Asbestosis is a long-term lung disease caused by inhaling asbestos fibres. Asbestos fibres in the air, when inhaled, get lodged in the lungs. As a consequence, lung tissue becomes scarred, and the lungs lose their ability to expand and contract normally. Asbestosis also increases the likelihood of getting asbestos-related lung cancer and mesothelioma, a rare type of cancer that is nearly always caused by asbestos.
There is no specific medication or treatment for asbestosis that can cure it, and the treatment and management are symptomatic, with a focus on relieving the symptoms and slowing the disease’s progression.
The most common symptoms of asbestosis include:
- A chronic dry cough
- Shortness of breath
- Tightness or pain in the chest
- Dry, crackling sounds from the lungs on inhalation
- Finger and toe tip deformity (becomes wider and rounder than normal, also called clubbing)
To confirm the diagnosis of asbestosis, imaging scans should show lung scarring, and pulmonary function tests should be often abnormal. The patient should also have a past history of exposure to asbestos, with a proper latency period between first exposure and the appearance of symptoms.
In order to diagnose asbestosis, doctors typically perform a physical examination and imaging tests, such as chest X-rays or CT scans.
The most essential tests for determining an asbestos-related disease are:
- Chest radiographs
- Pulmonary function test
Other asbestosis tests and methods used by specialists to diagnose asbestos-related diseases in circumstances that require further investigation include:
- Blood tests
- Bronchoalveolar lavage (BAL)
- Colon cancer screening
- Lung biopsy
- Computed tomography (CT) or high-resolution computerised (axial) tomography (HRCT)
The doctor will start by collecting a thorough medical and work-related history, followed by an extensive physical examination that includes the auscultation of lungs (listening to the lungs with a stethoscope) for high-pitched or crackling sounds that may suggest asbestosis.
Chest radiographs and a CT scan
A chest X-ray is performed to detect any anomalies in the lungs. The presence of excessive whiteness in lung tissue on the X-ray indicates advanced asbestosis. If the asbestosis is extensive, both lungs’ tissue may be damaged, giving a honeycomb appearance on the X-ray.
CT scans generate a cross-sectional picture of the body’s soft tissues and bones by combining a series of X-ray views captured from various angles. These scans typically provide significant details and may help identify asbestosis in its initial stages, even before the disease appears on a chest X-ray.
While reviewing imaging scans, the physician can look for the symptoms of asbestos exposure in the pleural lining (around the lungs). Asbestos inhalation can result in the development of pleural plaques, one of the signs of an asbestosis diagnosis.
Pulmonary function tests
This asbestosis health test consists of a series of breathing manoeuvres that are used to measure the flow of air and air volume in the lungs, allowing the doctor to evaluate the function of the lungs objectively.
During the test, the patient may be instructed to blow as hard as they can into a spirometer, which measures air pressure. More comprehensive pulmonary function tests can determine the amount of oxygen in the bloodstream.
Lung biopsy and BAL
Specialists may use bronchoalveolar lavage (BAL) to rule out other possible causes of lung pathology. It can be used to assess asbestos exposure by determining the quantity and type of asbestos bodies and fibres in lavage fluid. This is not only a somewhat invasive procedure, but these laboratory procedures are not readily available, as special lab facilities and expertise are necessary to perform this test.
A lung biopsy is a confirmatory asbestosis test used to verify asbestos-related diseases. Lung biopsies are very rarely used to make a diagnosis of asbestosis because these conditions are usually diagnosed based on patient medical and exposure histories, physical examination findings, and other tests.
Screening for colon cancer and other blood tests
Asbestos exposure appears to increase a patient’s risk of developing colon cancer. As a result, it is recommended to begin screening for colon cancer in asbestos-exposed patients at the age of 50.
Also, blood tests can sometimes help identify other possible causes of restrictive pulmonary (lung) disease.
It is important to note that asbestosis can take a long time to develop; so, even if you have been exposed to asbestos, it may not show up on a test for a while. It is also important to consult a doctor who specialises in occupational medicine or pulmonology for an asbestosis health test, treatment, and management.