ASBESTOSIS

Asbestosis is a chronic (long-term) lung condition caused by prolonged exposure to asbestos.

Asbestos is a general term referring to a group of minerals made of microscopic fibres. In the past, it was widely used in construction.

Asbestos can be very dangerous. It does not present a health risk if it is undisturbed, but if material containing asbestos is chipped, drilled, broken or allowed to deteriorate, it can release a fine dust that contains asbestos fibres.

When the dust is breathed in, the asbestos fibres enter the lungs and can gradually damage them over time. For asbestosis to develop, prolonged exposure to relatively high numbers of the fibres is necessary. However, it is not the only factor, as many people avoid getting asbestosis, despite heavy exposure.

Symptoms of asbestosis

Breathing in asbestos fibres may eventually scar the lungs of some people, which can lead to a number of symptoms, including:

  • shortness of breath – this may only occur after physical activity at first, but it can eventually become a more constant problem
  • a persistent cough
  • wheezing
  • fatigue (extreme tiredness)
  • chest pain
  • in more advanced cases, clubbed (swollen) fingertips

Nowadays, most people who are diagnosed with asbestosis were exposed many years ago, before there were effective controls on exposure to asbestos fibres in the workplace.

Diagnosing asbestosis 

When diagnosing asbestosis, a detailed history focusing on the symptoms and thorough examination is done. A careful chest examination with the use of a stethoscope is carried out to listen to lung sounds.

If the lungs have been affected by asbestos, a crackling noise will be heard.

Occupational history, particularly exposure to asbestos, will be obtained.

Referral to a specialist

If asbestosis is suspected, referral to a specialist in lung diseases will be done for tests to confirm any lung scarring. These may include:

  • a chest X-ray – to detect abnormalities in the structure of your lungs that could be caused by asbestosis
  • computerised tomography (CT) scan of the lungs – which produces more detailed images of the lungs and the membrane covering the lungs and can help identify less obvious abnormalities
  • lung function tests – to assess the impact of damage of the lungs, determine how much air your lungs can hold and assess how well oxygen crosses the membrane of the lungs into your bloodstream

Before confirming a diagnosis of asbestosis, the chest specialist will also consider and rule out other possible causes of lung inflammation and scarring, such as rheumatoid arthritis.

 

Treating asbestosis 

There is no cure for asbestosis, as the damage to the lungs is irreversible. However, supportive management will improve the quality of life.

These are outlined below.

Smoking cessation

If you have been diagnosed with asbestosis and you smoke, it’s very important to stop as soon as possible.

Smoking can worsen breathlessness and significantly increase risk of developing lung cancer at a later stage.

Vaccinations

Asbestosis can make the lungs more vulnerable to infection.

It’s recommended that to have the influenza (flu) vaccination to protect against flu, and the pneumococcal vaccination to protect you from the bacteria that can cause serious conditions, such aspneumonia.

The flu vaccine is recommended to prevent catching the annual flu. Most people only require one dose of the pneumococcal vaccine, although additional booster shots may be recommended if general health condition is poor.

Long-term oxygen therapy

If asbestosis is severe, the body may not be getting all the oxygen it needs to function properly. Oxygen therapy may be recommended if low oxygenation is evident.

Oxygen therapy is supplied through a machine called an oxygen concentrator, which purifies oxygen from the air in the room and produces a more oxygen-rich supply of air.

This oxygen-rich air is breathed in through a mask or a small, soft plastic tube placed just inside your nostrils (nasal cannula).

A small, portable oxygen tank and mask may be used when out of the house. This is known as ambulatory oxygen.

Smoking should be avoided when using an oxygen concentrator. This is because high concentrations of oxygen are highly flammable, and a lit cigarette or flame could cause a fire or an explosion.

Medication

Most people with asbestosis will not benefit from any specific medication for the condition, unless another condition also affecting the lungs, such as chronic obstructive pulmonary disease (COPD).

More severe cases may benefit from medicines, such as small doses of morphine to reduce breathlessness and a cough.

Serious side effects are uncommon with small doses. The most common side effect is constipation and a laxative will usually be given.

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