asbestose

Asbestosis is a form of interstitial lung disease caused by prolonged inhalation of asbestos fibers, leading to progressive scarring (fibrosis) of the lung parenchyma. It is part of a spectrum of asbestos-related diseases that also includes pleural conditions and asbestos-related cancers.

The condition arises from sustained asbestos exposure, commonly in industries such as mining, milling, construction, shipbuilding, insulation, and manufacturing. Latency from first exposure to symptom onset is typically many years, often 10 to 40 years. The risk increases with the intensity and duration of exposure, and smoking can worsen disease expression.

Symptoms usually develop gradually and include shortness of breath on exertion, a persistent dry cough, chest tightness, and fatigue. On examination, clinicians may hear fine basilar crackles. In advanced cases, exercise intolerance and reduced lung capacity are common. Clubbing of the fingers can occur but is not universal.

Diagnosis relies on a combination of exposure history, imaging, and lung function testing. Chest X-ray or high-resolution CT typically shows basilar-predominant interstitial fibrosis and may reveal pleural plaques. Pulmonary function tests often demonstrate a restrictive pattern with reduced diffusing capacity (DLCO). Confirmation may require histopathology showing interstitial fibrosis with asbestos bodies, although a noninvasive diagnosis is possible with concordant clinical and radiographic evidence.

There is no cure for asbestosis. Management focuses on relieving symptoms and slowing progression: supplemental oxygen as needed, pulmonary rehabilitation, vaccinations, and avoidance of further asbestos exposure. Smoking cessation is advised. Patients have an elevated lifetime risk of lung cancer and mesothelioma, which influences prognosis and monitoring needs.

Prevention hinges on reducing or eliminating asbestos exposure through occupational safety regulations and, in many countries, bans or phased substitutions of asbestos-containing materials.