Approach Considerations

Remain aware of the complications of asbestosis to expedite detection and treatment. Inform patients about the work-related causation of the disease (potentially compensable) and report it to appropriate state or federal agencies. Additionally, advise smokers to quit smoking, and provide referral to a smoking cessation clinic.

Assessment of disease severity and functional impairment are important for tailoring a treatment and follow-up plan (ie, frequency of clinic visits, chest radiographs, pulmonary function testing).

The treatment of asbestosis requires prompt antimicrobial therapy for respiratory infections, as well as immunization against influenza and pneumococcal pneumonia.^[1]

Assess the patient’s oxygenation status at rest and with exercise. If hypoxemia at rest or with exercise is detected, prescribe supplemental oxygen.

Provide palliative care for the relief of distressing symptoms in advanced disease; provide hospice referral (preferably at home) when the disease reaches the terminal phase.

Medications

Drugs are not effective in the treatment of asbestosis. Corticosteroids and immunosuppressive drugs do not alter the course of the disease.

Prevention and deterrence

The control of asbestos in the workplace is the most effective method for preventing asbestosis. Cessation of further exposure to asbestos once the diagnosis is made is imperative because additional exposure increases the rate of progression. However, the disease may progress even after exposure has stopped.

Consultations

Consult a pulmonologist to assess the need for long-term oxygen therapy and for the management of advanced cases and complications. Because of the likelihood of bronchogenic carcinoma, consult a thoracic surgeon if a solitary pulmonary nodule develops in a patient with asbestosis.

Guidelines

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Media Gallery

Asbestosis. Asbestos pleural plaques.

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Author

Christopher D Jackson, MD Faculty, Department of Internal Medicine, University of Tennessee Health Science Center College of Medicine-Memphis; Staff Physician, Christ Community Health Services; Staff Physician, Baptist Memorial Hospital

Christopher D Jackson, MD is a member of the following medical societies: American College of Physicians, Memphis Medical Society, National Medical Association, Southern Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Muthiah P Muthiah, MD, FCCP, D-ABSM Associate Professor of Medicine, Division of Pulmonary and Critical Care and Sleep Medicine, Vice Chair for Internal Medicine (VA Academic Affairs), University of Tennessee Health Science Center College of Medicine; Director of Medical Intensive Care Unit (MICU), Memphis Veterans Affairs Medical Center

Muthiah P Muthiah, MD, FCCP, D-ABSM is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American Thoracic Society, Society of Critical Care Medicine

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD, FACP, FCCP Geri and Richard Brawerman Chair in Pulmonary and Critical Care Medicine, Professor and Executive Vice Chairman, Department of Medicine, Medical Director, Women's Guild Lung Institute, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

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 College of Chest Physicians, American Association of Physicians of Indian Origin

Disclosure: Nothing to disclose.

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, Society of General Internal Medicine

Disclosure: Nothing to disclose.

Acknowledgements

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 Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment