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Home > Mesothelioma and asbestos > Asbestosis

Asbestosis

Asbestosis is one of the asbestos-related disease. It is a serious lung disease caused when asbestos fibers are inhaled and become lodged in the inner layers of the lungs. Asbestosis is not a type of cancer, and it is different from malignant mesothelioma. Malignant mesothelioma is a type of cancer. When malignant mesothelioma occurs in the lungs, it is called pleural mesothelioma. Some patients do acquire asbestosis and then develop pleural mesothelioma.

Asbestosis and asbestos pleural disease are nonmalignant asbestos diseases that are slowly progressive. They can be severely disabling and potentially fatal. These asbestos diseases cause impairment of pulmonary function, including small airway obstruction, a reduction in lung capacity, breathing restriction, and a reduction in the ability to transfer oxygen from air into the blood. Approximately one in seven people who suffer from asbestosis eventually develop asbestos lung cancer (Asbestos Fact Sheet, Lung Cancer, American Cancer Society).

Asbestosis and asbestos pleural disease are the result of cumulative exposure to asbestos. In individuals who develop these asbestos diseases, every nontrivial occupational exposure to asbestos is significant.

Asbestosis develops over time as the asbestos fibers cause inflammation in the lungs and the development of fibrosis or scar tissue. The diagnosis of asbestosis occurs when the scar tissue becomes large enough to be identified on an x-ray. As the scar tissue expands throughout the lungs, the lungs become increasingly dysfunctional and breathing becomes labored. Asbestosis can lead to disability and death.

Asbestos is a silicate (containing silica) mineral that occurs in a variety of forms; it is characterized by a fibrous structure and resistance to fire.

Causes and symptoms

Occupational exposure is the most common cause of asbestosis, but the condition also strikes people who inhale asbestos fiber or who are exposed to waste products from plants near their homes. Family members can develop the disease as a result of inhaling particles of asbestos dust that cling to workers' clothes.

It is rare for asbestosis to develop in anyone who hasn't been exposed to large amounts of asbestos on a regular basis for at least 10 years. Symptoms of the disease do not usually appear until 15-20 years after initial exposure to asbestos.

The first symptom of asbestosis is usually shortness of breath following exercise or other physical activity. The early stages of the disease are also characterized by a dry cough and a generalized feeling of illness.

As the disease progresses and lung damage increases, shortness of breath occurs even when the patient is at rest. Recurrent respiratory infections and coughing up blood are common. So is swelling of the feet, ankles, or hands. Other symptoms of advanced asbestosis include chest pain, hoarseness, and restless sleep. Patients who have asbestosis often have clubbed (widened and thickened) fingers. Other potential complications include heart failure, collapsed (deflated) lung, and pleurisy (inflammation of the membrane that protects the lung).

Diagnosis

Screening of at-risk workers can reveal lung inflammation and lesions characteristic of asbestosis. Patients' medical histories can identify occupations, hobbies, or other situations likely to involve exposure to asbestos fibers.

X rays can show shadows or spots on the lungs or an indistinct or shaggy outline of the heart that suggests the presence of asbestosis. Blood tests are used to measure concentrations of oxygen and carbon dioxide. Pulmonary function tests can be used to assess a patient's ability to inhale and exhale, and a computed tomography scan (CT) of the lungs can show flat, raised patches associated with advanced asbestosis.

Asbestosis development starts when a person inhales an amphibole. This particle travels deep into the lungs to one of the 300 million gas-exchanging structures called an alveolus. Each alveolus has many cleaning cells called macrophages that eat up any particles that made it down to the alveoli. Unfortunately, the macrophages cannot eat the amphibole because it is too long, but they still try.

In trying to eat this particle the macrophage essentially cuts itself open and the digestive molecules that were contained inside the macrophage have now spilled on the alveolus. These molecules injure the alveolus and cause it to form a scar. This scarring formation is called fibrosis. The same amphibole that could not be eaten attracts other macrophages from neighboring areas. They try to eat the particle and also fail, which further damages the lungs. People who are exposed to asbestos inhale hundreds and thousands of amphiboles, which causes large-scale injury. As a result, major lung damage (fibrosis) develops.

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