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Asbestosis

Asbestosis is a serious, progressive, long-term disease of the lungs. It is not cancer. It is caused by inhaling asbestos fibers that irritate lung tissues and cause the tissues to scar. The scarring makes it hard for lungs to do their job of getting oxygen into the blood. Symptoms of asbestosis include shortness of breath and a dry crackling sound in the lungs while inhaling.

The chance of getting asbestosis is very small for those who do not work with asbestos. Although there is no effective treatment for asbestosis, symptoms of the disease can be managed under the care of a physician. The disease, if severe, can cause disability and death.

Incidence and Cause

When people inhale air, it always contains small particles. These particles have to be filtered out because the lungs need to remain sterile. The nose and the bronchi (the airways leading down to the lungs) are the main air filters for the lungs. Asbestos particles (called amphiboles) are long, extremely thin, microscopic glass-like fibers that are not filtered by the nose or the bronchi because they are so thin and light.

Asbestosis development starts when a person inhales an amphibole. This particle travels deep into the lungs to one of the 300 million gas exchanging structures called an alveolus. Each alveolus has many cleaning cells called macrophages that eat up any particles that make it down to the alveoli. Unfortunately the macrophages can not eat the amphibole because it is too long, but they still try.

In trying to eat this particle the macrophage essentially cuts itself open and the digestive molecules that were contained inside the macrophage have now spilled on the alveolus. These molecules injure the alveolus and cause it to form a scar. This scarring formation is called fibrosis. The same amphibole that could not be eaten attracts other macrophages from neighboring areas. They try to eat the particle and also fail, and this further damages the lungs.

In reality, people who are exposed to asbestos inhale hundreds and thousands of amphiboles, which causes large-scale injury. Such large-scale injury is when major lung damage (fibrosis) develops and is named "Asbestosis" after the disease-causing particle. Asbestosis is found in people who are chronically exposed to asbestos material.

Those who are at the highest risk are the people who directly handle asbestos material at their job. This group includes vehicle mechanics, construction workers, shipyard workers, electricians and other workers in the building trades. Of importance to workers in the United States is the fact that old asbestos can be encountered during refurbishing and demolition of old buildings or other structures in which asbestos is still found.

Exposure to asbestos is not limited to those who directly handle the material. The painter who works with the construction worker or the construction worker’s wife who shakes out her husband’s clothes have also been known to be at risk for developing asbestosis.

A study conducted on Finnish asbestos workers who either worked construction for ten years or worked in shipyards for one year showed that 22% of the workers showed signs of asbestosis development. If one examines the entire population of a country instead of just those at high risk, Asbestosis is a relatively uncommon disease.

The signs and symptoms of asbestosis can show up many years after the asbestos exposure has ended. Manifestations rarely occur less than 10 years following first exposure and are more common after 20 years or more.

Asbestosis Symptoms
(what a patient with asbestosis will experience)

Shortness of breath.

Asbestosis has been called a monosymptomatic disease because the earliest, most consistently reported, and most distressing symptom is shortness of breath.

Occurs with heavy effort and then progressively diminishing levels of effort as the disease becomes worse.

Persistent and productive cough.

Almost as common as the shortness of breath.

Often occurs with distressing spasms.

Other symptoms include:

Chest tightness, Chest pain, General ill feeling, Fitful sleep, Hemoptysis, Appetite loss.

Asbestosis Signs (what your doctor will look for with asbestosis)

Basal crackles or rales. When a stethoscope is used to listen to the lower lungs, you can hear what sounds like Velcro opening up.

An early distinctive feature of asbestosis. Usually heard first over the basal regions.

Persistent (unaffected by coughing).

Precise timing (at first, mid to late inspiration and eventually during most of inspiration).

High pitched quality.

Small irregular opacities on X-ray (Looks like ground glass).

Obscures normal lung vasculature.

Usually first seen in the lower lateral lobes in between the rib shadows.

Borders of the heart, particularly the left side may be obscured.

Pulmonary function tests usually show restrictive disease but can also show obstructive and mixed disorders. This means that your lungs will lose the ability to breathe.

Reduced diffusion capacity.

Reduce lung volumes and capacities.

Reduced flow rates.

Clubbing of fingers and toes. Swelling of the fingers and toes due to excess blood accumulating there.

None of these symptoms are specific. Something as benign as the common cold could also give you these symptoms. Keep in mind that asbestosis is a chronic progressive disease meaning that once these symptoms start, they generally do not get better. Fortunately, the disease progresses slowly giving your doctor time to catch it.