Asbestosis

What is asbestosis?

Asbestosis is a lung disease that occurs in people who inhale asbestos fibers and dust over a long period of time. Asbestos is a mineral that forms tiny and long-lasting fibers when it’s in the air. People in certain industries and occupations like construction, manufacturing, mining, milling, mechanics and electricians (especially those who worked before the 1970s) are most at risk for asbestosis. People who remove asbestos products are also at risk, as are people who served in the Navy on ships where asbestos was in use.

When asbestos fibers and dust get into your lungs, they can cause fibrosis (thickening and scarring of your lungs). Asbestos can also cause the membranes surrounding your lungs (pleura) to thicken. This scarring and thickening of your lung tissue can make breathing difficult.

In some cases, asbestosis can lead to life-threatening health complications. In severe cases, asbestosis can be fatal. Asbestos exposure can also increase your risk of lung cancer.

What is asbestos?

Asbestos is a group of six natural mineral fibers. These fibers are known for their strength and fire- and chemical-resistant properties. Because of these qualities, the manufacturing and building industries use asbestos to:

• Strengthen cement and plastics.
• Provide insulation.
• Fireproof buildings, textiles and military vehicles.
• Absorb sound.

Asbestos fibers may be white, blue, brown, gray or green. White asbestos fibers (called chrysotile) are the most widely used worldwide.

How common is asbestos exposure?

Everyone is exposed to asbestos at some point in their life. Low levels of asbestos are virtually everywhere. Most people don’t get an asbestos-related disease. People who get an asbestos-related disease tend to have had exposure on a regular basis and over a long period of time.

The risk of asbestos exposure on the job was highest before the 1970s, though asbestos exposure can still occur today. Because it takes a long time to develop symptoms, providers are still diagnosing many new cases of asbestosis. Regulation of on-the-job exposure to asbestos has reduced the risk of asbestosis, but even with these regulations, workers can be exposed by accident.

How common is asbestosis?

According to the World Health Organization (WHO), millions of people face exposure to asbestos, mostly in the workplace. It’s hard to estimate how many people are living with asbestosis and other asbestos-related diseases because signs of the disease may not show up for 30 or 40 years. Some studies show that up to 20% of all workers who breathe in asbestos will develop a disease from exposure to asbestos. Not all workers who develop asbestos related disease will have asbestosis. There are other diseases that asbestos can cause, including:

• Interstitial lung disease (ILD).
• Pleural effusion.
• Certain kinds of lung cancer, including pleural mesothelioma.

What are the first signs of asbestosis?

Symptoms of asbestosis vary depending on the severity of the disease and may not appear for 20 to 30 years or more after asbestos exposure. The scarring on your lungs from asbestosis typically gets worse slowly. Because of that, you may not notice your symptoms right away.

The first symptom of asbestosis is having trouble breathing (being short of breath), especially when you’re working hard or exercising. Other signs and symptoms may include:

• Chest pain and tightness.
• Clubbing of your nails.
• Cough.
• Crackling sound when inhaling.
• Fatigue (extreme tiredness) and trouble exercising.
• Unexplained weight loss.

What causes asbestosis?

The main cause of asbestosis is inhaling tiny asbestos fibers or dust. Asbestos fibers are not harmful unless they release into the air. When they are released, the fibers break down into tiny particles. The particles become airborne, and we inhale them. Then they collect in the lungs, causing scarring and inflammation. Scarred lung tissue is stiff and unable to expand, which makes it hard to breathe.

The longer you had exposure to asbestos and the more intense the exposure, the higher your chances of developing asbestosis.

Building and manufacturing industries used asbestos widely in the past. People who work in these industries and repeatedly inhale asbestos particles are the most at risk for developing asbestosis.

Breathing in asbestos particles in the air causes asbestosis. Undisturbed asbestos — such as in insulation or tile — doesn’t increase your risk of the disease.

What products still contain asbestos?

Materials and products that may contain asbestos include:

• Car clutch pads and brake linings.
• Construction cement, putties and plaster.
• Insulation.
• Pipe wrapping.
• Siding and roof shingles.
• Vinyl floor tiles.
• Casings for electrical wires.
• Millboard.
• Patching and joint compound.
• Floor tile and adhesives.
• Soundproofing material.

Many household products and substances also contain asbestos, including:

• Artificial ashes and embers used in gas-fired fireplaces.
• Automobile brake pads and linings, clutch facings and gaskets.
• Fireproof gloves, stovetop pads, table pads and fire-resistant fabrics (including blankets and curtains).
• Some plastics, paints, coatings and adhesives.
• Vermiculite-containing attic insulation and consumer garden products.

How long can it take for asbestosis to develop?

Healthcare providers sometimes diagnose asbestosis in people who haven’t worked or been around asbestos for decades. It can take up to 30 years to develop symptoms.

What are the risk factors for asbestosis?

There are regulations in place now that reduce your asbestos exposure while on the job. Still, certain occupations face asbestos exposure, particularly if you demolish or renovate buildings built before the 1970s. Homes built before 1977 may also contain asbestos in materials like pipes, ceilings and floor tiles. Just because you live in a home built before 1977 doesn’t mean you’re at risk. Risk only occurs when asbestos is in an inhalable form like dust. When it’s in a solid state, you’re not at risk.

You’re more at risk of getting asbestosis if you have long-term exposure to asbestos. This is true if your job involves handling materials containing asbestos. These types of jobs include:

• Asbestos miners, installers or removers.
• Auto and aircraft mechanics.
• Construction crews.
• Electrical workers.
• Railroad and shipyard workers.

Studies also show that people who were involved in the rescue and cleanup at the site of the attacks on the World Trade Center (WTC) in New York City are at risk for asbestos-related diseases like asbestosis.

