Asbestosis is a chronic lung condition that develops in individuals who inhale asbestos fibres and dust over time. Asbestos is a naturally occurring mineral that crystallises into tiny, long-lasting fibres.
Asbestos fibres and dust can cause fibrosis (scarring) if they enter the lungs. Asbestos can also thicken the membranes that surround the lungs (the pleura). This thickening and scarring of lung tissue can make it difficult to breathe.
In some cases, the asbestosis disease can cause life-threatening complications such as lung cancer and heart failure.
What causes asbestosis?
The primary cause of asbestosis is exposure to asbestos. Asbestos is a naturally occurring mineral that was widely used in building materials, insulation, and other products due to its flame-retardant properties. Asbestos fibres are tiny and can easily become airborne when disturbed, making it easy for individuals to inhale them. When asbestos fibres are inhaled, they can become lodged in the lungs, causing inflammation and scarring. This scarring, known as fibrosis, can make it difficult for the lungs to expand and contract, leading to symptoms such as shortness of breath.
The risk of developing asbestosis increases with the amount and duration of asbestos exposure. Individuals who have worked in industries that involve the mining, manufacturing, or utilisation of asbestos are at the highest risk of developing asbestosis. These industries include construction, shipbuilding, and textile manufacturing. Individuals who have worked in these industries in the past, particularly before regulations were put in place to limit exposure to asbestos, are at an increased risk of developing asbestosis.
Smoking also increases the risk of developing asbestosis as well as lung cancer and mesothelioma in people who have been exposed to asbestos. Smokers who have been exposed to asbestos are at a much higher risk of developing lung cancer than non-smokers who have been exposed to asbestos.
Symptoms of Asbestosis
The symptoms of asbestosis typically develop gradually over time and may not become apparent until many years after exposure to asbestos. Common symptoms of this condition include:
- Chronic dry cough
- Shortness of breath
- Tightness or pain in the chest
- Weight loss as a result of appetite loss
- Fingertips and toes that are rounder and wider than normal (clubbing)
- While breathing, a dry and crackling sound in the lungs
What are the causes of asbestosis?
Lung fibrosis, or scarring, is the main cause of the shortness of breath and coughing―the most common asbestosis symptoms.
The capacity of the lungs to exchange carbon dioxide and oxygen decreases over time as they become inflamed and scarred, which results in decreased lung function and fatigue in patients. The amount of strain put on the lungs and heart by a lack of proper oxygen in the later phase of asbestosis can lead to lung and/or heart failure.
Shortness of breath is induced by pleural thickening (thickening of the lining of the lungs) as a result of long-term exposure to asbestos fibres or pleural effusion (accumulation of fluid between the lungs and chest wall). This effusion can be attributed to various other conditions, including pneumonia, lupus, and congestive heart failure. This thickening and effusion restrict pulmonary and cardiac movement, resulting in shortness of breath and increased fluid build-up.
Asbestosis can act as a trigger for various conditions. The disease prevents the lungs from completely oxygenating the blood, thus putting additional strain on the heart. Blood pressure rises when the heart works harder than normal. As blood pressure rises, fluid accumulates around the lungs and heart, causing swelling in the face and neck and, in turn, difficulty swallowing.
Fluids can also accumulate in the abdomen, causing bloating or tenderness and potentially leading to weight loss. If left untreated, the advanced cases of fluid retention will result in clubbing, a finger deformity.
Diagnosis & Testing of Asbestosis
A doctor diagnoses asbestosis using a variety of tests and assessments. These may include:
- Medical history
- Physical examination
- Simple breathing tests
- Work history (to evaluate the risks of exposure to asbestos while working)
A chest X-ray may show early signs of asbestosis and asbestos-associated lung diseases, enabling the most effective treatments to begin before symptoms become severe. It is important to note that doctors primarily use chest X-rays to screen for a lung disease because they cannot detect asbestos fibres in the lungs.
A biopsy may also be performed by a doctor to detect asbestos fibres in lung tissue samples. They cannot, however, use this procedure to determine the amount of asbestos in the lungs or to estimate if an asbestos-related disease will develop in the future.
Treatment for Asbestosis
When asbestos fibres get into the lungs, they cause inflammation and, eventually, scarring. They are also carcinogenic, which means they cause cancer. Once the fibres enter the lungs, they cannot be removed.
There is no cure for asbestosis, and its treatment is typically focused on managing the symptoms and slowing the progression of the disease.
A person can take steps to ease their symptoms and enhance their quality of life. These steps include:
- Stop smoking: While smoking increases the risk of developing lung cancer, it can also exacerbate other symptoms of asbestosis.
- Oxygen therapy: Breathing oxygen-rich air from a device or tank may help relieve shortness of breath.
- Pulmonary rehabilitation: When combined with medical advice, this exercise programme can help relieve symptoms.
Complications in Asbestosis
Asbestosis patients are also highly likely to develop other serious diseases. Moreover, asbestosis is associated with an increased risk of lung cancer and mesothelioma, a rare cancer of the lining of the chest and abdominal cavities. Individuals with asbestosis should be screened for these conditions on a regular basis.