eMedicine Specialties > Pulmonology > Occupational Lung Diseases

Asbestosis: Follow-up

Author: Basil Varkey, MD, FCCP, Professor Emeritus, Department of Internal Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin; Consulting Pulmonologist, Froedtert Memorial Lutheran Hospital
Coauthor(s): Anita B Varkey, MD, Assistant Professor, Department of Medicine, Loyola University Medical Center; Associate Program Director, Internal Medicine Residency; Medical Director, General Internal Medicine Clinic, Loyola Outpatient Center
Contributor Information and Disclosures

Updated: Nov 17, 2009

Follow-up

Deterrence/Prevention

  • Control of asbestos in the workplace is the most effective method for preventing asbestosis.

Complications

  • Pulmonary hypertension
  • Cor pulmonale
  • Right-sided heart failure
  • Progressive respiratory insufficiency: The risk factors for developing this complication are cumulative amount of asbestos inhaled; degree of dyspnea; cigarette smoking; combined pulmonary and pleural involvement; honeycombing visible on radiographs; and a high number of neutrophils, eosinophils, and fibronectin in BAL fluid.
  • Malignancy: A higher risk of lung carcinoma has been found in patients with asbestosis. Patients with asbestosis are also at risk for malignant mesothelioma and carcinomas of upper respiratory tract, esophagus, biliary system, and kidney.

Patient Education

  • Inform patients of the work-related causes of asbestosis (see Medical Care).
  • For excellent patient education resources, visit eMedicine's Procedures Center. Also, see eMedicine's patient education article Bronchoscopy.

Miscellaneous

Medicolegal Pitfalls

  • Diagnosis, causation, and impairment are the major issues with regard to medical/legal pitfalls.
  • Physicians often make the diagnosis without histopathologic confirmation. Errors may occur because other more common interstitial diseases (eg, idiopathic pulmonary fibrosis) mimic the clinical, radiologic, and pulmonary functional features of asbestosis. Bear in mind the long latency period between patient exposure and the manifestation of symptoms and signs of asbestosis. When lung tissue is available for histopathologic examination, confirmation of diagnosis requires both fibrosis and accumulation of asbestos bodies or fibers.
  • Determining the cause depends on assessment of the levels and duration of exposure and on knowledge of occupational epidemiologic studies.
  • Assessment of impairment, which is a key ingredient in determining disability, is based mainly on pulmonary function studies.
  • No evidence exists to confirm that small airway disease, which is detected by flow volume curves, progresses to asbestosis.
  • Pleural plaques may coexist with asbestosis, but pleural plaques alone are usually not associated with impaired pulmonary function. Nonetheless, pleural plaques are a reliable indicator of asbestos exposure.
 


More on Asbestosis

Overview: Asbestosis
Differential Diagnoses & Workup: Asbestosis
Treatment & Medication: Asbestosis
Follow-up: Asbestosis
Multimedia: Asbestosis
References
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References

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Further Reading

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Keywords

asbestosis, pneumoconiosis, pulmonary fibrosis, lung disease, bronchogenic carcinoma, malignant mesothelioma, coal worker's pneumoconiosis, dermatomyositis, hypersensitivity pneumonitis, idiopathic pulmonary fibrosis, sarcoidosis, silicosis, collagen vascular diseases, interstitial pulmonary diseases, asbestos inhalation, chrysotile fibers, amphibole fibers, calcified pleural plaques, noncalcified pleural plaques, pleural thickening, benign exudative pleural effusion, rounded atelectasis, malignant mesothelioma of the pleura

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Contributor Information and Disclosures

Author

Basil Varkey, MD, FCCP, Professor Emeritus, Department of Internal Medicine, Division of Pulmonary and Critical Care, Medical College of Wisconsin; Consulting Pulmonologist, Froedtert Memorial Lutheran Hospital
Basil Varkey, MD, FCCP is a member of the following medical societies: American Association of Physicians of Indian Origin, American College of Chest Physicians, American Federation for Clinical Research, American Thoracic Society, and Royal College of Physicians
Disclosure: Nothing to disclose.

Coauthor(s)

Anita B Varkey, MD, Assistant Professor, Department of Medicine, Loyola University Medical Center; Associate Program Director, Internal Medicine Residency; Medical Director, General Internal Medicine Clinic, Loyola Outpatient Center
Anita B Varkey, MD is a member of the following medical societies: American College of Physicians and Society of General Internal Medicine
Disclosure: Nothing to disclose.

Medical Editor

Sat Sharma, MD, FRCPC, Professor and Head, Division of Pulmonary Medicine, Department of Internal Medicine, University of Manitoba; Site Director, Respiratory Medicine, St Boniface General Hospital
Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H, Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine
Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine
Disclosure: Keck School of Medicine, USC None None

CME Editor

Timothy D Rice, MD, Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, Saint Louis University School of Medicine
Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians
Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center; Professor of Medicine, David Geffen School of Medicine at UCLA
Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society
Disclosure: Nothing to disclose.

 
 
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