Related articles: Asbestosis
Definition
Asbestosis is a chronic lung disease caused by the inhalation of asbestos fibers. The risk of developing this pneumopathy is generally related to the duration and intensity of exposure, but also to the type, length and thickness of respirable fibers.
Asbestosis is basically one of the occupational diseases. Asbestos, also known as asbestos, belongs to the family of silicates and has structural, mechanical and thermal characteristics that, in the past, made it useful for inclusion in building materials and boats, in car brake linings and in some fabrics. Today, the use of asbestos has been abandoned, however there are still many structures that have not been reclaimed. Specific occupations at risk include plumbers, miners, electricians, asbestos remediation workers and shipyard, construction, railway and metallurgical industry workers. Secondary exposure can also occur between the families of workers exposed to asbestos dust and between people who live near particularly polluted places.
Asbestosis is a form of pulmonary interstitial fibrosis. The very thin inhaled asbestos fibers penetrate deep into the respiratory system, where they trigger an inflammatory response; alveolar macrophages, in an attempt to gobble them up as a foreign element, release cytokines, growth factors and oxidizing substances, but fail to destroy them. Macrophages undergo cell death by releasing the fiber and several inflammatory mediators that recall new macrophages. The inflammatory process thus maintained has a detrimental effect on the bronchial and alveolar wall, stimulates the deposition of collagen in the interstitium and, finally, causes diffuse fibrosis.
Asbestosis can therefore progress even after the end of exposure. In addition to asbestosis, the inhalation of asbestos favors the onset of lung cancer (generally, non-small cell lung cancer) and pleural mesothelioma, particularly in smokers.
Most common symptoms and signs *
- Anorexia
- Arrhythmia
- Asthenia
- Cachexia
- palpitations
- Catarrh
- Cyanosis
- Dyspnoea
- Drumstick fingers
- Chest pain
- Edema
- Hemoptysis
- Hypoxia
- Multiple pulmonary nodules
- orthopnea
- Pallor
- Weight loss
- Wheezing breath
- Water retention
- Drowsiness
- Sweating
- Fainting
- tachypnoea
- Cough
- Pleural effusion
Further indications
The onset of asbestosis generally occurs many years after exposure. The patient experiences a progressive respiratory difficulty (first under stress, then also at rest), a sense of tightness in the chest, chronic cough (resistant to therapy), asthenia and decay of general health conditions. Sometimes, other peripheral signs appear, including drumstick fingers (hippocratism) and cyanosis.
In advanced stages, the disease can cause the formation of diffuse pleural effusions and plaques (areas of thickening and calcification) that reduce the elasticity of the lung. The evolution of asbestosis leads to a widespread thickening of the pleura which leads to respiratory failure.
The diagnosis of asbestosis requires an in-depth history of occupational exposure to asbestos-dispersed asbestos fibers, hence the finding of pulmonary and pleural alterations by radiograph and chest CT. Respiratory function tests and blood gas analysis help assess damage from diffuse pulmonary fibrosis and monitor disease progression over time. Lung biopsy and bronchoalveolar lavage are almost never necessary.
There is no specific treatment that can cure asbestosis. Therapy is symptomatic and aimed at improving respiratory capacity, so it can include the use of bronchodilators, supplemental oxygen and cortisone. The prognosis is variable: many patients have mild or absent symptoms; others develop a right ventricular failure (pulmonary heart) or a neoplasm.
Asbestos and smoking have a synergistic effect on lung cancer risk, so the habit should be eliminated. Furthermore, it is important to adopt preventive measures, such as proceeding to clean up the asbestos and to use adequate individual protections in the work environment at risk.
