Written by Sean Marchese, MS, RN | Medically Reviewed By Dr. Andrea Wolf | Edited By Walter Pacheco | Last Update: July 1, 2024

How Is Asbestosis Diagnosed?

Asbestosis is diagnosed through tests to detect lung irregularities and a positive history of asbestos exposure. The cause of asbestosis is inhaling asbestos, but no test can verify exposure. 

Tests to identify asbestosis and other forms of lung fibrosis look for key symptoms, such as strange breathing sounds, scar tissue in the lungs and pleural plaque buildup.

Doctors use the test results, in tandem with your medical history, to make an informed decision regarding your diagnosis. This diagnosis is likely to require several follow-ups to determine the appropriate actions to take, such as a treatment plan.

Testing for Asbestosis

Asbestosis tests focus on obtaining images and metrics regarding the lungs. Their air capacity, scarring and breathing irregularities can all indicate asbestosis.

Testing for Asbestosis. Stethoscope: One of the first tools a doctor will use in the diagnostic process is a stethoscope, which allows them to listen to the lungs. Spirometer: The patient blows into an instrument called a spirometer, which measures how much air the lungs can hold and how well air flows in and out. Chest X-Ray: Scarred lung tissue appears more opaque on an X-ray. In advanced cases of asbestosis, lung tissue may have a honeycomb-like appearance. CT Scan: Doctors use computerized tomography (CT) scanning when X-ray results are unclear.

Doctors usually implement several approaches for testing for asbestosis to ensure a more accurate diagnosis. These tests determine whether a patient’s condition meets the asbestosis diagnosis criteria, so patients should understand the most common methods and what they entail.

Medical History and Physical Examination

First, your doctor will likely review your medical history and conduct a brief physical. Listening to the lungs with the stethoscope can lead to further diagnostic tests. An exam also gives your doctor baseline information to work with, which helps make a more accurate diagnosis. 

Be sure to answer any questions as accurately as possible and inform the doctor of any past exposure to asbestos or diagnoses of conditions such as mesothelioma. Both are factors that could impact your treatment plan, so your doctor needs to know about them upfront.

Imaging Tests

Typically, doctors diagnosing asbestosis will take a chest X-ray, followed by a CT scan if the X-ray results are inconclusive. Imaging tests allow doctors to better assess the state of a patient’s lungs, one of the most important parts of an asbestosis diagnosis. 

The chest X-ray creates an image of your chest cavity and the vital organs inside. Lungs with asbestosis typically appear whiter or more opaque on an X-ray and may have a honeycomb-like appearance in severe cases.

Routine monitoring and initial diagnostic scans often involve CT scans. These create a much more detailed image of the body than X-rays, giving doctors a better idea of what conditions a patient may or may not have. A 2022 study noted the effectiveness of diagnostic computer programs when used in imaging tests, making this method increasingly reliable.

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Pulmonary Function Tests

Pulmonary function tests check how well a patient’s lungs function. Though the results of these tests can’t directly diagnose asbestosis, they provide valuable information. For example, if a patient’s pulmonary function test results are low, and they’ve been exposed to asbestos in the past, a doctor may look further into an asbestosis diagnosis.

Tests may include a lung capacity test, respiratory muscle strength and performance tests for mild cardio such as a 6-minute walk. These allow your doctor to check if your lungs are working as they should or if you are being forced to overwork to compensate for any damage.

Biopsy and Pathology

Lung biopsies are rarely used to diagnose asbestosis but can be a valuable tool. Doctors typically hesitate to perform a lung biopsy because it is invasive, but they will do so as a last resort.

To perform this test, doctors take a small sample of lung tissue and observe it under a microscope. They examine the tissue for any abnormalities, especially the presence of scarring and other signs of asbestos exposure. If an abnormal amount of either is detected, doctors consider the patient’s medical history and the results of previous tests to make their final diagnosis.

Importance of Diagnosing Asbestosis Early

Getting an asbestosis diagnosis as early as possible is crucial because it allows you to begin treatment promptly. Because treating asbestosis is mostly about managing symptoms, the earlier you start treatment, the more effective that treatment will be.

If you know you’ve been exposed to asbestos, we recommend going to regular medical screenings to find abnormalities. Whether or not you think you have asbestosis, screenings can see early signs of this disease and many other dangerous conditions.

Dr. Raja Michael Flores, Chief of Thoracic Surgery

New York, New York

Raja Michael Flores

Pleural Specialist | Thoracic Surgery

Expertise: Pleural Mesothelioma, Pleurectomy and Decortication Surgery, Lung Cancer, VATS, Lobectomy, Thoracotomy and Clinical Research

Languages: English, Spanish

Dr. Jeffrey Velotta, thoracic surgeon

Oakland, California

Jeffrey Velotta

Pleural Specialist | Thoracic Surgery

Expertise: Pleural Mesothelioma, Lung Cancer, Cardiothoracic Surgery, Cardiac Surgery and Surgical Oncology

Languages: English

Dr. Jacques Fontaine, pleural mesothelioma doctor and expert contributor for Asbestos.com

Tampa, Florida

Jacques Fontaine

Pleural Specialist | Thoracic Surgery

Expertise: Pleural Mesothelioma, Lung Cancer, Thoracic Diseases, Minimally Invasive Surgery, Pleurectomy and Decortication Surgery

Languages: English, Spanish, French, Arabic

Regular screenings can identify cancers such as mesothelioma in earlier stages and other interstitial lung abnormalities. Early treatment improves the prognosis for many of these conditions.

