Asbestosis is a pulmonary disease condition that is characterized by
diffusion and pulmonary fibrosis brought about by the inhalation of asbestos dust. Presently, most countries have enacted laws that restrict the use of asbestos and asbestos based materials in the construction industry, however there are still numerous unaccounted industrial companies that manufacture asbestos wherein there is exposure that occurred and may possibly occur in the future.
Asbestosis as a disease condition is prevalent in industries that produces asbestos based products, numerous occupations related it’s the manufacture, asbestosis mining, shipbuilding, demolition of structures containing asbestos and roofing. Materials such as shingles, vinyl asbestos, cement, fireproof paint, brake linings and filters containing asbestos based materials are still in existence. Other activities that predispose people to exposure to asbestos include; exposure to washing of clothes that have been in contact with asbestos and inhalation of debris from demolished buildings containing asbestos. Additional diseases related to asbestos exposure include lung cancer and asbestos relate pleural effusion.
Pathophysiology of asbestosis
Prolonged Inhalation of asbestos can lead to asbestosis. Asbestos particles and fibers enter the alveoli where they are rounded by fibrous tissue. These fibrous tissue will eventually proliferate, infiltrate and destroy the alveoli and underlying structures of the lower respiratory tract. The corresponding fibrous changes can also significantly affect the pleura which in turn thickens and develops into plaque which results in painful lung expansion during inhalation and expiration. The result of these physiologic changes is only restricted to lung diseases with decreased lung volume, diminished exchange of oxygen, carbon dioxide, central cyanosis and severe hypoxemia.
Clinical manifestations of asbestosis
The onset of asbestosis is usually insidious and individuals experience a progressive difficulty in breathing, persistent coughing that is usually dry, chest pain that varies from mild to moderate, anorexia, weight loss and body malaise. Early physical findings and manifestations include inspiratory crackles upon auscultation and clubbing of fingers. As the condition progresses, respiratory distress becomes more common, which results in respiratory failure if not properly managed and treated. A high proportion of workers who have been persistently exposed to asbestos particles, dusts and smoke have a high probability of acquiring lung cancer in the future.
Medical management of asbestosis
Presently there is no effective treatment modality of asbestosis because of the severity and permanent damage asbestos can do to the pulmonary system. In asbestosis, lung damage is almost always permanent and can no longer be reverted back to its healthy and non-diseased state. The best approach in caring for individuals suffering from asbestosis is directed towards controlling infection and treating the underlying lung disease. When oxygen-carbon dioxide exchange becomes severely compromised and greatly impairs the pulmonary circulation, continuous oxygen therapy is initiated in
order to improve activity tolerance and general comfort. The individual must be instructed to avoid additional exposure to any asbestos derived products and refrain from cigarette smoking since the high incidence of mortality in people predisposed to the disease is proportional to the higher prevalence of lung carcinoma as a secondary effect of the disease condition. Finally, if the individual reaches the terminal stage of the disease, end of life care is the primary focus of the health care team by providing comfort measures to an individual at the end stage of asbestosis.