Asbestosis

What is asbestosis?

Asbestosis is a chronic, inflammatory medical condition affecting the lungs. It occurs after a person has been exposed to asbestosis fibres over a long period and has inhaled the fibres into their lungs, where they cause health problems.

Asbestosis a mineral, was commonly used in insulation in buildings (due to its excellent heat insulation properties) and even in firefighter’s uniforms (due to its fire-retardant properties) in the past. Over time, it was noticed that the people working the factories who produced the materials with asbestos developed diseases of the lungs and a high percentage of workers (around 20-30%) died. Today, it is not often used in building materials or in many other areas.

Building (homes, industrial and commercial) built before 1977 usually contain some form of asbestosis, in the building and hot water insulation, for soundproofing walls, as decorative material sprayed on walls and ceilings, in older stove tops, in ironing board pads, some types of textured paints, some roofing and siding material and in vinyl floor tiles.

In general, even if asbestos was used in the home (or a building), as long as they are in good condition and they are not crumbling, or in some other way flaking off. It is only when asbestos is damaged that the fibres can be released into the air and inhaled.

Asbestosis causes a type of pulmonary fibrosis as it makes the lung tissue hardened and be unable to inspire and expire properly.

Facts about asbestosis

• Asbestosis is a progressive and irreversible lung condition that leads to subsequent respiratory disability
• Symptoms of asbestosis do not normally develop in individual for at least 5 years after exposure to asbestosis
• Reducing your exposure to asbestos is the best prevention strategy for avoiding this illness
• Asbestosis can develop into mesothelioma, which is generally a very rare form of lung cancer, but is increasing in frequency as people exposed to asbestos get older and develop it in more numbers
• Many homes (apartments and houses) built prior to 1970 contain asbestos in the insulation of the build, hot water and steam pipes, stove tops and vinyl floor tiles as well as a whole host of other parts of the building – these are deemed to be fine as long as they are not disturbed and the fibres remain unreleased and do not pose a health risk
• Repairs to any type of asbestos products need to be done by a professional, who know how to minimise risk of releasing the asbestos fibres into the air
• Having asbestosis gives a person a very high risk for developing many types of lung cancer (including mesothelioma, a very rare type of cancer that starts with tumours in the lungs)

Symptoms of asbestosis

Symptoms of asbestosis may take anywhere from 20-40 years after exposure to the asbestos to occur. If the asbestos exposure has been at really high concentrations (which is usually only in people who have worked with the asbestos directly), the symptoms of asbestosis may occur as quickly as 10 years after exposure.

General symptoms

• Lung (or chest) pain
• Shortness of breath (dyspnea), especially on exertion but also at any time (especially as the disease progresses)
• Unable to exercise for long due to shortness of breath

Other symptoms

• Abnormal sounds in the lungs when they are examined by a doctor with a stethoscope
• Blue tinge to the fingers or lips
• Clubbing in the ends of the fingers especially, but also the toes, where the underside of the fingertip has a almost bulbous, “clubbed” appearance
• Coughing up mucous (only in people with very high exposure to asbestos)
• Right side of the heart fail to function properly
• Wheezing (only in people with very high exposure to asbestos)

Causes of asbestosis

The only cause of asbestosis is – breathing in asbestosis fibres.

The immune system cannot break down the inhaled asbestos fibre to a harmless particle and remove from the body, which means the alveoli in the lungs become scarred and inflamed from the failed process. This called fibrosis.

The problem with the alveoli (the smallest branches in the lungs) becoming scarred and inflamed is that they are responsible for the carbon dioxide / oxygen exchange in the lungs and if this process stops working properly, then the lungs cannot oxygenate blood that is full of carbon dioxide and do not work effectively.

If many asbestosis fibres are inhaled over a period of time, this will scar and inflame many of the alveoli so that it makes it difficult for the lungs to work properly and eventually leads to severe fibrosis and even many types of cancer.

