Agency for Toxic Substances and Disease Registry
Case Studies in Environmental Medicine (CSEM) 

Asbestos Toxicity
What Instructions Should Be Given to Patients?

Learning Objective

Upon completion of this section, you should be able to

• list four instructions for patient self-care and two instructions for clinical follow-up.

Introduction

Patients with a history of asbestos exposure will vary widely in their clinical condition. Some will be asymptomatic and will continue to be so for life. Some will be beginning to show signs of asbestos-associated disease, and others will have more established disease. The care you provide will depend on the clinical status of the patient. All patients exposed to asbestos, however, need some basic guidance on

• self-care, so they can minimize further risks and avoid complications to the extent possible
• clinical follow up, so they understand when and why to return for further medical attention

Self Care

Patients should be advised to avoid exposures and conditions that might further increase their risk of disease or worsen their existing condition (see table).

If the patient smokes, advice them to stop smoking and provide advice on smoking cessation. All patients should avoid exposure to second-hand smoke.

Smoking decreases lung defenses, dramatically increases risk of lung cancer in case of asbestos exposure, and worsens effects of asbestosis.

Avoid exposure to respiratory irritants, such as air pollution, dusts, and fumes.

These irritants can worsen breathing problems.

Avoid exposure to respiratory infections.

Respiratory infections can be very serious in people with asbestos-associated respiratory conditions.

Clinical Follow Up

Patients should be advised to consult their physicians if they have

• any sign or symptom of respiratory infection
• signs or symptoms of other health changes (especially those possibly related to an asbestos-associated disease).

ATSDR’s patient education sheet on asbestos toxicity has a more detailed checklist that you can use to determine which types of follow-up are relevant for a given patient.

Key Points

Counsel patients as follows:

• if smoking, patients should stop
• avoid other respiratory irritants
• avoid exposure to respiratory infections
• contact their physician if you have a respiratory infection or other health changes
• use the patient education sheet and prescribed follow up check list on asbestos toxicity at http://www.atsdr.cdc.gov/csem/asbestos/pated_sheet.html

Progress Check