Asbestos-Related Diseases

What Diseases Can Be Caused by Asbestos?

There are two major disease types caused by exposure to asbestos: Benign and malignant, or cancerous. Even though some asbestos-related diseases are benign and non-malignant, they still can be life threatening.

The International Agency for Research on Cancer (IARC) notes a definitive link between asbestos exposure and four cancer types plus a possible link with three additional tumor types.

Malignant Asbestos-Related Diseases

Although any amount of exposure can cause asbestos-related cancer, people who have inhaled or ingested large amounts of asbestos for extended periods of time have the highest risk of developing an asbestos-related cancer.

Mesothelioma

A 2017 CDC analysis found that despite decades of asbestos regulations, more than 45,200 people died of mesothelioma in the U.S. between 1999 and 2015. Asbestos exposure remains the No.1 cause of work-related deaths in the world.

Approximately 3,000 people in the U.S. each year are diagnosed with mesothelioma, and on average, the prognosis is poor. Most patients live less than one year from time of diagnosis.

Mesothelioma forms in membranes of body cavities. Tumors can appear on the lining of the lungs, stomach, heart or testes. Respectively, these diseases are known as pleural mesothelioma, peritoneal mesothelioma, pericardial mesothelioma and testicular mesothelioma.

Each type of mesothelioma is associated with a unique set of symptoms, but chest or abdominal pain and shortness of breath affect many patients.

Lung Cancer

Even though asbestos is only responsible for a small portion of all lung cancer diagnoses, lung cancer is still one of the most fatal asbestos-related malignancies. The disease claimed more than 155,870 lives in the U.S. in 2017, according to the National Cancer Institute.

Asbestos-exposed smokers have significantly increased risk of small cell or non-small cell lung cancer above and beyond the risk of lung cancer in smokers without asbestos exposure.

Ovarian Cancer

Researchers confirmed the link between asbestos exposure and ovarian cancer in 2009. The fibers, which have repeatedly been found in the ovaries of asbestos-exposed women, may reach the organs via the bloodstream, lymph system or reproductive tract.

Laryngeal Cancer

Another asbestos-related malignant disease is laryngeal cancer. There is a proven link between this cancer and asbestos exposure, although smoking and heavy alcohol use are more important risk factors for laryngeal cancer.

Bile Duct Cancer

In 2009, results from a research study found an increased rate of bile duct cancer among patients who had sustained occupational or household exposure to asbestos.

Bile ducts connect the gallbladder to the liver and small intestines to deliver enzymes necessary for digestion. Asbestos fibers can become trapped in these tiny tubules.

Intrahepatic cholangiocarcinoma is bile duct cancer that is present within the liver. In a study published in 2020, 40% of ICC patients reported asbestos exposure as their only risk factor. ICC incidence and mortality are rising worldwide, and a link to asbestos exposure may explain this increase.

Other Asbestos-Related Cancers

Other cancers possibly associated with asbestos exposure include esophageal cancer, gallbladder cancer, kidney cancer and throat cancer.

However, studies on the connection between asbestos and these malignant tumors are inconsistent. Asbestos is a suspected contributor to risk, but the link is not definitively established.

Benign Asbestos-Related Diseases

Benign asbestos-related diseases are somewhat more common than asbestos-related malignancies.

This difference in prevalence may be due to differences in exposure intensity needed to cause each condition. Both benign and malignant diseases may develop after just one exposure, but malignant conditions typically result from years of cumulative exposure.

Asbestosis

Asbestosis is a chronic lung disease caused by exposure to asbestos fibers. While the lung disease is not cancer, it is potentially deadly and characterized by lung scarring and inflammation. Asbestosis prevents the lungs from expanding and relaxing normally, leading to symptoms such as shortness of breath and chest tightness.

Asbestosis is an interstitial lung disease (ILD). Other contributors to ILD include exposure to silica dust, coal dust, cotton dust, hard metal dusts and diseases such as lupus, rheumatoid arthritis, sarcoidosis and other connective tissue and blood disorders.

