Asbestosis: Causes, Risk Factors, Symptoms, Diagnosis, Prevention and Treatment

Asbestos is a naturally hydrated calcium and magnesium silicate. It is defined by a set of fibrous varieties of certain minerals.

Asbestos was used very often in construction until 1997.

Asbestos poses a health risk if it is damaged, chipped, punctured, resulting in the formation of dust containing asbestos fibers.

These powders that contain asbestos fibers are harmful to the body.

That they can be inhaled by exposed people and, therefore, contract the disease.

In the context where dust is inhaled, these asbestos fibers reach the lungs and can cause long-term damage.

Asbestosis does not occur from exposure to asbestos that is not in the form of an inhalable dust.

Exposure from buildings where asbestos insulation is not exposed to the air does not increase your risk of asbestosis.

Prolonged exposure to a large number of asbestos fibers is necessary for asbestosis to develop.

Prolonged exposure to a significant amount of asbestos fibers, however, is not the only risk factor for developing the disease.

In addition, the prevention of the exposure of populations to this natural silicate is essential to avoid any risk of development of the pathology.

The disease is characterized by inflammation of the lung tissue.
It is an irreversible disease without developed curative treatment.

The characteristic symptoms of asbestosis are shortness of breath, persistent cough, severe fatigue, rapid breathing, and chest pain.

This pathology can affect the daily life of the patient and cause certain complications. These complications can be lethal for the affected subject.

Inhaled asbestos fibers and dust are trapped in the lung.

The lung tries unsuccessfully to remove asbestos through the immune system, causing damage and scarring.

Asbestosis generally develops slowly and may not be noticeable for up to 20 years after exposure to asbestos dust.

Current regulatory aspects make it possible to reduce the exposure of populations to asbestos through controls, treatments and monitoring, particularly for older facilities.

Other health problems besides asbestosis are also related to asbestos exposure.

These include thickening and hardening of the lining of the lung (pleural plaques), fluid around the lung (pleural effusions), and malignant mesothelioma, a cancer that surrounds the lung.

Causes of asbestosis

When asbestos fibers are inhaled, they can cause inflammation and scarring of lung tissues. This is called “pulmonary fibrosis.”

Asbestosis is a disease that develops as a result of repeated exposure to a significant number of asbestos fibers.

Exposure is usually at the subject’s workplace. Some sectors of activity may be more affected by the phenomenon.

Asbestos was used for a long time in the construction and mineral extraction sectors.

In a healthy organism, when it is in contact with a foreign body, such as when dust containing asbestos fibers is inhaled, the cells of the immune system (macrophages) can fight against it and prevent it from reaching the bloodstream and certain vital organs such as the lungs, the heart, among others.

In the case of inhaling asbestos fibers, macrophages have great difficulty in eliminating them from the body.

When trying to attack and destroy inhaled asbestos fibers, macrophages damage the alveoli or the small sacs in the lungs.

These alveolar lesions caused by the body’s defense system are characteristic of the disease.

These cells play a fundamental role in the transfer of oxygen within the body.

They allow the entry of oxygen into the bloodstream and the release of carbon dioxide.

In the context in which cells are damaged, this gas regulation process in the body is affected and atypical symptoms appear: shortness of breath, wheezing, among others.

Risk factor’s

Health regulations for the past 50 to 60 years have steadily reduced worker exposure to asbestos, such that most people with asbestosis had their exposure before the late 1970s.

With strict regulations, asbestosis from workplace contamination is now extremely unlikely.

Some common products and materials that contain asbestos are:

  • Insulation systems for attics, walls, wood stoves, oil and coal furnaces, and door seals.
  • Vinyl tile and backing on vinyl sheet flooring and adhesive.
  • Shingles and tile cladding.
  • Plaster, cement, putties used on walls and ceilings.
  • Hot water wrap and steam wand.
  • Heat resistant fabrics.
  • Automobile clutch pads and brake linings.

The main risk factor for developing asbestosis is chronic (long-term) exposure to a large amount of dusts that contain asbestos fibers.

Exposure is through inhalation of small dust particles, deterioration of buildings, mineral extraction and others.

