Asbestosis is caused by inhaling asbestos fibers. It is an interstitial lung disease. There are two main types of asbestos that are named based on their shape. The serpentine family is more curved while the amphibole family is straighter and stiffer.
Types of Exposure
One article split asbestos exposure into three main types, although types of exposure are described differently depending on the reference and who you ask. The first type is direct or work-related environmental exposure that is frequent in industries such as shipyards and mining. The article then describes bystander asbestos exposure, which occurs in occupations such as painting, masonry and electrical work. Then there is community exposure in which people are exposed to asbestos through things like road surfaces, chemical paints, playground material and landfills. I have read about other categorizations of exposure, called occupational exposure, paraoccupational exposure, environmental exposure, domestic exposure, community exposure and secondary exposure.
Asbestosis is most common in people that are exposed to asbestos frequently and at a high rate. Pleural effusions, or fluid in the lungs, may also occur in people who have asbestosis. In nine cases per every 1,000 cases in heavily exposed groups, there is an instance of pleural effusion. Interstitial fibrosis is thought to be the main pathogenic mechanism of asbestosis. Asbestosis is a progressive disease, so the fibrosis increases over time. A recent study shows that the length of asbestos fibers has a direct correlation to pathogenesis, or the manner of the development of the disease.
When asbestosis is examined microscopically, it is found that there is interstitial fibrosis with both asbestos bodies and ferruginous bodies. Both bodies being present allows pathologists to determine that the disease is asbestosis and not interstitial lung fibrosis. A ferruginous body being present indicates that the patient was exposed to asbestos. When it comes to asbestosis, usually there has been 10 to 20 years of asbestos exposure and dyspnea, which is an intense shortness of breath. Patients may experience discomfort in their chest.
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Diagnosis
Knowing the history of asbestos exposure is important when it comes to diagnosing asbestosis. There are also pulmonary function tests that are conducted. These tests may include spirometry and lung volume. Included in this test are forced vital capacity, expiratory volume in 1 sec, total lung capacity, functional residual capacity and residual volume. Another test is diffusing capacity. Asbestosis is normally diagnosed by excluding other diseases. It presents very similar to idiopathic pulmonary fibrosis, based on symptoms. Both diseases have similar characteristics but need different treatments.
Chest radiographs and high-resolution computed tomography (HRCT) are ways in which asbestosis can be diagnosed. HRCT can show the difference between idiopathic pulmonary fibrosis and asbestosis. In a tomography, if a patient has asbestosis, there will most likely be pleural plaques and/or pleural thickening. A lung biopsy may also be done as well as bronchoscopy/video assisted thoracoscopy (VAT).
Treatment Options
There is no specific treatment for asbestosis, however different treatment options are available. One treatment is drug therapy. Corticosteroids are used to reduce lung damage, but do not have high success rates. Oxygenation is supplied to patients with hypoxemia at rest or on exertion, meaning they are supplied with oxygen. Surgery is also available for patients who are able to undergo it. A lung transplantation may end up being necessary and is the ultimate treatment option when all else fails.
Early detection of asbestosis calls for a greater success rate and prognosis. When people who have worked around asbestos undergo radiologic screenings, early abnormal changes can be detected. Complications may happen in patients who have asbestosis. Some complications include malignancy, respiratory failure, problems with the heart and other organs and the onset of cancers of other organs. When diagnosed with asbestosis, it is important that the patient has a multidisciplinary team composed of an oncologist, a pulmonologist, a radiologist, potentially a thoracic surgeon, a histopathologist, nurses and a pharmacist.
Overall, it is important to detect asbestosis early to allow for the best possible prognosis.
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