For someone to be at risk for developing asbestosis, there has to be a time during their life of consistent and extended exposure to asbestos, often for more than five years. All sources of asbestos exposure should be discussed during the evaluation and if possible, identify the duration, intensity and circumstance under which the exposure occurred.

Any history of asbestos exposure should start with a work history. Most people diagnosed with asbestos-related diseases, including asbestosis, come into contact with the mineral while on the job, so a job history is an important factor. Previous occupations should be questioned.

There is no such thing as an occupation that is most at risk, but several of them are: welders, shipyard workers, miners, insulators, roofers, floor installers, drywall installers and auto mechanics. In addition, those who served in the military are considered high-risk for developing an asbestos-related disease.

Latency – the amount of time between excessive exposure to asbestos and the time someone is confirmed to have the disease – is an integral part of the diagnostic process. If fibrosis is detected within only a few years since exposure, doctors are likely to look at other lung diseases before confirming asbestosis. Depending on the level of exposure, asbestosis usually takes 20 years or more from the time of initial exposure to present symptoms. Although clinical signs of asbestosis development can be seen in imaging scans as early as five years after exposure, such early detection is rare.

An asbestosis diagnosis cannot be confirmed until imaging scans demonstrate structural changes to the lungs. Signs of pleural thickening, pleural effusion and scarring are all indicators that asbestosis may be present.

Even though asbestos exposure may have occurred, it does not mean someone will develop lung problems as a result. Having occupational or environmental history as a probable source for exposure is necessary before asbestosis is even considered. In addition, the presence of pleural plaques or asbestos fibers in the lung tissue is the kind of evidence that often leads to an absolute diagnosis.

To accurately diagnose and confirm asbestosis, one or more tests may be required. Evaluating a series of imaging scans is the most common technique used to diagnose asbestosis.

One of the first tools a doctor will use in the diagnostic process is a stethoscope, which allows them to listen to the lungs. If the lungs are affected, the doctor will likely hear a dry, crackling sound while the patient breathes. After the preliminary physical examination, doctors will perform a range of tests and imaging scans before an asbestosis diagnosis can be confirmed.

Tests for asbestosis will analyze lung function or collect a lung sample for lab testing. A series of imaging scans are also required to detect locations where asbestos fibers have caused scarring of the lungs. While evaluating the results of these imaging scans, an oncologist will look for dark spots or pleural thickening as signs of asbestosis.

Some of the most common tests and imaging scans used to diagnose asbestosis include:

• Pulmonary Function Test: This test, which can be used for people suspected of having asbestosis, determines how well lungs are functioning. It is designed to test the air capacity of the lungs (how much air they can hold) and determine how well air flow is going in and out. The most common way of measuring these functions is by blowing into an instrument called a spirometer. Some reports have indicated the occurrence of abnormal pulmonary function tests in 50 to 60 percent of asbestosis patients. One of the key signs of the disease is a reduction in forced vital capacity, or the most air a patient can force from their lungs after a full inhalation.

• Bronchoscopy: Your doctor may recommend a bronchoscopy, where a thin fiber-optic scope is inserted into the lungs. This procedure is performed to obtain fluid or tissue samples from the lung area. A patient whose diagnosis is difficult to confirm may undergo this procedure so that fluid and tissue samples can be tested to ensure a correct diagnosis.

• Chest X-Ray: Diagnosing asbestosis may also involve undergoing a chest X-ray, which is used to detect any abnormalities present in lung tissue. On an X-ray, scarred lung tissue developing from asbestos exposure appears as dark, opaque areas, meaning light has a difficult time passing through it. In advanced cases of asbestosis in which an entire lung is affected, the area may have a honeycomb-like appearance in the upper lobe. Bilateral interstitial fibrosis, meaning both lungs exhibit fibrosis, may also be present.

• CT Scan: A computerized tomography (CT) scan may be recommended by the doctor to confirm a diagnosis of asbestosis. A CT scan can also be used for screening purposes, as these scans can sometimes detect asbestosis sooner than chest X-rays. In most cases though, a CT scan is used when doctors cannot get a confirmation from a chest radiograph.