Smoking is an additional risk factor for the development of this pathology.

The symptoms

Prolonged exposure to a large number of particles containing asbestos fibers can cause asbestosis.

In the case of the development of asbestosis, these fibers can cause lesions in the lungs (fibrosis) and lead to the development of some characteristic symptoms:

  • Shortness of breath that can appear after physical activity at first and then develop constantly.
  • A persistent cough
  • Intense fatigue
  • Tightness and chest pain.
  • Swelling at the ends of the fingers.
  • Loss of appetite with weight loss.
  • A dry crackling sound in the lungs as you breathe.

Exposures are generally related to the individual’s workplace.

Certain more specific symptoms and diseases can also be associated with asbestosis, such as:

  • Calcification of the pleura forming pleural plaques (accumulation of calcium deposits in the membrane that covers the lungs).
  • A malignant mesothelium (cancer of the pleura) that can develop 20 to 40 years after chronic exposure to asbestos fibers.
  • Pleural effusion, that is, the presence of fluid within the pleura.
  • Lung cancer.

Diagnosis

The current diagnosis of people with asbestosis is often related to exposure to asbestos fibers.

The severity of the disease is directly related to the duration of exposure to asbestos fibers and the amount inhaled.

Asbestos fibers that penetrate the bronchi and alveoli cause inflammation that gradually turns into pulmonary fibrosis, responsible for the hardening and thickening of the lung tissue.

Sooner or later permanent shortness of breath and very disabling actual respiratory failure appear.

In addition, the differential diagnosis is defined by responses on the history of the subject’s working conditions, on the possible period of exposure to asbestos, among other aspects.

If development of asbestosis is suspected, consultation with a pulmonologist is necessary to confirm the diagnosis. Identification of lung lesions is done by:

  • A thorough medical exam, which includes listening to your lungs with a stethoscope for characteristic or high-pitched crackling sounds that may indicate asbestosis.
  • Symptoms are sometimes mild and you may only be diagnosed with a chest X-ray to detect abnormalities in the lungs and excessive white color is seen on images of lung tissues.
  • In more serious situations, a chest X-ray will also be diagnosed, a chest CT scan is also indicated. This viewing medium provides more detailed images of the lungs, the pleura (the membrane that surrounds the lungs), and the pleural cavity.
  • The CT scan shows obvious abnormalities in the lungs.

Respiratory failure will be assessed by lung function tests.

A lung function test that consists of a series of breathing maneuvers that measure airflow and air volume in the lungs, allowing the doctor to objectively assess the function of your lungs.

Pulmonary tests are used to assess the impact of damage to the lungs, determine the volume of air contained in the lung alveoli, and gain insight into the passage of air from the membrane of the lungs into the bloodstream.

Thoracic endoscopy or thoracoscopy will be performed routinely to inspect the pleura for mesothelioma.

Prevention and treatment

To date, there is no cure for the disease.

However, there are alternatives to reduce the consequences of the pathology, limit the symptoms and improve the daily life of patients.

Since smoking is an additional risk factor for developing the disease and a factor that worsens symptoms, smokers are strongly advised to quit smoking.

For this, there are solutions such as therapies or drugs.

Furthermore, in the presence of asbestosis, the subject’s lungs are therefore more sensitive and more vulnerable to the development of infections.

Therefore, it is advisable that the patient is up-to-date on his vaccinations on the agents responsible for influenza or lung disease.

In severe forms of the disease, the person’s body can no longer perform certain vital functions properly.

Breathing can become more difficult over time as asbestosis progresses, even after you are no longer exposed to asbestos.

In this regard, supplemental oxygen therapy may be recommended to help the patient breathe if the oxygen level in the blood is lower than normal.

On the other hand, in the case of the presence of other lung diseases, such as Chronic Obstructive Pulmonary Disease, medications may be prescribed.

More severe cases may also benefit from medications such as small doses of morphine to reduce shortness of breath and cough.

From a preventive point of view, people with chronic exposure for more than 10 years should undergo a radiographic check of the lungs every 3 to 5 years to detect any associated disease as soon as possible.

The disease can lead to heart and lung failure and sometimes death.