Summary
Definition
History and exam
Key diagnostic factors
- occupational exposure
- longer duration of exposure
- smoking history
Other diagnostic factors
- dyspnea on exertion
- cough
- crackles
- indirect exposure
- chest pain
- clubbing
Risk factors
- cumulative dose of inhaled asbestos
- cigarette smoking
Diagnostic tests
1st tests to order
- chest x-ray: posterior-anterior (PA) and lateral
- pulmonary function tests
Tests to consider
- high-resolution CT chest
- lung biopsy
- bronchial lavage
Treatment algorithm
all patients
Contributors
Authors
Kenneth D. Rosenman, MD
Professor of Medicine
Division of Occupational and Environmental Medicine
Michigan State University
East Lansing
MI
Disclosures
KDR declares that he has no competing interests. KDR is the author of an article cited in this topic.
Peer reviewers
Henry A. Anderson, MD
Chief Medical Officer
Wisconsin Division of Public Health
Madison
WI
Disclosures
HAA declares that he has no competing interests.
Keir Lewis, MD
Senior Clinical Lecturer
Institute of Life Sciences
Swansea University
Swansea
UK
Disclosures
KL declares that he has no competing interests.
Thomasz J. Kuzniar, MD, PhD
Assistant Professor
Division of Pulmonary and Critical Care Medicine
Evanston Northwestern Healthcare
Evanston
IL
Disclosures
TJK declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
American Thoracic Society. Diagnosis and initial management of nonmalignant diseases related to asbestos. Am J Respir Crit Care Med. 2004 Sep 15;170(6):691-715.Full text Abstract
Wolff H, Vehmas T, Oksa P, et al. Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations. Scand J Work Environ Health. 2015 Jan;41(1):5-15.Full text Abstract
Markowitz SB, Levin SM, Miller A, et al. Asbestos, asbestosis, smoking, and lung cancer. New findings from the North American insulator cohort. Am J Respir Crit Care Med. 2013 Jul 1;188(1):90-6. Abstract
Banks DE, Shi R, McLarty J, et al. American College of Chest Physicians consensus statement on the respiratory health effects of asbestos. Results of a Delphi study. Chest. 2017 Sep 18;4(1):e000223.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Idiopathic pulmonary fibrosis
- Connective tissue disease
- Hypersensitivity pneumonitis (HP)
More DifferentialsGuidelines
- Consensus report: asbestos, asbestosis and cancer: the Helsinki criteria for diagnosis and attribution 2014
- Diagnosis and initial management of nonmalignant diseases related to asbestos
More Guidelines
Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer