Asbestosis

What Is Asbestosis?

Asbestosis is long term inflammation and scarring of the lungs due to asbestos fibres. Symptoms may include shortness of breath, cough, wheezing, and chest tightness. Complications may include lung cancer, mesothelioma, and pulmonary heart disease.

Asbestosis is caused by breathing in asbestos fibers. Generally it requires a relatively large exposure over a long period of time. Such levels of exposure typically only occur in those who work with the material. All types of asbestos fibers are associated with an increased risk. It is generally recommended that currently existing asbestos be left undisturbed. Diagnosis is based upon a history of exposure together with medical imaging. Asbestosis is a type of interstitial pulmonary fibrosis.

There is no specific treatment. Recommendations may include influenza vaccination, pneumococcal vaccination, oxygen therapy, and stopping smoking.[5] Asbestosis affected about 157,000 people and resulted in 3,600 deaths in 2015. Asbestos use has been banned in a number of countries in an effort to prevent disease.

Symptoms of Asbestosis

When scar tissue forms around the lungs’ microscopic air sacs, it gradually becomes harder for them to expand and fill with fresh air.

This can cause a series of symptoms, including:

• Shortness of breath
• Persistent dry cough
• Chest tightness and pain
• Fatigue
• Loss of weight and appetite
• Crackling sound when breathing

The stiffening of the lungs causes the coughing, discomfort and crackling sound associated with asbestosis, and it also results in less oxygen being delivered to the blood, causing shortness of breath. Because the body relies on oxygen for energy, chronic breathing difficulties lead to fatigue and weight loss.

Advanced Symptoms

Pulmonary hypertension

The formation of scar tissue may also constrict arteries and make it harder to pump blood out of the heart and into the lungs without increasing the pressure required to perform the action. This is called pulmonary hypertension, which is a different condition from the more commonly occurring “high blood pressure” or systemic hypertension. Pulmonary hypertension is dangerous because it forces the heart to work harder, potentially leading to earlier problems with coronary artery disease and congestive heart failure.

Clubbed fingers and toes

When the lungs deliver insufficient oxygen to the blood, a symptom called “clubbing” may arise. The tips of the toes and fingers appear wider and rounder than normal. Fingernails and toenails may become deformed because of the lack of oxygen reaching the body’s extremities.

Managing Symptoms

Patients can minimize symptoms of asbestosis by taking steps to improve their lifestyle:

• Eat a well-balanced diet and stay hydrated.
• Get adequate sleep every night and take short rests during the day.
• Exercise regularly without overexerting yourself.
• Prevent respiratory infections by getting flu and pneumonia vaccines, washing your hands and avoiding large crowds.
• Avoid air pollution and tobacco smoke.

Causes

If you are exposed to high levels of asbestos dust over a long period of time, some of the airborne fibers can become lodged within your alveoli — the tiny sacs inside your lungs where oxygen is exchanged for carbon dioxide in your blood. The asbestos fibers irritate and scar lung tissue, causing the lungs to become stiff. This makes it difficult to breathe.

As asbestosis progresses, more and more lung tissue becomes scarred. Eventually, your lung tissue becomes so stiff that it can’t contract and expand normally.

Smoking cigarettes appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease.

Risk factors

People who worked in mining, milling, manufacturing, installation or removal of asbestos products before the late 1970s are at risk of asbestosis. Examples include:

• Asbestos miners
• Aircraft and auto mechanics
• Boiler operators
• Building construction workers
• Electricians
• Railroad workers
• Shipyard workers
• Workers removing asbestos insulation around steam pipes in older buildings

In general, it’s safe to be around materials that are made with asbestos as long as the asbestos fibers are contained. This prevents them from getting into the air.

Complications

If you have asbestosis, you’re at increased risk of developing lung cancer — especially if you smoke or have a history of smoking.

Prevention

Reducing exposure to asbestos is the best prevention against asbestosis. In the United States, federal law requires employers in industries that work with asbestos products — such as construction — to take special safety measures.

