asbestosis

Asbestosis is a chronic interstitial lung disease caused by inhalation of asbestos fibers, leading to progressive fibrosis of the lung interstitium. It is a form of pneumoconiosis and is typically associated with occupational exposure in industries such as construction, shipbuilding, insulation, and manufacturing.

Inhaled asbestos fibers trigger inflammation and fibroblast activity, producing interstitial fibrosis that often has basilar and subpleural predominance. The latency period is long, usually several decades from first exposure, and the disease can continue to progress after exposure ends.

Common symptoms include progressive shortness of breath on exertion and a chronic dry cough. Physical examination may reveal basilar crackles. Lung function tests typically show a restrictive pattern with reduced diffusing capacity. Clubbing is not universal. Imaging often shows bibasilar interstitial changes and pleural plaques; high-resolution CT can reveal subpleural fibrosis. Diagnosis rests on a history of asbestos exposure, compatible radiographic findings, and exclusion of other causes; ferruginous bodies may be identified on biopsy or bronchoalveolar lavage in some cases.

Complications include an increased risk of bronchogenic carcinoma and mesothelioma, as well as pulmonary hypertension and respiratory failure in advanced disease. The prognosis depends on the extent of fibrosis and comorbidity; the disease is typically progressive and there is no cure.

Management is supportive and multidisciplinary, focusing on symptom relief, pulmonary rehabilitation, smoking cessation, vaccinations, and supplemental oxygen as needed. Preventive measures emphasize minimizing asbestos exposure through engineering controls, proper personal protective equipment, and regulatory bans where applicable. Epidemiology reflects historical use; cases continue to occur in individuals with past exposure, even where current use has ceased.