Asbestosis.Care & specialists in New Zealand

Asbestosis is a chronic scarring of the lungs caused by inhaling asbestos fibers. It develops 10-40 years after first exposure and causes progressive breathlessness, dry cough, and reduced lung function. There is no cure; treatment focuses on stopping further exposure, slowing decline, and managing symptoms.

The earliest signs are gradually worsening shortness of breath on exertion and a dry cough that persists for months. Doctors often hear fine crackles at the base of both lungs on examination. Pulmonary function tests show reduced lung volumes and reduced diffusion capacity before significant changes appear on imaging.

Asbestosis typically appears 10-40 years after first significant exposure. Mesothelioma, another asbestos-related disease, can develop 30-45 years after exposure. Risk and latency depend on cumulative exposure (fiber-years) and the type of fiber (amphibole forms are far more dangerous than chrysotile).

No. Asbestosis is scarring of the lung tissue itself caused by asbestos fibers. Mesothelioma is a cancer of the pleura (lung lining) or peritoneum (abdominal lining) caused by asbestos. Both come from the same exposure but they are different diseases with different clinical features, imaging, and treatment.

Diagnosis requires a credible history of significant asbestos exposure with adequate latency, characteristic findings on high-resolution CT (subpleural fibrosis, honeycombing, often with pleural plaques), restrictive pulmonary function, and exclusion of alternative causes. The Helsinki Criteria and ATS 2004 statement guide diagnosis worldwide.

No. The fibrosis is irreversible. Treatment focuses on stopping further exposure, smoking cessation, pulmonary rehabilitation, oxygen therapy when needed, vaccinations, and managing complications. Antifibrotic drugs (nintedanib, pirfenidone) may slow progression in selected progressive cases but do not reverse existing scarring.

Median survival ranges 9-15 years in lighter disease and 5-7 years in advanced disease with hypoxemia. The main causes of death are respiratory failure, cor pulmonale, infection, and asbestos-related lung cancer or mesothelioma. Smoking cessation and avoidance of further exposure significantly improve outcomes.

Workers in shipbuilding, insulation, demolition, construction, automotive brake repair, asbestos mining, boiler-making, and naval service before 1990 carry the highest risk. Family members exposed to fibers brought home on workwear (secondary exposure) and residents near asbestos mines or natural deposits are also at risk.

No. Risk depends on cumulative dose, fiber type, and individual susceptibility. Brief or low-intensity exposures rarely cause asbestosis, though they can still cause pleural plaques and modestly raise mesothelioma risk. Heavy occupational exposure over years is the typical setting for clinical asbestosis.

Workers with documented significant exposure should have a baseline chest X-ray, pulmonary function tests, and a low-threshold approach to HRCT if respiratory symptoms develop. The American Thoracic Society recommends periodic surveillance for exposed workers; specific schedules vary by jurisdiction and employer scheme.

Yes. Homes built before national asbestos bans (1999 in the UK, partial bans in the US since 1989) may contain asbestos in insulation, floor tiles, roofing, pipe lagging, and textured ceilings. Undisturbed material is generally safe; renovation or demolition requires licensed assessment and abatement.

Smoking accelerates lung function decline in established asbestosis and dramatically multiplies the risk of asbestos-related lung cancer — 28-50-fold higher than smoking or asbestos alone. Smoking cessation is the single most important intervention for any asbestos-exposed person, regardless of asbestosis status.

No. Pleural plaques are localized thickening of the pleura (lung lining) caused by asbestos exposure and are usually asymptomatic. They are a marker of exposure rather than fibrosis. Asbestosis is fibrosis of the lung tissue itself and causes breathlessness and reduced lung function.

Yes, in most industrialized countries. Workers' compensation, government schemes (UK Pneumoconiosis Etc. Act, US state and federal funds), and asbestos trust funds established through industry bankruptcies provide payments for diagnosed cases. Documentation of exposure history is essential — keep employment records, photos, and witness statements.

Asbestosis is caused by asbestos fibers and produces lower-lobe predominant interstitial fibrosis with honeycombing, often with pleural plaques. Silicosis is caused by crystalline silica (sandblasting, mining, stone fabrication) and produces upper-lobe nodules and progressive massive fibrosis. Exposure history distinguishes them.

Asbestosis itself is not contagious or genetic. However, asbestos fibers brought home on workwear, hair, or skin can be inhaled by family members and cause asbestosis or mesothelioma in them. Showering and changing clothes at work before going home are essential to prevent secondary exposure.

Asbestosis is not cancer, but the same asbestos exposure that causes asbestosis greatly raises the risk of lung cancer and mesothelioma. Patients with established asbestosis carry the highest individual cancer risk of any asbestos-exposed group. Surveillance and prompt investigation of new respiratory symptoms are critical.

Pulmonary rehabilitation, breathlessness coping techniques, and inhaled bronchodilators (when concomitant airflow obstruction) all help. Long-term oxygen therapy is indicated when resting blood oxygen falls below 55 mmHg or 60 mmHg with cor pulmonale. Low-dose opioids reduce severe breathlessness in advanced disease.

Yes. Long-standing low oxygen levels raise pulmonary artery pressure, eventually causing right-sided heart failure (cor pulmonale) with peripheral edema, raised jugular venous pressure, and reduced exercise capacity. Early recognition and oxygen therapy slow this progression.

Yes, in carefully selected patients under approximately age 65 with end-stage asbestosis, no asbestos-related malignancy, and acceptable comorbidities. Five-year survival after lung transplantation in interstitial lung disease is approximately 50-60%. Mesothelioma or active lung cancer disqualifies a patient.

Patients with asbestosis attend pulmonology clinic every 6-12 months for symptom review, pulse oximetry, spirometry, and DLCO. HRCT is repeated every 1-2 years or sooner if symptoms change. Low-dose CT screening for lung cancer is reasonable in heavy smokers with asbestos exposure aged 50-80.