Asbestosis Flashcards
What is asbestosis?
This is diffuse, interstitial fibrosis of the lung as a consequence of exposure to asbestos fibres.
What can be seen in asbestosis?
Pleural abnormalities, which are also caused by the inhalation of asbestos fibres, include plaques that may or may not be calcified, diffuse pleural thickening, benign pleural effusions or rounded atelectasis.
When does the disease occur after initial exposure to asbestos?
After 10 years.
Aetiology of asbestosis?
Inhalation of asbestos fibres.
Asbestos is a fibrous silicate, which exists as a naturally occurring mineral.
Pathophysiology of asbestosis?
When asbestos fibres are inhaled, they deposit at alveolar duct bifurcations and cause alveolar macrophage alveolitis.
Activated macrophages release cytokines which initiate a process of fibrosis.
Signs and symptoms of asbestosis?
Cough Crackles Chest pain Clubbing Dyspnoea on exertion
Risk factors of asbestosis?
Occupational exposure Indirect exposure Longer duration of exposure Smoking history Cumulative does of inhales asbestos
Investigations for asbestosis?
CXR- first-line: this is less sensitive than a CT scan but more specific than pulmonary function testing Lung function tests High-resolution CT after CXR Lung biopsy (risk of mesothelioma) Bronchial lavage
Differentials of asbestosis?
Idiopathic pulmonary fibrosis Connective tissue disease Silicosis Sarcoidosis Hard metal lung disease Hypersensitivity pneumonitis (HP)q
Screening for asbestosis?
Workplace regulations require workers exposed to asbestos at or above 0.1 fibres/cm3 to have an annual examination.
CXR is required every 5 years.
Management of asbestosis?
Advice on the importance of not smoking.
Supportive care (antibiotics should be given if there is evidence of infection)
Pulmonary rehabilitation + oxygen therapy
2nd line: Pleural decortication or lung transplant.
Complications of asbestosis?
Cor pulmonale Lung cancer Mesothelioma Colon cancer Laryngeal cancer
