What Are Asbestos-Related Lung Diseases?
Asbestos-related lung diseases are diseases that
develop from exposure to asbestos (as-BES-tos) fibers. Asbestos is a mineral
that, at one time, was widely used in many industries.
Asbestos is made up of tiny fibers that can escape
into the air. When breathed in, these fibers can stay in your lungs for a long
time. If the fibers build up in your lungs, they can lead to:
- Pleural plaque. In this condition, the tissue
around the lungs and diaphragm (the muscle below your lungs) thickens and
hardens. This tissue is called the pleura. Pleural plaque usually causes no
symptoms. Rarely, as the pleura thickens, it can trap and compress part of the
lung. This may show up as a mass on an x-ray image.
- Pleural
effusion. In this condition, excess fluid builds up in the pleural space.
The pleural space is the area between the lungs and the chest wall.
- Asbestosis (as-bes-TO-sis). In this condition, the lung tissue
becomes scarred. People who have asbestosis are at greater risk for lung
cancer, especially if they smoke.
- Lung cancer. This type of cancer forms in the lung tissue,
usually in the cells lining the air passages.
- Mesothelioma (MEZ-o-thee-lee-O-ma). This disease is cancer of
the pleura.
Asbestos also can cause cancer in the lining of the
abdominal cavity. This lining is known as the peritoneum (PER-ih-to-NE-um).
Asbestos-Related Lung Diseases
Figure A shows the location of the
lungs, airways, pleura, and diaphragm. Figure B shows lungs with
asbestos-related diseases, including pleural plaque, lung cancer, asbestosis,
plaque on the diaphragm, and mesothelioma.
Overview
Until the 1970s, asbestos was widely used in many
industries in the United States. For example, it was used to insulate pipes,
boilers, and ships; make brakes; strengthen cement; and fireproof many
materials, such as drywall.
People who worked around asbestos during that time
are at risk for asbestos-related lung diseases. People at highest risk for
these diseases include:
- Unprotected workers who made, installed, or
removed products containing asbestos. People who worked near those who did
these jobs also are at risk.
- Family members of workers who were exposed to
asbestos. Family members may have breathed in asbestos fibers that workers
brought home on their clothes, shoes, or bodies.
- People who lived in areas with large deposits of
asbestos in the soil. However, this risk is limited to areas where the deposits
were disturbed and asbestos fibers escaped into the air.
Asbestos fibers also can be released into the air
when older buildings containing asbestos-made products are destroyed. Removing
these products during building renovations also can release asbestos fibers
into the air.
Generally, being around asbestos-made products
isnt a danger as long as the asbestos is enclosed. This prevents the
fibers from escaping into the air.
Now, people in the United States are less likely to
develop asbestos-related lung diseases because the mineral is no longer widely
used.
The use of asbestos is heavily restricted, and rules
and standards are now in place to protect workers and others from asbestos
exposure. Asbestos is found in only a few new products, such as gaskets used in
brakes.
However, many countries do not yet restrict asbestos
use, and people in those places are still exposed.
Outlook
The outlook for people who have asbestos-related
lung diseases can vary. Their outlook will depend on which disease they have
and how much it has damaged their lungs.
No treatments can reverse the effects of asbestos on
your lungs. However, treatments may help relieve symptoms, slow the progress of
the disease, and prevent complications.
If you've been exposed to asbestos, let your doctor
know. He or she can watch you for signs of asbestos-related problems and start
treatment early, if needed. Early treatment may help prevent or delay
complications.
Quitting smoking and making other lifestyle changes
can help prevent certain complications in people who are at high risk for
asbestos-related lung diseases. These lifestyle changes may prevent more
serious disease, including cancer.
Other Names for Asbestos-Related Lung Diseases
Other names for asbestos-related pleural diseases
include:
Other names for
asbestosis include:
- Fibrotic lung disease
- Pneumoconiosis (NOO-mo-ko-ne-O-sis)
- Interstitial (in-ter-STISH-al) pulmonary
fibrosis
Other names for
lung cancer include:
- Small cell lung carcinoma (kar-si-NO-ma)
- Nonsmall cell lung carcinoma
Another name for
mesothelioma is cancer of the lining of the lung.
