Asbestosis (as-bes-TOE-sis) is a chronic lung disease caused by inhaling asbestos fibers. Prolonged exposure to these fibers can cause lung tissue scarring and shortness of breath. Asbestosis symptoms can range from mild to severe, and usually don't appear until many years after continued exposure.

Asbestos is a natural mineral product that's resistant to heat and corrosion. It was used extensively in the past in products such as insulation, cement and some floor tiles.

Most people with asbestosis acquired it on the job before the federal government began regulating the use of asbestos and asbestos products in the 1970s. Today, its handling is strictly regulated. Acquiring asbestosis is extremely unlikely if you follow your employer's safety procedures. Treatment focuses on relieving your symptoms.

The effects of long-term exposure to asbestos typically don't show up for 10 to 40 years after initial exposure. Asbestosis signs and symptoms can include:

  • Shortness of breath
  • A persistent, dry cough
  • Loss of appetite with weight loss
  • Fingertips and toes that appear wider and rounder than normal (clubbing)
  • Chest tightness or pain

When to see a doctor

If you have a history of exposure to asbestos and you're experiencing increasing shortness of breath, talk to your doctor about the possibility of asbestosis.

If you are exposed to high levels of asbestos dust over a long period of time, some of the airborne fibers can become lodged within your alveoli — the tiny sacs inside your lungs where oxygen is exchanged for carbon dioxide in your blood. The asbestos fibers irritate and scar lung tissue, causing the lungs to become stiff. This makes it difficult to breathe.

As asbestosis progresses, more and more lung tissue becomes scarred. Eventually, your lung tissue becomes so stiff that it can't contract and expand normally.

Smoking cigarettes appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease.

People who worked in mining, milling, manufacturing, installation or removal of asbestos products before the late 1970s are at risk of asbestosis. Examples include:

  • Asbestos miners
  • Aircraft and auto mechanics
  • Building construction workers
  • Workers removing asbestos insulation around steam pipes in older buildings
  • Electricians
  • Shipyard workers
  • Boiler operators
  • Railroad workers

In general, it's safe to be around materials that are made with asbestos as long as the asbestos fibers are contained. This prevents them from getting into the air

If you have asbestosis, you're at increased risk of developing lung cancer — especially if you smoke or have a history of smoking.

You're likely to start by seeing your family doctor for the disorder's most common symptom — shortness of breath. He or she might refer you to a doctor specializing in lung problems (pulmonologist).

What you can do

Before your appointment, you might want to write a list of answers to the following questions:

  • What are your symptoms and when did they start?
  • Have your symptoms stayed the same or gotten worse?
  • What kind of work have you done in your career? Be specific.
  • Have you been involved in any home-remodeling projects or other building renovations occurring over a long period of time?
  • Do you or did you smoke? If so, how much?
  • What medications and supplements do you take?

If you have had chest X-rays in the past, you might want to bring along copies of the images so your doctor can compare them to your current scan.

What to expect from your doctor

During the physical exam, your doctor will use a stethoscope to listen carefully to your lungs to ascertain if you make a crackling sound while inhaling.

Asbestosis can be difficult to diagnose because its signs and symptoms are similar to those of many other types of respiratory diseases A variety of diagnostic tests might be needed to help pinpoint the diagnosis.

Imaging tests

  • Chest X-ray. Advanced asbestosis appears as excessive whiteness in your lung tissue. If the asbestosis is severe, your entire lungs might be affected, giving them a honeycomb appearance.
  • Computerized tomography (CT). CT scans combine a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. These scans generally provide greater detail and might help detect asbestosis in its early stages, even before it shows up on a chest X-ray.

Pulmonary function tests

These tests determine how well your lungs are functioning. Pulmonary function tests measure how much air your lungs can hold and the airflow in and out of your lungs. For example, you might be asked to blow as hard as you can into an air-measurement device called a spirometer. More complete pulmonary function tests can measure the amount of oxygen being transferred to your bloodstream.

There's no treatment to reverse the effects of asbestos on the alveoli. Treatment focuses on slowing the progression of the disease and relieving symptoms. You'll need routine follow-up care, such as chest X-rays and lung function tests, at regular intervals depending on the severity of your condition.

Therapy

To ease breathing difficulty caused by advanced asbestosis, your doctor might prescribe supplemental oxygen. This is delivered by thin plastic tubing with prongs that fit into your nostrils or a mask.

Surgery

If your symptoms are severe, you might be a candidate for a lung transplant.

  • Stop smoking. Asbestosis increases the risk of lung cancer. Quitting smoking can reduce this risk. Try to avoid secondhand smoke. Smoking might also cause emphysema, which further reduces your lung reserves.
  • Get vaccinated. Talk to your doctor about flu and pneumonia vaccines, which can help lower your risk of lung infections. Promptly treat respiratory infections.

Reducing exposure to asbestos is the best prevention against asbestosis. In the United States, federal law requires employers in industries that work with asbestos products — such as construction — to take special safety measures.

Many homes built before the 1970s have materials such as pipes and floor tiles that contain asbestos. Generally, there's no cause for concern as long as the asbestos is enclosed and undisturbed. It's when materials containing asbestos are damaged that there's a danger of asbestos fibers being released into the air. However, asbestosis typically occurs only after prolonged exposure to asbestos fiber.

Jan. 02, 2014