Non-malignant asbestos-related diseases: a clinical view

Our plain-English summary of Non-malignant asbestos-related diseases: a clinical view, by D. Fishwick, C.M. Barber (Clinical Medicine, 2014).

The study

• Authors: D. Fishwick, C.M. Barber
• Journal: Clinical Medicine
• Published: 2014;14(1):68-71
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this clinical review, two consultant respiratory physicians from the Centre for Workplace Health in Buxton, UK, described the non-malignant respiratory conditions linked to asbestos exposure, covering symptoms, radiology, lung function, diagnosis, follow-up and advice to patients. They described pleural plaques as markers of previous exposure that were not thought to cause symptoms or alter lung function, and stated that patients with isolated plaques should normally be discharged from follow-up. The authors' practice was to quote approximate lifetime risks of 5–10% for progression of plaques, 2–5% for diffuse pleural thickening and 1–2% for mesothelioma, although they noted that the evidence base was poor. Diffuse pleural thickening, with about 400–500 new cases assessed for government benefits each year in Great Britain, was described as able to cause breathlessness and as needing specialist follow-up. Rounded atelectasis was described as a form of pleural thickening that may appear mass-like. Asbestosis, with about 700 new cases and around 400 deaths a year in Great Britain, was described as showing a usual interstitial pneumonitis pattern on high-resolution CT. Its treatment was supportive, and the authors called smoking cessation support vital because lung cancer risk is particularly high in heavy smokers. UK compensation routes were outlined. The authors concluded that peak exposure in the 1960s and 1970s and the long latency of asbestos diseases will account for their continuing high prevalence in the decades to come.

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 was a clinical review written for doctors. It reported no new patients or data of its own. The authors described non-malignant conditions linked to asbestos: pleural plaques, diffuse pleural thickening, rounded atelectasis and asbestosis. They wrote that pleural plaques mark past exposure, are not thought to cause symptoms, and on their own do not alter lung function tests. In their practice they quoted approximate lifetime risks for people with plaques: 5–10% for progression of plaques, 2–5% for diffuse pleural thickening and 1–2% for mesothelioma. They noted that the evidence base for these figures is poor. They also cited a separate Health and Safety Executive case–control study giving a 5.9% lifetime mesothelioma risk for carpenters born in the 1940s. They reported that diffuse pleural thickening can cause breathlessness and chest discomfort. They also reported that Great Britain sees about 700 new asbestosis cases and around 400 asbestosis deaths a year. The authors concluded that, because exposure peaked in the 1960s and 1970s and these diseases take a long time to appear, they will stay common for decades.

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 clinical review (continuing medical education article); no original study data
• Who was studied: No study population. The article discusses patients with non-malignant asbestos-related respiratory disease, mainly in a UK (Great Britain) clinical context.
• Exposure: Asbestos in general. The authors name chrysotile (white), amosite (brown) and crocidolite (blue) as the most commercially relevant types, used in building materials, industrial insulation, ships and railway carriages.
• Main results:
  • Pleural plaques are not thought to cause symptoms
  • Isolated pleural plaques do not alter lung function test results
  • For patients with pleural plaques, the authors' practice was to quote approximate future lifetime risks of 5–10% for progression of plaques, 2–5% for diffuse pleural thickening and 1–2% for mesothelioma
  • The authors cited a separate Health and Safety Executive case–control study (not their own data) giving a lifetime mesothelioma risk of 5.9% for carpenters born in the 1940s
  • Diffuse pleural thickening can cause shortness of breath and chest discomfort
  • In Great Britain there are about 700 new asbestosis cases and around 400 asbestosis deaths each year
  • The fibrosis from asbestosis is irreversible and often progresses slowly
  • The authors stated that the future lung cancer risk in people with asbestosis is particularly high in heavy smokers, with the risk more than additive
• The authors' conclusion: The authors concluded that because asbestos exposure in Great Britain peaked in the 1960s and 1970s, and these diseases have a long latency, they will remain highly prevalent for decades to come.
• Limitations the authors state:
  • The authors state that the evidence base for future risk estimates in patients with pleural plaques is poor
  • The authors state that the evidence for risk estimates in diffuse pleural thickening is also poor

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Pleural Plaques, Diffuse Pleural Thickening, Mesothelioma, Rounded Atelectasis, Pleural Thickening, Interstitial, Pneumonitis.

Related studies

• Rounded atelectasis and its association with asbestos-induced pleural disease — R.A. Mintzer, R.M. Gore, et al. (1981)
• The association of asbestos-induced pleural disease and rounded atelectasis — R.A. Mintzer, D.W. Cugell (1982)
• Rounded atelectasis. Clinical experience with 74 patients — G. Hillerdal (1989)
• Asbestos: when the dust settles an imaging review of asbestos-related disease — H.D. Roach, G.J. Davies, et al. (2002)
• Asbestos-related chest diseases: plain radiographic findings — W.T. Miller, W.B. Gefter, et al. (1992)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)

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