What Causes Asbestos-Related Lung Diseases?
Significant exposure to asbestos fibers causes
asbestos-related lung diseases. "Significant" usually means you were exposed
for at least several months to visible dust from the fibers.
Asbestos fibers are very tiny. When you breathe them
in, they can get stuck deep in your lungs. The fibers remain in your lung
tissue for a long time and may cause scarring and inflammation. This can lead
to pleural plaque and widespread pleural thickening,
pleural
effusion,
asbestosis,
lung cancer, or
mesothelioma.
Generally, asbestos-related lung diseases develop 10
to 40 or more years after a person has been exposed to asbestos.
Being around products that contain asbestos isn't a
danger, as long as the asbestos is enclosed. This prevents the fibers from
escaping into the air.
Who Is At Risk for Asbestos-Related Lung
Diseases?
Until the late 1970s, asbestos was widely used in
many industries in the United States. During that time, workplace rules to
ensure workers' safety around asbestos weren't required by law.
Asbestos was used in or with many products. Examples
include steam pipes, boilers, furnaces, and furnace ducts; wallboard; floor and
ceiling tiles; wood-burning stoves and gas fireplaces; car brakes, clutches,
and gaskets; railroad engines; roofing and shingles; and wall-patching
materials and paints.
Asbestos also was used in various other items, such
as fireproof gloves, ironing board covers, cooking pot handles, and hairdryers.
Anyone employed for a prolonged period in mining,
milling, making, or installing asbestos products before the late 1970s is at
risk for asbestos-related lung diseases. Some examples of these workers
include:
- Miners
- Aircraft and auto mechanics
- Building construction workers
- Electricians
- Shipyard workers
- Boiler operators
- Building engineers
- Railroad workers
In general, the risk is greatest for people who
worked with asbestos and were exposed for at least several months to visible
dust from asbestos fibers. The risk for asbestos-related lung diseases also
depends on:
- How much asbestos you were exposed to.
- How long you were exposed to asbestos, and how
often during that time you were in direct contact with it.
- The size, shape, and chemical makeup of the
asbestos fibers. Different types of asbestos fibers can affect the lungs
differently. For example, chrysotile asbestosa curly fiberis less
likely to cause
mesothelioma than amphibole asbestos, a straight fiber.
- Your individual risks, such as smoking or
existing lung diseases.
Family members of people exposed to asbestos on the
job also may be at risk. Family members may have breathed in asbestos fibers
that were brought home on workers clothes, shoes, and bodies.
People who live in areas that have large deposits of
asbestos in the soil also are at risk for asbestos-related lung diseases.
However, this risk is limited to areas where the deposits were disturbed and
asbestos fibers escaped into the air.
Asbestos fibers also can be released into the air
when older buildings containing asbestos-made products are destroyed. Removing
the products, such as during a building renovation, also can release asbestos
fibers into the air.
Generally, being around asbestos-made products
isnt a danger as long as the asbestos is enclosed. This prevents the
fibers from escaping into the air.
Today, people in the United States are less likely
to develop asbestos-related lung diseases because the mineral is no longer
widely used. Also, where asbestos is still used, rules and standards are now in
place to protect workers and others from asbestos exposure.
What Are the Signs and Symptoms of Asbestos-Related
Lung Diseases?
The signs and symptoms of asbestos-related lung
diseases vary. They depend on the disease and how much lung damage has
occurred. Signs and symptoms may not appear for 10 to 40 or more years after
exposure to asbestos.
If you have pleural plaque, you may not have any
signs or symptoms.
Pleural
effusion may cause pain in the chest on one side. Both conditions often are
found with a
chest
x ray. These conditions may occur earlier than other asbestos-related lung
diseases.
The main symptom of
asbestosis is shortness of breath with physical exertion. You
also may have a dry cough and feel tired. If your doctor listens to your lungs
with a stethoscope, he or she may hear a crackling sound when you breathe
in.
The symptoms of
lung cancer may include a worsening cough or a cough that
won't go away, trouble breathing, ongoing chest pain, and coughing up blood.
