What Are Asbestos Related Lung Diseases?

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 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, which is the muscle below your lungs starts to thicken 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. 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. 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.

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 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.

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.

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 asbestos—a curly fiber—is 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 isn’t 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 you’re 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 can’t 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 don’t need to take special precautions.

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.

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.