Asbestosis
Asbestosis Signs and Symptoms
The signs and symptoms of asbestosis can show up many years after the
asbestos exposure has ended. Manifestations rarely occur less than 10
years following first exposure and are more common after 20 years or
more.
Symptoms (what a patient with asbestosis will experience)
- Shortness of breath.
- Asbestosis has been called a monosymptomatic disease because the
earliest, most consistently reported, and most distressing symptom
is shortness of breath.
- Occurs with heavy effort and then progressively diminishing
levels of effort as the disease becomes worse.
- Persistent and productive cough.
- Almost as common as the shortness of breath.
- Often occurs with distressing spasms.
Other symptoms include:
- Chest tightness, Chest pain, General ill feeling, Fitful
sleep, Hemoptysis, Appetite loss.
Signs (what your doctor will look for with asbestosis)
- Basal crackles or rales. When a stethoscope is used to
listen to the lower lungs, you can hear what sounds like
Velcro opening up.
- An early distinctive feature of asbestosis.
- Usually heard first over the basal regions.
- Persistent (unaffected by coughing)
- Precise timing (at first, mid to late inspiration and
eventually during most of inspiration)
- High pitched quality.
- Small irregular opacities on X-ray (Looks like ground
glass).
- Obscures normal lung vasculature.
- Usually first seen in the lower lateral lobes in between
the rib shadows.
- Borders of the heart, particularly the left side may be
obscured.
- Pulmonary function tests usually show restrictive
disease but can also show obstructive and mixed disorders.
This means that your lungs will lose the ability to breathe.
- Reduced diffusion capacity.
- Reduce lung volumes and capacities
- Reduced flow rates.
- Clubbing of fingers and toes. Swelling of the
fingers and toes due to excess blood accumulating there.
None of these symptoms are specific. Something as
benign as the common cold could also give you these
symptoms. Keep in mind that asbestosis is a chronic
progressive disease meaning that once these symptoms
start, they generally do not get better. Fortunately,
the disease progresses slowly giving your doctor time to
catch it.
Treatment and Prevention
Treatment
Unfortunately, there currently is no cure for
asbestosis. The treatment involves preventing
further complications of the disease and treating
its symptoms.
Prevention
A patient with asbestosis must first prevent any
further contact with asbestos and if they are a
smoker they should be advised to quit.
The asbestosis patient should receive aggressive
medical care for any respiratory infection, with
frequent use of antibiotics when warranted.
Vaccinations for the flu and pnuemococcus should be
kept up to date. They should also participate in
respiratory therapies such as bronchial drainage or
the use of an ultrasonic mist humidifier that assist
in the clearing of secretions from the lungs.
Patients should avoid situations that may expose
them to respiratory infections such as large crowds.
These steps should help to avoid the complications
of serious lung infections. Finally, the asbestosis
patient should undergo regular chest x-rays to
screen for cancers associated with asbestosis.
Symptomatic Treatment
Shortness of breath is treated with bronchodilators
that open up the bronchial tubes and allow passage of
air. The patient may also receive supplemental oxygen.
Respiratory treatments that remove secretions from the
lung through postural drainage may also be used.
Productive cough is treated with humidifiers,
breathing therapies and chest percussion. These
therapies loosen and thin out bronchial secretions
allowing them to be expelled by the cough. Chest pain
can be treated with normal over the counter drugs such
as acetaminophen or ibuprofen.
Prognosis
Once asbestosis has been established by findings on
chest X-ray, regression of the disease is rare. The
disease may remain unchanged, but it is generally slowly
progressive due to accumulating damage caused by
asbestos fibers in the lung. Rapid progression after the
onset of symptoms is rare. Evidence of progression as
seen on chest X-ray may require comparison of chest
X-rays taken as many as 4-6 years apart.
