Asbestosis is a type of pulmonary fibrosis caused by asbestos exposure typified by excess connective tissue in the lungs. Because the disease manifests in the lungs, common asbestosis symptoms include respiratory problems such as coughing, swelling in the neck or face, cracking sound when breathing, or difficulty swallowing.
Fibrosis usually occurs due to the lungs reacting to and repairing damage to lung tissue over a long period of time; such as, continuous exposure to asbestos fibers. This reparative scar tissue replaces normal lung tissue, and an excess amount of scar tissue can cause reduced pulmonary function.
During exposure, asbestos fibers are inhaled, and they can become lodged in lung tissue. The sharp, straight shape of the fibers makes them difficult for a body to dislodge and expel. Once in a body for a long period, the fibers cause irritation, inflammation and scarring, which cause symptoms that primarily affect the lungs.
In most asbestosis patients, symptoms develop within 20 to 30 years after being exposed to asbestos. If someone is exposed to asbestos for a long time, a decade or more, the latency period of symptom development is shorter: closer to 20 years.
Although the severity and frequency of symptoms can vary among patients at the time of diagnosis, the most common asbestosis symptoms include:
swelling in the neck or face
high blood pressure
blood in sputum
crackling sound when breathing
shortness of breath
loss of weight/appetite
Many of these symptoms can also be associated with pleural mesothelioma, the most common type of mesothelioma. Other conditions that exhibit symptoms similar to asbestosis include lung cancer and pneumonia.
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Lung scarring, or fibrosis, is the direct cause for the coughing and shortness of breath symptoms most commonly associated with asbestosis.
As the lungs become scarred and inflamed over time, their ability to exchange oxygen and carbon dioxide decreases, resulting in a reduction of lung function and subsequent fatigue in patients. In the later stages of asbestosis, the amount of stress placed on the lungs and heart from the lack of proper oxygen can lead to serious lung and/or heart failure.
Shortness of breath arises because of pleural thickening, the thickening of the lining of the lungs, caused by the longtime presence of asbestos fibers, or pleural effusion, the buildup of fluid between the chest wall and the lungs. Effusions can be caused by many conditions (pneumonia, lupus, congestive heart failure) and can stem from inflammation of the lungs. The thickening and effusions constrict movement of the lungs and eventually the heart. At that point, neither organ expands or contracts properly, which leads to shortness of breath and more fluid build up.
Asbestosis can set in motion a cycle of conditions. The disease prevents lungs from fully oxygenating blood, forcing the heart to work harder. As the heart works harder, blood pressure increases. As blood pressure increases, fluid builds up around the heart and lungs, which can lead to swelling in the neck and face, which in turns can lead to difficulty swallowing.
Fluid up can also build up in the abdomen, creating bloating or tenderness, which can lead to a loss of appetite and potential weight loss. In advanced cases, fluid retention, if untreated, will lead to finger deformity, known as clubbing.
Although there is no cure for asbestosis, doctors recommend several treatment options to relieve symptoms, and there are some changes to lifestyle and diet and patients can do to feel better. Some medications are available to help with coughing and pain. Other treatments include the use of inhalers, supplemental oxygen and antibiotics.
Pulmonary rehabilitation is another option. Used in conjunction with medical treatments, pulmonary rehab is considered a long-term approach to helping patients, who are taught new breathing strategies; smarter exercise techniques; and ways to manage stress. Pulmonary rehabilitation can also increase energy levels, strengthen exercise performance and improve overall survival and quality of life.
Because coughing and shortness of breath are the most common symptoms of asbestosis, palliative treatment often aims to reduce these symptoms The pleural effusion that causes many of the symptoms experienced by people with asbestosis, can be treated by using two non-invasive surgeries, a thoracentesis and a pleurodesis.
In severe cases of asbestosis, a doctor may recommend a lung transplant. This surgery typically comes when the patient battles some other condition, such as lung cancer. The one-year survival rate for lung transplant patients is around 80 percent, but the aggressive surgery is often viewed as a last-resort treatment.
To help alleviate some symptoms, patients may alter their lifestyle by quitting smoking or reducing the amount of daily physical activity. Some adjustments in diet also can help, particularly early in the diagnostic process. Slippery elm bark, an herbal supplement, is a natural treatment for coughs and sore throats, and astragalus plays a prominent role in Chinese medicine for treating respiratory functions.
Karen Selby joined Asbestos.com in 2009. She is a registered nurse with a background in oncology and thoracic surgery and was the regional director of a tissue bank before becoming a Patient Advocate at The Mesothelioma Center. Karen has assisted surgeons with thoracic surgeries such as lung resections, lung transplants, pneumonectomies, pleurectomies and wedge resections. She is also a member of the Academy of Oncology Nurse & Patient Navigators. Read More