Asbestos-related diseases are disorders of the lung and pleura which arise out of the inhalation of asbestos. Asbestos is made of fibers. . Asbestos-related diseases include non cancerous conditions such as as asbestosis, (pulmonary fibrosis due to asbestos), diffuse pleural thickening, pleural plaques, pleural effusion and malignancies (cancers) such as lung cancer and malignant mesothelioma.
Workers in jobs with significant asbestos dust exposure are at the highest risk of developing asbestos-related disease. Asbestos was prsent in many building materials. There still remain asbestos in buildings that were built prior to the restriction of asbestos use. Older buildings have asbestos fragments that are released in the air and create a potential hazard. Anyone around the asbestos-containing material during home maintenance and renovation can be affected. This includes many workers such as pipefitters, plumbers, electricians, construction workers, auto workers among many others.
Non-malignant asbestos-related pleural diseases
Benign asbestos-related diseases encompass four types of pleural changes:
Pleural plaques
Diffuse pleural thickening
Benign asbestos pleural effusions
Rounded atelectasis (folded lung)
Pleural plaques
Pleural plaques are the most common manifestation of asbestos exposure, affecting up to 58% of asbestos-exposed workers. The chest xray is the usual tool for diagnosing pleural plaques but chest CT Scan is more sensitive and specific in this regard. Pleural plaques are evidence of past asbestos exposure and indicate an increased risk for the future development of other asbestos-related diseases. Pleural plaques in themselves are not pre-malignant. Individuals with pleural plaques are usually not compensated in most compensation systems.
Diffuse pleural thickening
Diffuse pleural thickening (DPT) is non-circumscribed fibrous thickening of the visceral pleura with areas of adherence to the parietal pleura and obliteration of the pleural space It often extends over the area of an entire lobe or lung, with fibrotic areas involving Diffuse pleural thickening develops 20 to 40 years after first exposure. All types of asbestos can cause diffuse pleural thickening and a dose-related relationship has been described. It is thought that asbestos fibres that reach the pleura induce subpleural fibroblasts and mesothelial cells to produce scar tissue and collagen deposition, resulting in subpleural thickening. It usually begins with an inflammation of the pleura that is accompanied by a pleural effusion. DPT has a significant impact on pulmonary function, causing a decrease in forced vital capacity, reducing total lung capacity and diffusing capacity.
Benign asbestos pleural effusion
Benign asbestos pleural effusion is a buildup of fluid between the two pleural layer following asbestos exposure. It is relatively uncommon and the earliest manifestation of disease following asbestos exposure, usually occurring within 10 years from exposure. Effusions may be asymptomatic but rarely, they can cause pain, fever, and breathlessness. Diagnosis relies on a compatible history of asbestos exposure and exclusion of other probable causes.
Rounded atelectasis
Also known as Blesovsky’s or folded lung syndrome) develops from infolding of thickened visceral pleura with collapse of the intervening lung parenchyma.] Rounded atelectasis is the least common asbestos-related benign pleural disease. Exposure to asbestos is the most likely cause today but it can occur following other medical conditions. It is a chronic condition and usually asymptomatic.
Asbestosis
Asbestosis is a chronic lung disease caused by scarring of lung tissue, which results from prolonged exposure to asbestos. It is defined as diffuse interstitial pulmonary fibrosis secondary to asbestos exposure. It initially affects the lung bases and usually manifests after 15 or more years from initial exposure. It occurs after high intensity and/or long-term exposure to asbestos. Asbestos-related fibrosis is progressive because it continues to progress in the lung even if no further asbestos is inhaled. The scar tissue causes the alveolar walls to thicken, reducing the lung capacity which leads to the patient experiencing shortness of breath.. Sufferers are at an increased risk for heart failure and certain malignancies.
Malignant asbestos-related diseases
Malignant mesothelioma
Malignant Mesothelioma is an aggressive and incurable tumor caused by asbestos arising from mesothelial cells of the pleura, (the lining of the abdominal cavity) and rarely elsewhere. Pleural mesothelioma is the most common type of mesothelioma, representing about 75 percent of cases. Peritoneal mesothelioma or stomach mesothelioma is the second most common type, consisting of about 10 to 20 percent of cases.. The symptoms include shortness of breath, chronic chest pain, cough, and weight loss. A biopsy is needed to confirm a diagnosis of malignant mesothelioma. Mesothelioma has a poor prognosis, with most patients dying within 1 year of diagnosis. T
Asbestos-related lung cancer
Asbestos can cause cancer that is identical to lung cancer from other causes. Exposure to asbestos is associated with all major histological types of lung carcinoma (aenocarcinoma, squamos cell carcinoma, large cell carcinoma and small cell carcinoma). The latency period between exposure and development of lung cancer is 20 to 30 years. It is estimated that 3%-8% of all lung cancers are related to asbestos. The risk of developing lung cancer depends on the level, duration, and frequency of asbestos exposure (cumulative exposure). Treatment involves surgical removal of the cancer, chemotherapy, radiotherapy, or a combination of these (multimodality treatment). Prognosis is generally poor unless the cancer is detected in its early stages. Out of all patients diagnosed with lung cancer, only 15% survive for five years after diagnosis.
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