Prevention of asbestosis

Asbestosis may be unpreventable in certain circumstances:

• Inhaling asbestos fibres – a person who has been exposed to asbestos fibres may be at very high risk to developing asbestosis, if those fibres are inhaled into the lungs or ingested accidentally

There is no known way of preventing asbestosis from occurring except to stay away from asbestos in order not to inhale any of the asbestos fibres. Once the asbestos fibre has been inhaled into the lungs (or ingested into the stomach), it will generally cause asbestosis, although it wont happen for many years after the exposure.

Preventable risk factors

There are some well-known risk factors associated with the development of asbestosis:

• Asbestos in the home – many buildings, prior to 1977, were insulated with asbestos and if the asbestos fibres were disturbed in some way (renovation work, part of the structure accidentally coming apart), then there would be a risk of inhaling the asbestos fibres and developing asbestos at some point in the future
• Asbestos workers – people who work with asbestos (and it is still in some use today), have a risk of developing asbestosis, but with tighter regulations about protective clothing when handling this material, this risk should be quite minimal
• Chrysotile workers – there is a new material which has been manufactured, which is a supposed to be a more tightly bound material and less likely to degenerate, but it is still made of asbestos, so the risk of exposure still exists and care should be taken when handling this material
• Smoking cigarettes – research shows that smoking cigarettes increases the risk of developing asbestosis, due to the damage to the lungs that smoking causes, which makes them more likely to succumb to damage from the asbestos fibres

Complications of asbestosis

Asbestosis can cause a number of very serious and life threatening complications:

• Lung cancer – exposure to asbestos and having asbestosis increases the risk of lung cancer, but for people who smoke as well, the risk is significantly increased
• Malignant mesothelioma – this is a cancer of the lining of the lung (pleura) or the lining of the abdomen (peritoneum). Mesothelioma is linked directly to asbestos exposure, although there are thought to be some people who develop this disease and who may not have had asbestosis. Mesothelioma can usually develop around 30 years after asbestos exposure
• Pleural disease – the lining of the lungs may be affected, in a non-malignant way in people who have had asbestos exposure. While this condition is not life threatening, it is serious, as it can cause fluid build-up around the lungs, which may be the first sign of an asbestos-related injury to the lungs. Pleural disease can cause shortness of breath, scar tissue around the lungs, plural calcification which may look like a tumour and some bleeding around the lungs

Other cancers linked to asbestosis

• Cancer of the larynx (voice box)
• Cancer of the esophagus
• Cancer of the gallbladder
• Cancer of the kidneys
• Cancer of the upper throat (oropharynx)

When to see a doctor about asbestosis

A family doctor should be consulted if you notice any of the symptoms relating to asbestosis, especially if you think you have been exposed to any asbestos in the past (either at work, at home, or elsewhere).

People who have existing asbestosis need to maintain regular visits with their doctor and lung specialist, to monitor the health of their lungs, to monitor any medication and to determine if there is any worsening of symptoms.

Diagnosis of asbestosis

Asbestosis is initially diagnosed through the following tests:

• Medical history – the doctor will ask a series of questions about the symptoms; when did they start, how severe and how long the duration. Your doctor will also ask if you smoke and if you have had any known exposure to asbestos in the past
• Physical examination – the doctor will usually perform a simple examination of the lungs, to determine if there are any abnormal “noises” when you breath, if there is any wheezing , if lung capacity is markedly reduce in any way or if there are any other lung problems

Diagnostic tests

Other tests that can be used to diagnose asbestosis are:

• CT scan – a CT (computerised tomography) scan is used when an x-ray is normal, but symptoms point to asbestosis. The CT scan can help to better rule out other disorders and help to diagnose asbestosis, but the CT scan may still show normal lung function even when asbestosis is suspected
• Lung function test – a lung function test is used to test the capacity of the lungs, to determine if there has been any reduction in capacity of the lungs. The lung function tests are normally used to diagnose asthma as well as chronic obstructive pulmonary disease (emphysema and chronic bronchitis)
• Sputum test – in this test, the sputum (fluid or flegm) from the lungs is analysed to try to detect if there are any asbestos fibres in that fluid
• X-ray – an x-ray is a good initial test to determine if there are any abnormalities in the lining of the lungs, including thickening of the lining of the lungs or any other abnormalities in the lower parts of the lungs. Unfortunately, x-rays can be normal even in a person with asbestosis, so a CT scan may be required

Conventional treatment of asbestosis

There is currently no treatment to reverse the effects of asbestosis on the lungs (and alveoli in particular). There are though some medical strategies that are used to prevent further damage to the lungs:

Medications

There are no medications that are used to treat asbestosis, but people who have pulmonary hypertension are treated with the following medications:

• Anti-hypertensive medications – to reduce the high blood pressure in the lungs from the condition
• Blood thinning medications – to prevent blood clots from forming in the lungs which may obstruct the blood vessels in the lungs

Oxygen

Oxygen supplementation (through an oxygen mask or by a plastic piece that fits into the nostrils) is normally given to patients with breathing difficulties or if they are in the advanced stages of the disease.

Lung transplant surgery

This is often a last resort treatment, as it is so radical and this surgery will only occur if there is an available set of lungs to use in the lung transplant surgery.

There are other strategies which are recommended to reduce further deterioration and progression of symptoms:

Flu vaccine

People with asbestosis are at increased risk for any type of lung condition, so it is recommended that people with asbestosis have a flu vaccine to prevent further stress on the lungs that a flu infection would cause, which may exacerbate breathing difficulties.

Stop smoking

People with asbestosis should stop smoking, as cigarette smoking puts extra stress on the lungs which may exacerbate breathing difficulties and smoking greatly increases the risk for lung cancer especially in people with asbestosis.

Alternative / complementary treatment of asbestosis

Asbestosis has no cure, so alternative/complementary strategies can only treat the symptoms and help to strengthen the immune system to prevent worsening of symptoms.

Herbs

There are a few herbs which have immune system stimulating effects and others which help reduce lung inflammation symptoms:

• Garlic – the herb garlic is best if eaten fresh, cooked with food or taken as a supplement. Garlic has potent anti-viral and anti-bacterial properties, which may reduce risk of infection in the lungs and because it has blood thinning properties, it may reduce the risk of blood clots due to high blood pressure in the lungs. People taking any type of blood thinning medicine need to consult their doctor about taking garlic, as too much garlic in combination with blood thinning medications may thin the blood too much and create a risk of internal bleeding
• Ginger – the herb ginger has potent anti-inflammatory effects on the whole body, including the lungs and may prevent worsening of symptoms by reducing inflammation in the lungs from the asbestosis

Vitamins

There are a few vitamins which may help the immune system function better:

• Bioflavonoids – the bioflavonoids are used together with vitamin C as they are a potent antioxidant which helps to support the immune system function more effectively
• Vitamin A – the mucous membranes in and around the lungs need adequate levels of vitamin A to be healthy and function properly. Vitamin A is also an excellent antioxidant which can help reduce risk of infection in the lungs. Since vitamin A can be toxic in large amounts, always consult your natural health care professional to ensure you are not exceeding recommended amounts
• Vitamin C – the antioxidant vitamin C may be especially required to help support the immune system from oxidative damage and inflammation. Vitamin C is more effective if it is also combined with the bioflavonoids, both of which occur naturally together in certain fruits and vegetables
• Vitamin D3 – this is the active form of vitamin D, which is obtained from sunshine and is vital to the lung health. Studies have shown that a lack of vitamin D may contribute to lung cancer
• Vitamin E – studies show the antioxidant vitamin E may be beneficial for reducing inflammation in the lungs and so reduce this may reduce the severity and duration of symptoms in people with asbestosis, in which the lining of the lungs becomes inflamed and scarred. People taking any type of blood thinning medications must be careful if they want to take vitamin E, as this vitamin may thin the blood too much and the combination may cause internal bleeding if levels of the blood thinning medications and vitamin E are high