Doctors can run critical tests, give important advice, and prescribe the treatment you need to manage your condition and retain a high quality of life. Starting treatment before asbestosis advances maximizes your chances of a positive outcome.

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Grades of Asbestosis Severity

When you are diagnosed with asbestosis, your doctor will assign your condition one of five grades: Grade 0 is the lowest, while grade 4 is the highest. Understanding what each grade means is important because it will affect your treatment.

The 5 Grades of Asbestosis
  • Grade 0: Some scarring in the passageways and air sacs of the lungs, known as bronchioles and alveoli, respectively.
  • Grade 1: Scarring in most of the bronchioles and some of the alveoli.
  • Grade 2: Scarring in most of the bronchioles and alveoli.
  • Grade 3: Extreme scarring throughout the lungs. Some alveoli are destroyed at this point.
  • Grade 4: Scarring has reached such an extreme point that the lungs have a honeycomb-like pattern.

Typically, the amount of scarring in your lungs determines the grade of your asbestosis diagnosis. Advanced scarring indicates a more severe case, which requires a more advanced treatment plan as a result.

Challenges in Diagnosing Asbestosis

Asbestosis is one of the more difficult asbestos-related conditions to diagnose because it is similar to other conditions. While many asbestos-related conditions share symptoms, most have a few strong distinguishing factors. This isn’t the case for asbestosis.

Asbestosis Symptoms Common With Other Lung Diseases
Symptoms Asbestosis Pleurisy Pneumonia COPD Emphysema Mesothelioma
Chest tightness and pain
Clubbing of fingers and toes x x x
Crackling sounds when breathing ✓ (crackling is expected with pleural thickening, which is a sign of mesothelioma)
Fatigue
Loss of weight and appetite
Persistent cough ✓ (dry) ✓ (dry) ✓ (wet) ✓ (typically wet, but can be dry) ✓ (wet) ✓ (dry)
Shortness of breath

As this table demonstrates, the symptoms of asbestosis are shared with many other asbestos-related and lung-related conditions. This means it can go misdiagnosed or entirely undiagnosed for years at a time, presenting a much greater risk when it’s finally discovered. Because of this, you should seek medical attention as soon as you suspect you may have asbestosis and get multiple professional opinions throughout the process.

Survivor Story
Survivor Story
Jerry Cochran Asbestosis Patient

Navy Veteran With Asbestosis Has a Passion for Justice

In 2010, Jerry Cochran was diagnosed with asbestosis after seeing the same doctor who had diagnosed him with silicosis nearly 20 years earlier. He said he struggles to breathe because his lungs can’t expand and contract how they’re supposed to. The paint he scraped off the aircraft carrier all those years ago contained asbestos. Asbestosis is incurable, but many patients survive several decades with treatment.

Read Jerry’s Story

What Should I Do After an Asbestosis Diagnosis?

Receiving an asbestosis diagnosis can be jarring. While the condition is incurable, treatment for asbestosis can help reduce its impact. However, it’s essential to start as early as possible.

The first and most crucial step after receiving an asbestosis diagnosis is to avoid any further asbestos exposure. For example, if you’re working in a field with frequent occupational exposure to asbestos, consider moving to a different position within your company. Once you’re no longer exposed to asbestos, reports show that simple changes such as a healthy diet and a moderate cardio routine can sometimes manage asbestosis symptoms.

When you are diagnosed, discuss treatment and management options with your doctor. Patients who start and follow a suitable treatment plan are often able to live long and fulfilling lives following an asbestosis diagnosis.

Common Questions About Diagnosing Asbestosis

What are the symptoms associated with asbestosis?

Asbestosis has symptoms similar to those of many other lung conditions. Signs can include chest pain, clubbing of fingers and toes, crackling sounds when breathing, fatigue, loss of appetite, sudden weight loss, dry cough and shortness of breath.

What should you do if you think you have asbestosis?

Immediately seek a medical opinion if you suspect you have asbestosis. This is a severe condition, and diagnosing it early is the best way to mitigate some of its effects.

How do doctors test for asbestosis?

Doctors may use imaging tests, pulmonary function tests, or, rarely, lung biopsies to test for asbestosis and other forms of lung scarring. Past asbestos exposure must be present in your medical history to confirm an asbestosis diagnosis.

Why is it essential to get a second opinion?

Because asbestosis is indistinguishable from other forms of pulmonary fibrosis and lung scarring, it can easily be misdiagnosed. Get a second opinion to ensure you have asbestosis rather than a different condition.

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