Asbestosis is an incurable lung disease caused by repeated exposure to asbestos dust.
A naturally occurring fibrous mineral, asbestos was once used in a wide variety of industrial products and building materials. Workers in industries with heavy asbestos exposure have been at the greatest risk for developing asbestosis later in life. It can take more than ten years for disease symptoms to appear.
Disease Process
Asbestos fibers are very thin and needle-like. When asbestos is handled or processed, tiny bits of these fibers break off and float in the air as dust where they can be breathed into the lungs.
In the lungs, the fibers work their way into the alveoli – the small air sacs where the blood absorbs oxygen through very thin cell walls. When an asbestos fiber becomes lodged in the alveoli and penetrates its cell wall, the body’s immune system launches an attack on the foreign matter.
Macrophages, tiny cells designed to surround and digest invading bacteria, try to consume the fiber. But because the mineral fiber is too large and chemical resistant, the macrophage self-destructs and its digestive compounds are released into the alveoli, permanently damaging it. As more and more alveoli are damaged in this process, lung function begins to decrease and symptoms appear.
Symptoms of Asbestosis
When exposure to asbestos stops, progression of the disease also stops. Persons whose exposure was limited may suffer few noticeable symptoms from the minimal damage caused by the fibers. Others may experience a progression of the following symptoms based on the severity of lung scarring.
- Shortness of breath during physical activity (in the early stages)
- Shortness of breath at rest (in the advanced stages)
- A persistent, dry cough
- Tightness in the chest
- Chest pain
Some sufferers may also exhibit clubbing of the fingers. This condition, caused by a lack of oxygen in the blood, causes the flesh under the fingernail to thicken, resulting in a nail that curves downward in an inverted spoon-shape.
Diagnosis
Asbestosis symptoms can be very similar to the symptoms of other lung diseases. An accurate diagnosis usually depends on a reported exposure to asbestos.
On examination with a stethoscope, the asbestosis patient’s lungs typically produce a dry, crackling sound. X-rays or CT scans can show scar tissue and plaques revealing the extent of the lung damage. The doctor may also order pulmonary function testing (breathing tests) to determine how severely normal physical activity is affected.
Asbestosis Treatment
Stopping all exposure to asbestos is the first imperative. The disease does not progress once exposure ends. Then the primary aim of treatment is to aid breathing and prevent respiratory infections.
For smokers, quitting smoking is also important for two reasons. The first is that smoking inflicts continuing damage on lungs that are already compromised, leading to increasingly severe breathing problems sooner. Second, studies have shown that smokers who have been exposed to asbestos are many more times likely to develop lung cancer than other smokers.
Flu vaccinations are recommended, as well as prompt treatment for cold, flu, or other respiratory conditions.
Depending on the severity of the condition, the doctor may also prescribe various medications to improve breathing. In the most advanced cases, supplemental oxygen may be necessary.
In some cases, after doing their damage to the alveoli, the asbestos fibers can continue working their way through the lungs into the lining around the lungs. This may cause fluid build-up around the lungs, causing pain and difficulty breathing. It may be necessary to remove the fluid using a needle in a procedure called thoracentesis.
A few of the severest cases have required lung transplants.
Complications of Asbestosis
- High Blood Pressure. Scar tissue in the lungs can lead to high blood pressure in the pulmonary arteries (pulmonary hypertension), which in turn can lead to heart damage. Hypertension is treated with blood pressure lowering and blood thinning medications.
- Lung Cancer. Asbestosis sufferers – most especially those who smoke – are at risk for also developing lung cancer.
- Mesothelioma. Prolonged exposure to asbestos also puts asbestosis sufferers at risk for developing mesothelioma – an asbestos-caused cancer of the lining surrounding the lungs, heart, or abdominal organs. Mesothelioma may develop many years after the symptoms of asbestosis appear.
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