Asbestosis

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Probable Outcomes

Prognosis depends on the level of exposure and the presenting symptoms. The presence of asbestos bodies or pleural plaques alone does not significantly alter life expectancy. However if asbestosis (that is fibrosis) develops, the overall prognosis is quite poor. This is a progressive disease and to date there has been no treatment identified that can halt the process. If your asbestosis is complicated by cancer of the lung or pleura (membrane covering of the lungs) the prognosis is even worse. The median survival following diagnosis of mesothelioma is only 2 years.

How Will Asbestosis Affect Me?

Typical symptoms of asbestosis include progressive breathlessness and a dry cough. As your lungs become stiffer you may notice that you are breathing faster and shallower.

Your doctor will also take a detailed occupational to determine whether there has been a significant level of asbestos exposure. This helps distinguish asbestosis from other causes of pulmonary fibrosis. In addition it is important to know your smoking history to determine your risk of developing lung cancer.

Clinical Examination

Your doctor will perform a careful clinical examination of your respiratory system. In particular they will be looking for clubbing of the fingers (swelling of the end of the fingers or loss of the angle between the nail and the nail bed) and inspiratory crackles when listening to the chest. This sound is caused by the stiff and fibrotic airways popping open at the end of inspiration.

How is Asbestosis Diagnosed?

To confirm the diagnosis of asbestosis, your doctor may perform the following investigations:

Chest x-ray- This helps detect fibrosis or scarring of the lungs. The X-ray may also detect asbestos plaques in the pleura confirming asbestos exposure. Occasionally the chest X-ray may also show fluid at the base of the lungs (pleural effusion) or other lesions such as lung cancer. The X-ray below shows fibrosis which may be consistent with asbestosis in an exposed individual. The fibrosis is the white streaky opacities on the left side. The lung fields should normally be should be black as they are filled with air.
CT scan of the chest will demonstrate lung fibrosis.
Lung function tests, particularly spirometry, may be useful in demonstrating a restrictive pattern of lung disease as opposed to obstructive patterns seen in other lung diseases such as asthma.