Other symptoms of lung cancer include frequent lung infections, fatigue
(tiredness), and weight loss without a known cause.
Symptoms of
mesothelioma include shortness of breath and chest pain due to
pleural effusion.
How Are Asbestos-Related Lung Diseases
Diagnosed?
Your doctor will diagnose an asbestos-related lung
disease based on your past exposure to asbestos, your symptoms, a physical
exam, and the results from tests.
Specialists Involved
Your primary care doctor, such as a family doctor or
internist, may think youre at risk for or have an asbestos-related lung
disease and provide ongoing care. Other specialists also may be involved in
your care, including a:
- Pulmonologist. This is a doctor who specializes
in diagnosing and treating lung diseases.
- Radiologist. This is a doctor who is specially
trained to supervise x-ray tests and look at x-ray pictures.
- Surgeon or medical oncologist. A medical
oncologist is a doctor who specializes in diagnosing and treating cancer. The
surgeon or oncologist may take a tissue sample from you to study under a
microscope.
- Pathologist. A pathologist is a doctor who
specializes in identifying diseases by studying cells and tissues under a
microscope. A pathologist may study your tissue sample.
Exposure to Asbestos
Your doctor will want to know about your history of
asbestos exposure. He or she may ask about your work history and your spouse's
or other family members work histories.
Your doctor also may ask about your location and
surroundings. For example, he or she may ask about areas of the country where
you've lived.
If you know you were exposed to asbestos, your
doctor may ask questions to find out:
- How much asbestos you were exposed to. For
example, were you surrounded by visible asbestos dust?
- How long you were exposed to asbestos and how
often during that time you were in direct contact with it.
Symptoms
Your doctor may ask whether you have any symptoms,
such as shortness of breath or cough. The symptoms of asbestos-related lung
diseases vary, depending on the disease and how much lung damage has occurred.
Your doctor also may ask whether you smoke. Smoking,
along with asbestos exposure, raises your risk for lung cancer.
Physical Exam
Your doctor will listen to your breathing with a
stethoscope to find out whether your lungs are making any strange sounds.
If you have a
pleural
effusion with a lot of fluid buildup, your doctor might hear a dull sound
when he or she taps on your chest. Or, he or she might have trouble hearing any
breathing sounds. If you have
asbestosis, your doctor may hear a crackling sound when you
breathe in.
Your doctor will check your legs for swelling, which
may be a sign of lung-related problems. He or she also will check your fingers
for clubbing. Clubbing is the widening and rounding of the tips of your fingers
and toes.
Clubbing most often is linked to heart and lung
diseases that cause lower-than-normal blood oxygen levels.
Chest X Ray
Chest
x ray is the most common test for detecting asbestos-related lung diseases.
A chest x ray is a painless test that creates pictures of the structures inside
your chest, including the lungs.
A chest x ray cant detect asbestos fibers in
the lungs. However, it can show asbestos-related diseases, such as pleural
plaque and pleural effusion. Pleural effusion also can be a sign of more severe
disease, such as
mesothelioma.
A chest x ray also can show asbestosis. Often the
lung tissue will appear very white. The size, shape, location, and degree of
whiteness can help your doctor figure out how much lung damage you have. Severe
asbestosis may affect the whole lung and have a honeycomb look on the x-ray
pictures.
If you have
lung cancer, a chest x ray may show masses or abnormal
fluid.
If you have mesothelioma, a chest x ray will show
thickening of the pleura. The pleura is the tissue around the lungs and
diaphragm (the muscle below your lungs). The chest x ray also will usually show
signs of pleural effusion in people who have mesothelioma.
Other Diagnostic Tests
To help confirm a chest x-ray finding or to find out
how much lung damage you have, you may have more tests.
Chest Computed Tomography Scan
A chest computed tomography (to-MOG-ra-fee) scan, or
chest
CT scan, is a painless test that creates precise images of the structures
inside your chest, such as your lungs. A CT scan is a type of x ray, but its
pictures show more detail than standard chest x ray pictures.
For asbestos-related lung diseases, a chest CT scan
can give doctors more precise information about the condition of your lungs.
This may be very helpful for finding asbestosis in its earliest stages, before
a standard chest x ray can detect it.
Lung Function Tests
Lung
function tests measure the size of your lungs, how much air you can breathe
in and out, how fast you can breathe air out, how well your lungs deliver
oxygen to your blood, and how much oxygen is in your blood.
These tests can show whether your lung function is
impaired. They also can help your doctor track your disease over time.
Biopsy
The only way to confirm a diagnosis of lung cancer
or mesothelioma is for a pathologist to check samples of your cells or tissues.
A pathologist is a doctor who identifies diseases by studying cells and tissues
under a microscope.
There are many ways to collect tissue samples. One
way is through
bronchoscopy
(bron-KOS-ko-pee). For this procedure, your doctor will pass a thin, flexible
tube through your nose (or sometimes your mouth), down your throat, and into
the airways. He or she will then take a sample of tissue from your lungs.
If mesothelioma is suspected, you may have a
thoracoscopy (thor-a-KOS-ko-pee). For this procedure, you'll have anesthesia so
you don't feel any pain. Your doctor will make a small cut through your chest
wall.
He or she will put a thin tube with a light on it
into your chest between two ribs. This allows your doctor to see inside your
chest and get tissue samples.
How Are Asbestos-Related Lung Diseases
Treated?
No treatments can reverse the effects of asbestos on
your lungs. However, treatments may help relieve symptoms and prevent or delay
complications. If you have lung cancer, treatments may help slow the progress
of the disease.
Treatments for Pleural Plaque, Pleural Effusion,
and Asbestosis
If you have pleural plaque,
pleural
effusion, or
asbestosis and you smoke, your doctor will advise you to quit
smoking. People who have these conditions can lower their risk for
lung cancer if they quit smoking.
If you have trouble breathing or shortness of breath
and a very low blood oxygen level, your doctor may recommend oxygen therapy.
For this treatment, you're given oxygen through nasal prongs. Oxygen therapy
may be done at home or in a hospital or other health facility.
If excess fluid around the lungs (pleural effusion)
is making it hard for you to breathe, your doctor may do a procedure called
thoracentesis
(THOR-a-sen-TE-sis).
For this procedure, your doctor will insert a thin
needle or plastic tube into the space between your lungs and chest wall. He or
she will then draw out the excess fluid.
Treatments for Lung Cancer and Mesothelioma
If you have lung cancer or
mesothelioma, your treatment may include surgery,
chemotherapy, radiation therapy, targeted therapy, or a combination of these
treatments.
Targeted therapy uses medicines or other substances
to find and attack specific lung cancer cells without harming normal cells.
You also may be treated with medicines to prevent
fluid buildup, ease pain, or relieve other complications of your disease.
If you have lung cancer or mesothelioma, talk to
your doctor about whether you should get flu and pneumonia vaccines. These
vaccines can help lower your risk for lung infections.
How Can Asbestos-Related Lung Diseases Be
Prevented?
You can prevent asbestos-related lung diseases by
limiting your exposure to asbestos fibers. If your job requires you to work
around asbestos, make sure to follow workplace rules for handling it. For
example, make sure that air levels are measured and that you wear the proper
respirator to avoid breathing in asbestos fibers.
If you live in a house or work in a building that
has pipes or other products containing asbestos, you generally dont need
to take special precautions.
Being around products that contain asbestos
isnt a danger, as long as the asbestos is enclosed. This prevents the
fibers from escaping into the air.
If you smoke, quit. Smoking greatly increases your
risk for
lung cancer if you have pleural plaque,
pleural
effusion, or
asbestosis.
Talk to your doctor about programs and products that
can help you quit smoking. Also, try to avoid secondhand smoke.
Living With Asbestos-Related Lung Diseases
The outlook for people who have asbestos-related
lung diseases varies. It will depend on which disease they have and how much it
has damaged their lungs.
No treatments can reverse the effects of asbestos on
your lungs. However, treatments may help relieve symptoms and prevent
complications. If you have
lung cancer, treatments may help slow the progress of the
disease.
