Asbestosis

Our plain-English summary of Asbestosis, by A.A. Lazarus, A. Philip (Disease-a-month, 2011).

The study

• Authors: A.A. Lazarus, A. Philip
• Journal: Disease-a-month
• Published: 2011;57(1):14-26
• Type of article: Historical article, Review
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This narrative review described asbestosis, the pneumoconiosis caused by inhaling asbestos fibers. It covered the types of asbestos fiber, the history of recognition and regulation, the occupations at risk, pathogenesis, pathology, clinical features, imaging, diagnosis, management and mortality. The authors reported a typical latency of 20-30 years. In the USA, years of potential life lost from asbestosis rose from 146 per year in 1968-1972 to 239.6 per year in 2001-2005, and recorded asbestosis deaths rose from 77 in 1968 to 1265 in 1999. They described the hallmark asbestos bodies, a restrictive pattern with reduced diffusing capacity on lung function tests, and lower-lobe reticular opacities on chest radiographs. Radiographs were classified with the International Labour Office (ILO) system, which has low sensitivity in early disease. High-resolution CT was described as the test of choice when plain films are indeterminate. Diagnosis required a history of significant exposure, an appropriate latency and a radiograph of ILO 1/1 or greater. Pleural plaques supported the diagnosis. The authors stated that there is no effective therapy, so management focuses on stopping exposure, smoking cessation, vaccination, surveillance and supplemental oxygen when needed. Asbestosis deaths were not predicted to decline significantly over the next 10-15 years. The authors concluded that a thorough occupational history, chest radiographs and high-resolution CT are required to make a definitive diagnosis.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This narrative review of asbestosis, a lung disease caused by breathing asbestos fibers, reports no new study of its own. The authors described the six asbestos minerals (including chrysotile, crocidolite and amosite), exposure-linked jobs, and a typical 20-30 year delay before disease appears. They described signs of asbestosis: worsening shortness of breath on exertion, crackles at the lung bases, a restrictive pattern on breathing tests, and scarring on chest X-ray or CT. They stated that diagnosis requires a chest X-ray score of 1/1 or greater on the International Labour Office scale. They added that high-resolution CT is the test of choice when plain films are indeterminate. There are no effective therapies for asbestosis, they wrote. Citing NIOSH data, they reported that deaths rose from 77 in 1968 to 1265 in 1999 among US residents aged 15 or older with asbestosis listed as an underlying or contributing cause on the death certificate. A cited study predicted no significant decline in US asbestosis-related deaths over the next 10-15 years. The authors concluded that a thorough occupational history is paramount to evaluating respiratory symptoms.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: narrative review (no original data)
• Who was studied: No study population of its own; the review discusses asbestos-exposed workers and residents in general, drawing on published studies and US national data
• Exposure: Asbestos in general: chrysotile (serpentine), crocidolite and amosite as the most commonly used fibers, plus tremolite, anthophyllite and actinolite; also vermiculite contaminated with asbestos (e.g., from Libby, Montana)
• Main results:
  • The authors stated that asbestos-related lung diseases typically appear after a latency period of 20-30 years
  • The authors stated that, for an asbestosis diagnosis, the chest radiograph must be 1/1 or greater on the ILO scale
  • The authors stated that high-resolution CT has become the test of choice for diagnosing asbestosis when plain films are indeterminate
  • The authors stated that there are no effective therapies for asbestosis; management focuses on surveillance, prevention and symptom relief
  • From NIOSH data shown in a figure: the number of deaths of US residents aged 15 or older with asbestosis recorded as an underlying or contributing cause on the death certificate rose from 77 in 1968 to 1265 in 1999. Asbestosis was the underlying cause in nearly a third of these deaths each year.
  • Citing a published study (reference 44), the authors reported that asbestosis-related deaths in the USA are not predicted to decline significantly over the next 10-15 years
  • Citing published studies (references 47-49), the authors stated that asbestosis is an independent risk factor for mesothelioma and lung cancer with asbestos exposure
• The authors' conclusion: The authors concluded that because asbestosis appears many years after exposure, a thorough occupational history is paramount when evaluating respiratory symptoms. They also concluded that chest radiographs followed by high-resolution CT are required for a definitive diagnosis in patients with symptoms.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Pathology, Latency, Asbestos Bodies, Diffusing Capacity (DLCO), Chest X-Ray, High-Resolution CT (HRCT), Pleural Plaques.

Related studies

• Pulmonary endpoints (lung carcinomas and asbestosis) following inhalation exposure to asbestos — B.T. Mossman, M. Lippmann, et al. (2011)
• Evaluation of the deposition, translocation and pathological response of brake dust with and without added chrysotile in comparison to crocidolite asbestos following short-term inhalation: interim results — D.M. Bernstein, R. Rogers, et al. (2014)
• Asbestos, asbestosis, and lung cancer: observations in Quebec chrysotile workers — B.W. Case, A. Dufresne (1997)
• Progression of small, irregular opacities in chest radiographs of former asbestos workers — B. Świątkowska, W. Sobala, et al. (2012)
• Asbestos and lung diseases: introduction and epidemiology — J.A. Nations, A.A. Lazarus (2011)
• Lung inflammation caused by inhaled toxicants: a review — J. Wong, B.E. Magun, et al. (2016)

Browse more research in Disease-a-month, or return to medical research.