Factors that affect your risk of developing asbestosis

The following factors play a role in your risk:

• Duration: How long you were exposed to asbestos. In general, the longer your exposure, the higher your risk.
• Intensity: How much asbestos you were exposed to.
• Type of industry: Your risk is lower if asbestos is bonded into a product (such as walls or tiles). Your risk is higher if asbestos is released into the air, such as during sawing or demolition.
• Personal risk factors: Smoking or preexisting lung disease.
• Genetics: Having a genetic mutation to the BAP1 gene.

People with the disease tend to have had exposure for many years through an occupation. You’re not likely to get asbestosis if you disrupt asbestos during a home renovation, for example.

What are the complications that may be associated with asbestosis?

Many people who have asbestosis have breathing trouble and a cough that doesn’t go away. In more severe cases, complications can be life-threatening.

Complications of asbestosis may include:

• Lung cancer: People who have asbestosis and smoke cigarettes have an even higher risk of lung cancer.
• Mesothelioma: Cancer that forms in the lining of your abdomen, chest or lungs.
• Respiratory failure: Your lungs can’t put enough oxygen into your blood, and carbon dioxide builds up in your tissues.
• Right-sided heart failure: The right side of your heart stops working correctly.

How is asbestosis diagnosed?

Your healthcare provider will examine you and ask about your medical history. Remember to tell them about your exposure to any harmful substances like asbestos.

Your healthcare provider may also order tests to complete the diagnosis. These might include:

• A chest X-ray.
• A computed tomography (CT) scan.
• Lung function tests like spirometry.
• Bronchoscopy.

How is asbestosis treated?

Treating asbestosis aims to manage symptoms and preserve function in your lungs.

Treatment can’t reverse lung damage from asbestos. Treatment for asbestos-related diseases aims to relieve symptoms, treat complications related to the disease and slow its progress.

Your treatment depends on the severity of the disease. Your options might include:

• Oxygen therapy: Receiving extra oxygen through a mask or tube in your nostrils helps you breathe more comfortably.
• Pulmonary rehabilitation: Exercises and behavioral changes can improve your quality of life.
• Lung transplant surgery: In rare cases, a new, healthy lung from a lung transplant can relieve symptoms and prolong life.
• Medication: Medicines called “anti-fibrotics” can slow down the rate at which scarring gets worse, but can’t heal existing scarring. Your provider can discuss the risks and benefits of these medicines and help you decide what’s best for your health.

What can I do at home to manage the symptoms of asbestosis?

To make things easier on yourself if you have asbestosis, you can follow a healthy lifestyle by:

• Not smoking. If you do smoke, get help quitting. Smoking speeds up the progression of the disease and makes it worse.
• Avoiding breathing air contaminated with allergens, pollution or secondhand smoke.
• Avoiding sick people and practicing good handwashing hygiene.
• Drinking lots of water.
• Eating nutritious foods.
• Exercising regularly after discussing an exercise plan or routine with your healthcare provider.

How can you prevent asbestosis?

You can reduce your risk of asbestosis by avoiding long-term exposure to asbestos. If your job involves exposure to the mineral, you should wear a respirator (a mask that filters particles from the air). This protective mask keeps you from inhaling asbestos fibers or dust.

If you know you’ve had asbestos exposure, you should have regular exams and chest X-rays. These tests don’t prevent asbestosis but can help catch it early.

If you smoke and have exposure to asbestos, quitting smoking is your best way to reduce your risk of getting cancer.

Should I avoid all asbestos products?

Asbestos fibers are only harmful when they get in the air. Today, building materials and many other products use bonded asbestos. This process keeps them from being released into the air. There’s little to no risk of harmful health effects from these products. However, take care not to sand, tear or otherwise damage or crumble the material. This can release the fibers into the air.

Do I need to remove asbestos materials from my home?

If you have asbestos materials in your home that are in good condition, it’s best to leave them alone. If you touch or disturb the material, you risk releasing the fibers into the air. Have these materials inspected from time to time for signs of damage or deterioration.

What is the prognosis (outlook) for people with asbestosis?

There isn’t a cure for asbestosis, and you can’t reverse the damage from the disease. Once you breathe in asbestos fibers, they stay in your body. Your prognosis varies depending on how long and how much exposure you had to the particles.

Many people with mild asbestosis live fulfilling lives for many years after being diagnosed. Others get worse and need medical treatment for the rest of their lives.

Your healthcare provider is likely to order chest X-rays and lung function tests every few years to look for changes in the scarring in your lungs. The findings on your imaging tests will change as the stages of your condition progress.

What is the life expectancy of someone with asbestosis?

The average life expectancy is about 10 years once you receive a diagnosis. It depends on how severe the disease is and how fast it progresses.

When should I see a healthcare provider?

Contact your healthcare provider if you’ve had exposure to asbestos and have trouble breathing, chest discomfort or a cough that doesn’t go away. Be sure to tell your provider about your asbestos exposure, even if it’s secondhand.

If I was exposed to asbestos through my job, does that increase health risks for my family members?

It’s possible to have “secondhand” asbestos exposure. When a person works with asbestos materials, they can bring home particles on their shoes, clothing, skin and hair.

To decrease this risk, most jobs that use asbestos materials make sure that the workers change when they arrive and leave work. Most companies also have showers available for employees to clean particles from hair and skin. These precautions lower the risk of family members developing any diseases.

What is the difference between asbestosis and mesothelioma?

The main difference between asbestosis and mesothelioma is that mesothelioma is cancer and asbestosis isn’t cancer. The disease of asbestosis remains in your lungs and pleura (the covering of your lungs). Mesothelioma begins in the tissue of your lungs and abdomen. It can spread throughout your body.