestosis.

Lung transplantation is the best long-term treatment for asbestosis, but few patients qualify for this serious procedure. Other treatments help to control symptoms and slow progression of the disease.

Asbestosis Treatment Options

Asbestosis is an irreversible condition. With the exception of lung transplantation, all asbestosis treatment options are palliative, meaning they address the symptoms of asbestosis to improve the patient’s quality of life.

Because the condition gets worse over time, patients require increased treatment as they age. Working with a doctor who specializes in asbestosis treatment is important in controlling disease progression and symptoms.

Top Pulmonologists Treating Asbestosis

Treatments include supplemental oxygen, medications, pulmonary rehabilitation and lung transplants. Supplemental oxygen from a portable oxygen tank is often necessary for patients with reduced lung capacity. Medications can thin lung secretions to make coughing easier and relieve chest pain. However, corticosteroids (anti-inflammatory medications) and immunosuppressants are ineffective for treating asbestosis.

Pulmonary rehabilitation helps patients learn techniques and make lifestyle changes to better cope with chronic breathing difficulties. A team of therapists work together to provide for both physical and psychological needs. Exercise therapy is a complementary addition to pulmonary therapy that helps patients with physical fitness and lung function, while improving quality of life.

Lung transplants are most often considered when asbestosis is severe or accompanied by other lung diseases such as emphysema. It is a highly invasive, last-resort treatment. In order to be put on a lung transplant waiting list, a patient has to undergo extensive screening to determine the relative chances of success. Patients who present with pleural effusions, which is excess fluid around the lungs, may undergo a noninvasive surgical procedure called thoracentesis to drain the fluid. 

Some patients also find relief through complementary therapies such as acupuncture, massage therapy and nutritional medicine. While none of these treatments offers a cure for asbestosis, many of them do offer relief from pain and improved pulmonary function.

Lifestyle changes may improve how you feel with asbestosis. For example, quitting smoking will slow progression of the disease. Eating a healthy diet and getting regular exercise and plenty of sleep will help your body cope with the effects of asbestosis, including reduced oxygen intake.

Common Questions About Asbestosis

How long can you live with asbestosis?

Unlike mesothelioma, asbestosis is considered a chronic disease. Patients with an asbestosis diagnosis often live for several decades. However, the disease can be deadly, and many asbestosis patients suffer from severe respiratory issues.

What are the symptoms of asbestosis?

Asbestosis symptoms commonly include:

• High blood pressure
• Shortness of breath
• Chest pain
• Weight loss

What is the difference between asbestosis and mesothelioma?

Mesothelioma is cancer that forms in the mesothelial tissue surrounding the lungs, chest cavity and abdomen. Asbestosis is not cancer, but a chronic respiratory disease and a type of pulmonary fibrosis. Asbestosis and mesothelioma have the same cause as other asbestos-related diseases.

What causes asbestosis?

Asbestosis is caused by years of chronic inflammation and tissue scarring as a result of asbestos fibers lodged in the lungs. The only cause of asbestosis is asbestos exposure. The amount, concentration and type of asbestos all contribute to the risk of developing asbestosis.

Can asbestosis be cured?

There is no cure for asbestosis due to its similarity to pulmonary fibrosis and other chronic respiratory illnesses. Asbestosis treatment options focus on reducing symptoms and improving breathing ability.