Many homes built before the 1970s have materials such as pipes and floor tiles that contain asbestos. Generally, there’s no cause for concern as long as the asbestos is enclosed and undisturbed. It’s when materials containing asbestos are damaged that there’s a danger of asbestos fibers being released into the air.

Long-Term Outlook and Complications of Asbestos

Asbestosis can lead to malignant mesothelioma, a severe form of lung cancer. Other types of lung cancer may develop if you smoke. Chronic obstructive pulmonary disease is another serious condition that can result from asbestosis. A buildup of fluid around your lungs, known as pleural effusion, is also associated with asbestosis.

Factors that affect the severity of the disease include how long you were exposed to asbestos and how much of it you inhaled. The condition progresses at a slower rate once your exposure to asbestos stops. People who have the disease but do not develop complications can survive for decades.

What to Do If You’ve Been Exposed

If you’ve been dealing with asbestos exposure for more than ten years, you should visit your doctor for a chest X-ray and screening every 3 to 5 years. Be sure to use every piece of safety equipment at work and follow all safety procedures if your job regularly exposes you to asbestos.

Employers must watch the levels of exposure in the workplace and only allow work that involves dealing with asbestos to be done in specified areas. Federal laws also require workplaces to have decontamination areas. Employee training sessions are required as well. Routine medical exams, which can lead to an early diagnosis of asbestosis, are also covered under federal law.

You should contact the nearest OSHA office if you think your employer doesn’t comply with these standards. They can check your workplace and provide more information on health issues. They also keep track of emergencies and workplace accidents.

Frequently Asked Questions

What is asbestos?

Asbestos is a group of naturally occurring silicate minerals. Mined and milled from native rock, asbestos is fibrous, thin, and strong. Chrysotile, amosite, crocidolite, tremolite, anthophyllite, and actinolite fibers are the most common types of asbestos minerals. However, only chrysotile, crocidolite, and amosite varieties are of industrial importance. Characteristics, like heat resistance, chemical inertness, and insulating capacity, coupled with the flexibility to be woven make asbestos suitable for use in many industrial applications.

How might I be exposed to asbestos fibers?

Asbestos can enter the environment from weathered natural mineral deposits and fiber releases arising from manmade asbestos products. Asbestos may be found in products like floor tiles, roof shingles, cement, and automotive brakes. Electrical, plumbing, acoustical, and structural insulation applications are also very common. Asbestos fibers are released into the air when these products are disturbed.

 How do asbestos fibers enter and leave the body?

Breathing asbestos-containing air into the lungs is the exposure route of greatest concern. Some of the asbestos fibers reaching the lungs are eliminated in exhaled air and others are coughed from the lungs with mucous. The fibers reaching the deepest air passages of the lungs can produce the greatest damage.

The digestive system can be exposed to asbestos fibers from drinking water and mucous cleared from the lungs. A small number of fibers may penetrate the cells that line the digestive system, but only a few will reach the bloodstream. These fibers will be released in the urine. Asbestos fibers contacting the skin rarely pass through the skin into the body.

How can asbestos affect my health?

Information on human health effects of asbestos comes mostly from long-term studies of people exposed to asbestos in the workplace. Asbestos workers who breathe in asbestos may develop a slow build-up of scar-like tissue in the lungs called asbestosis. This scarred tissue state impairs the ability of the lungs and heart to adequately provide oxygen to the body. This is a serious disease, and can eventually lead to disability or death in people exposed to high amounts of asbestos. Asbestos workers also have increased chances of developing two types of cancer: Lung cancer starts within the respiratory tissues, and mesothelial cancer grows from the thin membranes that surround the lung or the abdominal cavities. Both lung cancer and mesothelioma are usually fatal. These asbestos-related diseases do not appear immediately, but may develop 20 to 50 years after exposure.

The health effects from oral asbestos exposures are unclear. In some areas where the residents are exposed to asbestos fibers in the drinking water, cancers of the esophagus, stomach, and intestine may be a greater concern. After reviewing the scientific evidence from human experience and animal testing; however, health authorities are still unsure of asbestos links to cancer in the digestive system.

