Asbestosis Treatment & Management

  • Author: Basil Varkey, MD, FCCP; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Sep 15, 2010
 

Medical Care

Control of asbestos in the workplace is the most effective method for preventing asbestosis. Cessation of further exposure to asbestos once the diagnosis of asbestosis is made is imperative because further exposure increases the rate of progression. However, the disease may progress even after cessation of exposure. Additionally, note the following:

  • Advise smokers to quit smoking, and provide referral to a smoking cessation clinic.
  • Inform patients on the work-related causation of the disease (potentially compensable) and report it to appropriate state or federal agencies.
  • Assessment of disease severity and functional impairment are important in tailoring a treatment and follow-up plan (ie, frequency of clinic visits, chest radiographs, pulmonary function testing).
  • Treatment requires prompt attention to respiratory infections and immunizations against influenza and pneumococcal pneumonia.
  • Perform prompt antimicrobial treatment of respiratory infections.
  • Assess oxygenation status at rest and with exercise. If testing detects hypoxemia at rest or with exercise, prescribe supplemental oxygen.
  • Remain aware of the complications of asbestosis to expedite detection and treatment.
  • Provide palliative care for the relief of distressing symptoms in advanced disease.
Next

Consultations

Consult a pulmonologist to assess the need for long-term oxygen therapy and for the management of advanced cases and complications (see Mortality/Morbidity). If patients smoke, refer them to a smoking cessation clinic. Because of the likelihood of bronchogenic carcinoma, consult a thoracic surgeon if a solitary pulmonary nodule develops in a patient with asbestosis. Provide hospice referral (preferably at home) when disease reaches the terminal phase.

Previous
Proceed to Medication
 
 
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 and American College of Chest 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.

Specialty Editor Board

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.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

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: Nothing to disclose.

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St 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.

References

  1. Churg A, Stevens B. Enhanced retention of asbestos fibers in the airways of human smokers. Am J Respir Crit Care Med. May 1995;151(5):1409-13. [Medline].

  2. Sichletidis L, Chloros D, Spyratos D, et al. Mortality from occupational exposure to relatively pure chrysotile: a 39-year study. Respiration. 2009;78(1):63-8. [Medline].

  3. Antao VC, Pinheiro GA, Wassell JT. Asbestosis mortality in the USA: facts and predictions. Occup Environ Med. May 2009;66(5):335-8. [Medline].

  4. Centers for Disease Control and Prevention. Asbestosis-related years of potential life lost before age 65 years. United States 1968-2005. MMWR. Dec 12 2008;57:1321-25.

  5. Hammond EC, Selikoff IJ, Seidman H. Asbestos exposure, cigarette smoking and death rates. Ann N Y Acad Sci. 1979;330:473-90. [Medline].

  6. Ameille J, Letourneux M, Paris C, Brochard P, Stoufflet A, Schorle E, et al. Does asbestos exposure cause airway obstruction, in the absence of confirmed asbestosis?. Am J Respir Crit Care Med. Aug 15 2010;182(4):526-30. [Medline].

  7. Billings CG, Howard P. Asbestos exposure, lung cancer and asbestosis. Monaldi Arch Chest Dis. Apr 2000;55(2):151-6. [Medline].

  8. Karjalainen A, Piipari R, Mantyla T, et al. Asbestos bodies in bronchoalveolar lavage in relation to asbestos bodies and asbestos fibres in lung parenchyma. Eur Respir J. May 1996;9(5):1000-5. [Medline].

  9. Ross RM. The clinical diagnosis of asbestosis in this century requires more than a chest radiograph. Chest. Sep 2003;124(3):1120-8. [Medline].

  10. Voisin C, Fisekci F, Voisin-Saltiel S, Ameille J, Brochard P, Pairon JC. Asbestos-related rounded atelectasis. Radiologic and mineralogic data in 23 cases. Chest. Feb 1995;107(2):477-81. [Medline].

  11. Sette A, Neder JA, Nery LE, Kavakama J, Rodrigues RT, Terra-Filho M, et al. Thin-section CT abnormalities and pulmonary gas exchange impairment in workers exposed to asbestos. Radiology. Jul 2004;232(1):66-74. [Medline].

  12. American Thoracic Society. Diagnosis and initial management of nonmalignant diseases related to asbestos. Am J Respir Crit Care Med. Sep 15 2004;170(6):691-715. [Medline].

  13. Begin R. Asbestos-related lung diseases. In: Banks DE, Parker JE, eds. Occupational Lung Disease: An International Perspective. London, England: Chapman & Hall Medical; 1998:219-38.

  14. Gamsu G, Salmon CJ, Warnock ML, Blanc PD. CT quantification of interstitial fibrosis in patients with asbestosis: a comparison of two methods. AJR Am J Roentgenol. Jan 1995;164(1):63-8. [Medline].

  15. Kamp DW, Weitzman SA. The molecular basis of asbestos induced lung injury. Thorax. Jul 1999;54(7):638-52. [Medline].

  16. Levin SM, Kann PE, Lax MB. Medical examination for asbestos-related disease. Am J Ind Med. Jan 2000;37(1):6-22. [Medline].

  17. Osinubi OY, Gochfeld M, Kipen HM. Health effects of asbestos and nonasbestos fibers. Environ Health Perspect. Aug 2000;108 Suppl 4:665-74. [Medline].

  18. Schwartz DA, Davis CS, Merchant JA, Bunn WB, Galvin JR, Van Fossen DS, et al. Longitudinal changes in lung function among asbestos-exposed workers. Am J Respir Crit Care Med. Nov 1994;150(5 Pt 1):1243-9. [Medline].

  19. Selikoff IJ. Historical developments and perspectives in inorganic fiber toxicity in man. Environ Health Perspect. Aug 1990;88:269-76. [Medline].

  20. van Loon AJ, Kant IJ, Swaen GM, Goldbohm RA, Kremer AM, van den Brandt PA. Occupational exposure to carcinogens and risk of lung cancer: results from The Netherlands cohort study. Occup Environ Med. Nov 1997;54(11):817-24. [Medline].

  21. Weill H. Asbestos-associated diseases. Science, public policy, and litigation. Chest. Nov 1983;84(5):601-8. [Medline].

  22. Weiss W. Asbestosis: a marker for the increased risk of lung cancer among workers exposed to asbestos. Chest. Feb 1999;115(2):536-49. [Medline].

 
Previous
Next
 
Asbestos pleural plaques.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.