There are several factors that determine progression,
including the level and duration of exposure to
asbestos, cumulative exposure, the type of asbestos
fiber, and according to some studies, the status of the
chest X-ray at the time of diagnosis. Progression will
occur even in the absence of further exposure to
asbestos, and it will likely be accelerated in the face
of continued exposure.
As the disease progresses, the individual’s shortness
of breath becomes more pronounced. The shortness of
breath initially experienced during heavy effort will be
produced by lower levels of effort. It will eventually
interfere with the ability to carry out everyday
activities, and the individual may require oxygen. The
end result of progression is failure of the lungs and
eventual heart failure, resulting from the stress being
placed on the heart.
Increased risk of infection may be a complication of
asbestosis, although tuberculosis is uncommon.
Individuals with asbestosis are at a considerably
increased risk for developing lung cancer and other
cancers associated with asbestos exposure, including
mesothelioma and bronchogenic carcinoma.
There are certain measures a patient can take to slow
the progression of the disease and prolong life. As
mentioned previously, one way is to avoid further
exposure to asbestos. Another thing is to stop smoking.
Smoking may increase the rate of disease progression,
and it definitely increases the risk of developing lung
cancer.
Severe asbestosis is becoming a less common cause of
death. More people are dying of other causes before
their asbestosis progresses beyond the mild to moderate
stage.
Definition:
Asbestosis is a respiratory disease caused by
inhaling asbestos fibers. Asbestosis is one form of lung
disease related to asbestos inhalation. Inhalation of
asbestos fibers can cause a variety of diseases, from
thickening of the lining of the lungs, which is usually
asymptomatic, to malignant mesothelioma (a cancer
arising from the lining of the lung).
Alternative Names:
Pulmonary fibrosis - from asbestos exposure;
Idiopathic interstitial pneumonitis - from asbestos
exposure
Causes, incidence, and risk factors:
Inhaling asbestos fibers can cause scar tissue
(fibrosis) to form inside the lung. Scarred lung tissue
does not expand and contract (elasticity) normally. The
severity of the respiratory disease depends upon the
duration of exposure and the amount inhaled.
Asbestos fibers were commonly used in construction
before 1975. Asbestos exposure occurs from asbestos
mining and milling industries, construction,
fireproofing, and other industries. In families of
asbestos workers, exposure can also occur from particles
brought home in the worker's clothing. Asbestos-related
disease includes pleural plaques (calcification),
malignant (cancerous) tumor called mesotheliomas--see
mesothelioma (malignant), and pleural effusion.
Mesotheliomas may develop 20 to 40 years after exposure.
More than 9 million workers are at risk of developing
this disease. Cigarette smoking increases the risk of
developing the disease. The incidence is 4 out of 10,000
people.
Symptoms:
- shortness of breath on exertion
- cough
- tightness in the chest
- chest pain
- nail abnormalities or clubbing of fingers may
occur
Signs and tests:
- Listening to the chest with a stethoscope
(auscultation) reveals a crackling sound.
These tests also help diagnose the disease:
- a chest X-ray
- pulmonary function tests
- a CT scan of the lungs
This disease may also alter the results of the
following test:
Treatment:
There is no cure available. Stopping further exposure
to asbestos is indicated. Supportive treatment of
symptoms includes respiratory treatments to remove
secretions from the lungs by postural drainage, chest
percussion, and vibration. Aerosol medications to thin
secretions may be prescribed. Oxygen by mask or by a
plastic piece that fits into the nostrils (cannula) may
be needed.
Support Groups:
The stress of illness can often be helped by joining
a support group where members share common experiences
and problems.
Expectations (prognosis):
The outcome depends upon the duration and extent of
the exposure;
mesotheliomas have a poor prognosis
(probable outcome) with 75% of those affected dying
within 1 year.
Complications:
- mesothelioma (malignant)
- pleural effusion
Calling your health care provider:
Call for an appointment with your health care
provider if exposure to asbestos is suspected or if
unexplained symptoms occur.
Prevention:
Early screening by chest X-ray of people who are
exposed to asbestos.
|