Is there a medical test to determine whether I have been exposed to asbestos fibers?

The most common test used to determine if you have been exposed to asbestos is a chest x-ray. The x-ray cannot detect the asbestos fibers themselves, but can detect early signs of lung disease caused by asbestos exposure. Another tool used by physicians, called a pulmonary function test, can also be useful in identifying lung capacity changes.

Periodic health examinations by a physician, including a chest x-ray and review of asbestos-based risk factors, can be effective. Asbestos risk factors include levels, frequency, and length of asbestos exposures; period of time since exposures; and smoking history. The combined impact of cigarette smoking and fiber exposures can increase the chances of asbestos-related lung diseases.

 I have asbestos in my home. Do I need to do anything about it to protect my health?

Most of the time, no. The common materials used in home construction are floor tile, roofing and siding. These materials are very strong and don’t readily crumble and release the asbestos fibers unless they are subjected to strong forces. Occasionally other materials such as pipe insulation and thermal insulation, such as batt or blown-in insulation, are used in home construction. If you determine that you have this type of material, through inspection and analysis by a properly qualified inspector and laboratory, you should seek the help of a consultant to aid you in determining what you need to do to remedy your situation. If you never have the need to disturb these materials, you may be able to leave them alone. But if you know that a needed repair or renovation will disturb the material, you may want to start planning with your consultant to abate the asbestos during the project.

 I am going to perform a renovation or demolition to my building. Is there anything I should know about asbestos before I begin my project?

The Environmental Protection Agency (EPA) National Emission Standards for Hazardous Air Pollutants (NESHAP) requires that you perform a survey to determine the presence of asbestos in your building before doing a renovation or demolition. You must also notify before you start such a project. In Texas you must notify the Texas Department of State Health Services. Texas also has rules that pertain to public buildings that require similar notification as the NESHAP and further requirements such as licensed persons to perform the survey and to remove the asbestos.

 How do I get licensed to perform asbestos-related work in Texas?

We can send you an application package. Licenses are required to perform asbestos-related work in public buildings in Texas for Contractors, Supervisors, Workers, Consultants, Management Planners, Inspectors, Air Monitors, Laboratories, Transporters, and Training Providers.

I do site assessment surveys. Do I need a license to inspect for asbestos?

Yes. Regardless of the number of samples that you take during your survey, any sample for asbestos in a public building requires a license.

I need to get properly trained with respect to asbestos. Where can I receive the proper training?

We have a list of all licensed trainers in Texas. Any licensed trainer in Texas can give you the training you require under the revised Model Accreditation Plan (MAP) or that required by Occupational Safety and Health Administration, such as that required in 29 CFR 1926.1101. In April 1994 the Environmental Protection Agency’s (EPA) Revised Model Accreditation Plan (MAP) became effective. It covers training requirements for persons working with asbestos in public and commercial buildings. Most occupational exposure to asbestos is covered under the Occupational Safety and Health Administration regulations and requires training that meets the same criteria as the revised MAP. Since Texas asbestos law covers training requirements in public buildings and requires trainers to meet the EPA revised MAP, this is the best training for most circumstances.

I hear that to remove floor tile or sheet vinyl flooring that I don’t need a license. Is that true?

Yes. The Texas Asbestos Health Protection Rules (TAHPR) allow a person who has had the Resilient Floor Covering Institute (RFCI) guidelines training to use those guidelines for flooring removal in leu of a license. The guidelines must be followed strictly. Also, before beginning any removal, the flooring material must be sampled by a licensed inspector to determine the presence of asbestos per TAHPR and that the inspector makes an assessment per the revised Model Accreditation Plan as to whether the flooring can be removed properly by the RFCI guidelines, call the Resilient Floor Covering Institute at (301) 340-8580.

Who can conduct an asbestos survey in a public building?

• Asbestos Consultant Agency
• Asbestos Management Planner Agency
• Asbestos Individual Consultant
• Asbestos Individual Managment Planner
• Asbestos Inspector