Minerals

There are a few antioxidant vitamins which help the immune system function better:

• Selenium – the mineral selenium is an antioxidant which helps support the immune system to function more effectively, by reducing oxidative damage to the cells
• Zinc – the mineral zinc supports the immune system to function more effectively and also heals any type of damage to the body tissues much more quickly, so may help to reduce scar damage in the lungs

Other nutrients

There are a number of other nutrients which may help to reduce symptoms:

• Co-enzyme Q10 – the nutrient co-enzyme Q10 has anti-inflammatory properties which may help to reduce symptoms in the lungs
• Omega 3 fatty acids – the omega 3 fatty acids are vital to help reduce inflammation in every part of the body, including the lungs (and bronchi), which may help to reduce scarring and damage to the lungs and help with better breathing, in the person with asbestosis

Dietary modifications

There are a number of dietary modifications that can be used to help reduce asbestosis symptoms:

• Eat more oily fish – the diet should include oily fish about 3-4 times a week to help boost the intake of omega-3 fatty acids and reduce inflammation in the body in general. Best forms of oily fish are: salmon, trout, tuna, blue mackerel, sardines, mullet, golden perch, red fish, sea mullet, yellow fin brim, yellowtail kingfish, tailor, trevally silver, orange roughy, herring, cod. The fish should be cooked fresh as canned fish generally have less omega-3 fatty acids. If fish cannot be eaten, then a fish oil supplement should be taken on a regular basis. People taking any type of blood thinning medications should consult their doctor about taking omega-3 fatty acids supplements, because taking both together can increase the risk of internal bleeding
• Garlic and onions – both garlic and onions (but especially garlic) should be eaten every day, or as much as can be tolerated to help the open up the airways, reduce inflammation and prevent scarring
• Ginger – fresh ginger should be used as much as can be tolerated in cooking to help the open up the airways, reduce inflammation and prevent scarring
• Limit intake of processed foods – this includes all soft drinks, all canned and processed meats (from the deli), processed cheeses, instant soup, ice cream, toppings, puddings, cakes, pizza, take-away food, which can trigger symptoms in some people with asbestosis, mainly due to the additives, high fat content and high sugar content which increase inflammatory symptoms

Lifestyle modifications

There are some lifestyle modifications that can be implemented to reduce symptoms:

• Meditation and relaxation – many studies have shown that any form of meditation is a useful technique to help reduce symptoms of asbestosis and this is because meditation helps to control the mind, which ultimately helps to control and manage breathing
• Reduce stress – this one may be a little difficult to achieve, especially if stress is unavoidable, but stress really needs to be better managed to reduce further inflammation symptoms
• Stop smoking – people who have been diagnosed with asbestosis and who also smoke are advised to give up smoking, as it will continue to make symptoms worse. Smoking also greatly increases the risk of lung cancer if asbestosis has also been diagnosed
• Yoga – many people who practice yoga regularly report that they have reduced symptoms and better lung functioning (less pain and inflammation), especially if it is a yoga which uses breathing and relaxation techniques during the classes

Alternative treatments

• Acupuncture – some studies have shown that acupuncture greatly reduces symptoms associated with lung inflammation and disorders. Always see a qualified acupuncturist who has experience dealing with people that have any type of serious lung problems

Always ensure that you notify your medical practitioner of any supplements that you want to take – it may interfere with other medication or conditions you have. Confirm with your doctor it is safe to take before you try it.

Living with asbestosis

Management of asbestosis should be focused on trying to reduce severity of symptoms and providing a better quality of life.