Ongoing Care
If you have an asbestos-related lung disease, you'll
need routine followup care for the rest of your life. This may include
chest
x rays and
lung
function tests every 3 to 5 years.
Follow your treatment plan as your doctor
prescribes. Call your doctor if you notice new or worsening symptoms. Talk to
your doctor about whether you should get flu and
pneumonia
vaccines. These vaccines can help lower your risk for lung infections. Avoiding
lung infections can help prevent other, more serious complications.
If you smoke, quit. Smoking raises your risk for
lung cancer if you have pleural plaque,
pleural
effusion, or
asbestosis.
Talk to your doctor about programs and products that
can help you quit smoking. Also, try to avoid secondhand smoke.
Emotional Issues and Support
Living with an asbestos-related lung disease may
cause fear, anxiety, depression, and stress. It's important to talk about how
you feel with your health care team. Talking to a professional counselor also
can help. If you're feeling very depressed, your health care team or counselor
may prescribe medicines to make you feel better.
Joining a patient support group may help you adjust
to living with an asbestos-related lung disease. You can see how other people
who have the same symptoms have coped with them. Talk to your doctor about
local support groups or check with an area medical center.
Support from family and friends also can help
relieve stress and anxiety. Let your loved ones know how you feel and what they
can do to help you.
Key Points
- Asbestos-related lung diseases are diseases that
develop from exposure to asbestos fibers. Asbestos is a mineral that, at one
time, was widely used in many industries.
- Asbestos is made up of tiny fibers that can
escape into the air. When breathed in, these fibers can build up in your lungs
and lead to pleural plaque,
pleural
effusion,
asbestosis,
lung cancer, and
mesothelioma.
- Significant exposure to asbestos fibers causes
asbestos-related lung diseases. "Significant" usually means you were exposed
for at least several months to visible dust from the fibers. Generally,
asbestos-related lung diseases develop 10 to 40 or more years after a person
has been exposed to asbestos.
- Until the late 1970s, asbestos was widely used in
many industries in the United States. Anyone employed for a prolonged period in
mining, milling, making, or installing asbestos products before the late 1970s
is at risk for asbestos-related lung diseases.
- In general, the risk is greatest for people who
worked with asbestos and were exposed for at least several months to visible
dust from asbestos fibers. People who worked near those who did these jobs (for
example in shipyards or construction sites) also are at risk. Family members of
workers exposed to asbestos on the job also are at risk.
- People who live in areas that have large deposits
of asbestos in the soil also are at risk if the deposits were disturbed and
asbestos fibers escaped into the air.
- Generally, being around asbestos-made products
isn't a danger as long as the asbestos is enclosed. This prevents the fibers
from escaping into the air.
- Now, people in the United States are less likely
to develop asbestos-related lung diseases because the mineral is no longer
widely used. Also, rules and standards are now in place to protect workers and
others from asbestos exposure.
- The signs and symptoms of asbestos-related lung
diseases vary, depending on the disease and how much lung damage has occurred.
Symptoms may include shortness of breath, cough, fatigue (tiredness), chest
pain, lung infections, and more.
- Your doctor will diagnose an asbestos-related
lung disease based on your past exposure to asbestos, your symptoms, a physical
exam, and the results from a
chest
x ray and other tests.
- No treatments can reverse the effects of asbestos
on your lungs. However, treatments may help relieve symptoms and prevent or
delay complications. Treatments may include lifestyle changes, vaccines, oxygen
therapy, medicines, or medical procedures or surgery.
- You can prevent asbestos-related lung diseases by
limiting your exposure to asbestos fibers. If your job requires you to work
around asbestos, make sure to follow workplace rules for handling it.
- The outlook for people who have asbestos-related
lung diseases varies. Their outlook will depend on which disease they have and
how much it has damaged their lungs.
- If you have an asbestos-related lung disease,
you'll need routine followup care for the rest of your life. Follow your
treatment plan as your doctor prescribes. Call your doctor if you notice new or
worsening symptoms.
Links to Other Information About Asbestos-Related
Lung Diseases
NHLBI Resources
Non-NHLBI Resources
Clinical Trials
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