Even though it is benign, asbestosis can be extremely serious. For seven of the eight years between 2000 and 2007, asbestosis was an underlying or contributing cause of death for more than 1,400 people in the United States.

According to a 2018 study published in the journal NPJ Primary Care Respiratory Medicine, asbestosis is prevalent in a wide range of construction jobs such as carpentry, pipefitting, lagging and painting.

Pleural Effusions

Pleural effusions are a buildup of fluid between the layers of the pleural membrane. It collects in the chest cavity, between the lung and the ribs, leading to a compression of the lung, causing shortness of breath. Effusions can develop independently of other asbestos-related disease but often are a symptom of late-stage mesothelioma or nonmesothelioma cancers.

On their own, pleural effusions are not immediately life-threatening. Over time, they may cause pain and interfere with breathing. Even after the fluid is drained, it is likely to recur unless a procedure called a pleurodesis is performed. A pleurodesis causes the pleural membranes to stick together, making the lung stick to the chest wall and preventing a space to form for the liquid to accumulate.

Even after pleurodesis, fluids can still accumulate around the lung in the chest cavity if the membranes surrounding the lungs did not sufficiently stick together.

Peritoneal Effusions

Peritoneal effusion refers to an excess collection of fluid in the abdominal cavity. This condition also may be referred to as ascites and can be treated by removing the fluids.

Similar to pleural effusions, if the underlying contributor to fluid accumulation is not addressed, the condition can recur.

Peritoneal mesothelioma is a rare cause of the condition and effusions are more likely linked with benign conditions or other cancer types.

Pericardial Effusions

Pericardial effusion is the accumulation of excess fluid between the layers of the membrane surrounding the heart. This condition leads to significant shortness of breath and chest pain.

While treatments to remove the fluid are available, pericardial effusion is often a sign of a very serious underlying health issue, such as pericardial mesothelioma. However, benign diseases, including viral infections, can cause it as well.

Pleural Plaques

Pleural plaques occur frequently after asbestos exposure. These calcified buildups on the pleural membrane are not considered a serious health issue, but they can make breathing painful if they become very thick.

There is disagreement among experts regarding whether plaques directly lead to cancer or are simply a marker of previous asbestos exposure, with the exposure as the true cause of mesothelioma.

Pleuritis

Asbestos fibers cause inflammation of the pleura, known as pleuritis, pleurisy or pleuritic chest pain. The inflamed surfaces become rough and rub against each other, causing sharp pain in the chest or shoulder.

The pain is often worse when the patient is breathing, coughing or moving. Pleurisy may be accompanied by pleural effusions.

Diffuse Pleural Thickening

Asbestos exposure can cause diffuse pleural thickening, which results from lesions forming on the pleural lining. Depending on the diagnostic standard being used, diffuse pleural thickening is diagnosed when between 8 centimeters and one-quarter of the pleura are affected.

This condition may decrease lung function. In rare cases, it becomes severe enough to prevent adequate airflow to the lungs, contributing to death.

Atelactasis

Atelactasis is an underinflation of the lungs upon inhalation. Atelectasis, or partial collapse of the lung, may be secondary to multiple other causes. By itself, it is rarely associated with asbestos exposure. However, in rare instances, it is an asbestos-associated disorder and may be called asbestos psuedotumor or Blesovsky syndrome.

It is an uncommon asbestos-related condition and may accompany pleural thickening. Although it is benign, atelectasis may look like cancer on an imaging scan. Doctors may request a biopsy or a repeat scan with a “breath-hold” to have the lungs fully inflated to differentiate this benign condition from asbestos-related cancers.

COPD

Asbestos exposure does not directly cause Chronic Obstructive Pulmonary Disease (COPD), but it can increase a person’s risk of developing the condition. COPD may weaken the lungs, making a person more susceptible to additional asbestos-related diseases.

In some cases, patients may develop benign COPD-type illnesses and malignant cancers. Anyone who has been exposed to asbestos should participate in regular screenings for the rest of their life to ensure timely diagnosis of all pulmonary and asbestos-related conditions.