Strategies to manage symptoms

• Add garlic to the diet – fresh garlic should be eaten every day, or as much as can be tolerated to help the open up the airways, reduce inflammation and prevent scarring, which is very beneficial in lungs which are inflamed and prone to scarring as is the case in asbestosis
• Add ginger to the diet – fresh ginger should be used as much as can be tolerated in cooking to help the open up the airways, reduce inflammation and prevent scarring, which is very beneficial in lungs which are inflamed and prone to scarring as is the case in asbestosis
• Eat more oily fish – the diet should include oily fish about 2-4 times a week to help boost the intake of omega-3 fatty acids and reduce inflammation in the lungs. Best forms of oily fish are: salmon, trout, tuna, blue mackerel, sardines, mullet, golden perch, red fish, sea mullet, yellow fin brim, yellowtail kingfish, tailor, trevally silver, orange roughy, herring, cod. The fish should be cooked fresh as canned fish generally have less omega-3 fatty acids. If fish cannot be eaten, then a fish oil supplement should be taken on a regular basis. People taking any type of blood thinning medications should consult their doctor about taking omega-3 fatty acids supplements, because taking both together can increase the risk of internal bleeding
• Flu vaccine – if your lungs are particularly sensitive and you catch infections easily, you may consider getting a yearly flu vaccine, which helps to reduce the severity and duration of any influenza infection and reduces the risk of any infection of the lungs from developing into a more severe infection (such as pneumonia and pleurisy)
• Reduce intake of processed foods – this includes all soft drinks, all canned and processed meats (from the deli), processed cheeses, instant soup, ice cream, toppings, puddings, cakes, pizza, take-away food, which can trigger symptoms in some people with asbestosis, mainly due to the additives, high fat content and high sugar content which increase inflammation and this can make symptoms much worse
• Regular visits to the doctor – you need to ensure you visit your doctor on a regular basis, so that your doctor can check your symptoms and disease progression. If your symptoms have worsened and breathing becomes difficult, your doctor can give advise about treatment options
• Stop smoking – if you have asbestosis, you must give up smoking, as cigarette smoking puts extra stress on the lungs (which are already not functioning at a healthy level), exacerbates breathing difficulties and significantly increases the risk of developing lung cancer

Caring for someone with asbestosis

Partner

People who have a partner with asbestosis can help their partner with the following strategies:

• Doctor consultation – it would be beneficial for your partner if you go with them to their doctor’s appointments, as some of the information may be useful for you to know, how to take care of them, for example, how to help them with their oxygen mask, if required. You need to encourage your partner to see their doctor if they have worsening of symptoms
• Healthy diet – try to have a healthy diet, with lots of fresh vegetables and fruit, nuts and seeds, legumes, wholegrains and some fish to help increase intake of vital nutrients and antioxidants which may help your partner’s overall health and reduce severity of symptoms. Try to limit intake of processed foods and saturated fat (from high fat dairy and red meat) as they can increase inflammation and make your partner have worsening of symptoms
• Stop smoking – you must not smoke cigarettes around your partner, because the unfiltered smoke from your cigarettes can further damage their lungs and increase their risk of developing lung cancer. If you must smoke, do so outside or elsewhere than the house
• Support – your partner needs to know that you are there for them , to listen to their concerns and help support them

Friends

People who have a friend with asbestosis can help their friend with the following strategies:

• Stop smoking – you must not smoke cigarettes around your friend, because the unfiltered smoke from your cigarettes can further damage their lungs and increase their risk of developing lung cancer
• Support – your friend needs to know that you are there for them, to listen to their concerns and help support them

Family member

People who have a family member with asbestosis can help their family member with the following strategies:

• Stop smoking – you must not smoke cigarettes around your family member, because the unfiltered smoke from your cigarettes can further damage their lungs and increase their risk of developing lung cancer. If you must smoke, do so outside or elsewhere
• Support – your family member needs to know that you are there for them, to listen to their concerns and help support them

References

Last reviewed and updated: 14 May 2024