Asbestosis onset occurs ≥10 years following the initial exposure to asbestos.
Patients may be asymptomatic or have progressive shortness of breath.
A chest x-ray is the preferred initial test.
There is no definitive treatment.
Cigarette smoking cessation is important to reduce risk of lung cancer.
Prognosis is related to extent of fibrosis noted at diagnosis and past cumulative exposure to asbestos.
Asbestosis is diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos fibres. Pleural abnormalities, which are also caused by the inhalation of asbestos fibres, include plaques that may or may not be calcified, diffuse pleural thickening, benign pleural effusions or rounded atelectasis. These pleural abnormalities may occur either in concordance with or in the absence of parenchymal fibrosis.
History and exam
Key diagnostic factors
- occupational exposure
- longer duration of exposure
- smoking history
Other diagnostic factors
- dyspnoea on exertion
- indirect exposure
- chest pain
- cumulative dose of inhaled asbestos
- cigarette smoking
1st investigations to order
- CXR: posterior-anterior (PA) and lateral
- pulmonary function tests
Investigations to consider
- high-resolution CT chest
- lung biopsy
- bronchial lavage
Kenneth D. Rosenman, MD
Professor of Medicine
Division of Occupational and Environmental Medicine
Michigan State University
KDR has been an expert witness for both defendants and plaintiffs in work-related lawsuits concerning asbestos exposure. KDR is also the author of several papers referenced in this topic.
Henry A. Anderson, MD
Chief Medical Officer
Wisconsin Division of Public Health
HAA declares that he has no competing interests.
Keir Lewis, MD
Senior Clinical Lecturer
Institute of Life Sciences
KL declares that he has no competing interests.
Thomasz J. Kuzniar, MD, PhD
Division of Pulmonary and Critical Care Medicine
Evanston Northwestern Healthcare
TJK declares that he has no competing interests.
- Idiopathic pulmonary fibrosis
- Connective tissue disease
- Hypersensitivity pneumonitis (HP)
- Malignant pleural mesothelioma: ESMO clinical recommendations for diagnosis, treatment and follow-up
- Consensus report: asbestos, asbestosis and cancer: Helsinki criteria for diagnosis and attribution 2014
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