Asbestos-related Lung Disease

Question 1

Asbestos lung disease

Answer 1

Spectrum of pulmonary diseases arising due to long-term exposure to asbestos fibres.
Includes:
- pleural plaques
- pleural thickening
- asbestosis
- mesothelioma
- lung cancer

Question 2

Pathogenesis of asbestos lung diseases

Answer 2

1. inhalation of fibres -> ** distal airways **
2. fibres lodge in terminal bronchioles and alveoli
3. macrophages try phagocytose fibres - but fail
4. inflammatory response -> fibrosis

Question 3

Clinical presentation of asbestos lung disease

Answer 3

• generally non-specific respiratory symptoms
• SOB, chest pain, cough…

Question 4

Diagnosing asbestos lung disease

Answer 4

• occupational hx.
• imaging (high-res CT, chest x-ray)
• histopathology

Question 5

Asbestos lung disease

Pleural plaques

Answer 5

• benign
• require no follow-up
• most common consequence of asbestos
• occur 20-40 years after exposure

Question 6

Asbestosis

Answer 6

• latency 15-30 years
• lower lobe fibrosis
• features: SOB, finger clubbing, bilateral lung crackles
• lung function tests: restrictive pattern, reduced gas transfer

Question 7

Management of asbestosis

Answer 7

Conservative
no successful interventions/cure

Question 8

Mesothelioma

Answer 8

• malignant disease of lung pleura
• features: SOB, chest pain, plearal effusions…
• caused by asbestos exposure

Question 9

Most dangerous type of asbestos

(to cause mesothelioma)

Answer 9

crocidolite (blue) asbestos

Question 10

Managing mesothelioma

Answer 10

• palliative chemo
• limited role for radiotherapy or surgery
• VERY POOR PROGNOSIS

Question 11

Most common type of cancer related to asbestos exposure

Answer 11

lung cancer (not mesothelioma)

Question 12

Importance of smoking cessation in lung cancer due to asbestos exposure

Answer 12

tobacco inhalation has synergistic effect with asbestos fibres to cause/worsen cancer