Asbestosis is a chronic (long term) lung condition associated to breathing in asbestos fibres and dust which usually develops between 20 – 30 years after initial exposure and is characterised by inflammation and scarring of the lung tissue. Damage is irreversible and whilst there is no cure the symptoms can be managed to preserve and sometimes improve quality of life.
Once potentially harmful asbestos fibres and dust are inhaled the fibres travel through the body into the lungs where the body’s defence mechanism attempts to break down the foreign bodies before they are able to penetrate lung tissue and enter the bloodstream. The body’s defence system within the lungs is known as ‘macrophages’ which are lung cells that release a substance intended to seek out and destroy such foreign bodies. Unfortunately, asbestos fibres are able to defeat the body and which over time leads to scarring of the lungs causing the lungs to shrink and harden resulting in breathlessness and other symptoms.
Asbestosis is associated to prolonged exposure to asbestos fibres often over many years and figures provided by The Health and Safety Executive (HSE) indicate the annual number of reported cases and deaths from asbestosis is increasing, particular in men over the age of 75 years. It is important to recognise that ‘asbestosis’ is a form of lung fibrosis which is often under reported owing to the fact the condition is mistaken for other types of lung fibrosis which might include ‘idiopathic cases’ (lung fibrosis of unknown cause) with similar symptoms to asbestosis. Sadly this represents the legacy of heavy asbestos exposure in the past.
Asbestosis is normally associated to workers who have endured ‘moderate’ levels of asbestos exposure typically 5 – 10 years as one might expect with construction workers and those who have endured ‘heavy exposure’ over a year or more, as would be expected of someone who worked in the insulation industry, manufacturing of asbestos products or asbestos spraying.
Other tradesmen with moderate to heavy asbestos exposure at risk is likely to include;
If your lungs have been harmed by asbestos it is likely they will produce a crackling sound when you breathe in and this can be detected by your GP who will examine you and listen to your lungs using a stethoscope. Your GP will ask about your work history and general health and it is important you discuss those health concerns which took you to see your GP in the first instance and be clear about your previous work with asbestos materials or working in environments where asbestos was used.
A number of diagnostic investigations can be carried out to confirm asbestosis which might include,
Asbestosis is normally found in the lower areas of the lungs and presents itself as shadowing which is often confirmed by CT Scan. An x-ray will detect abnormalities in the structure of the lung associated to asbestos exposure and might also confirm the existence of another asbestos related condition such as pleural plaques which is a benign scarring condition of the lungs caused by inhalation of asbestos fibres or asbestos related pleural thickening.
CT Scan (computerised tomography)
This is a painless process which produces more detailed 3D images of the lungs and can help identify less obvious abnormalities missed by x-ray such as early stage asbestosis.
Lung function tests (LFT)
Routine lung function tests include spirometry, lung volumes and gas transfer which are designed to measure the effectiveness of your lungs. The tests can help identify an abnormal or impaired result but can also be used to track and monitor a disease over periods of time.
Spirometry is a test which involves blowing through a mouthpiece into a spirometer to measure how well you can inhale and exhale using maximum effort. Maximum effort is required and the test might need to be repeated a number of times.
Lung volumes can be measured using similar equipment to a spirometer located within in a small glass sided area during which time you will have a small clip placed on your nose. This test is quite painless and a member of staff is always in attendance watching and speaking with you.
Gas transfer test measures the amount of oxygen passing from the lungs into the bloodstream and is undertaken using a mouthpiece through which you will be asked to fill your lungs with a harmless gas for a few seconds before exhaling.
This is a painless process whereby a series of x-rays are taken to produce a 3D image.
Asbestos fibres found in the lungs confirm asbestos exposure but in itself this is not sufficient to enable a firm clinically significant diagnosis of asbestosis. Fibres found could indicate the existence of some other asbestos related lung condition, such as pleural plaques or pleural thickening.
A biopsy of lung tissue, sometimes from a nodule or lesion, will distinguish asbestosis from other similar lung conditions such as idiopathic pulmonary fibrosis (IPF) sometimes referred to as usual interstitial pneumonia, chronic obstructive pulmonary disease (COPD), emphysema or silicosis.
A biopsy can also help to confirm the existence and type of any cancer such as mesothelioma or lung cancer when examined in a laboratory under the microscope by a Pathologist.
Needle aspiration – A thin needle is inserted into the lung to recover sample cells for examination which is normally undertaken during a CT Scan and under local anaesthetic.
Bronchoscopy – Involves a doctor or trained nurse inserting a thin and flexible tube (fibre-optic bronchoscope with mini camera) through the mouth or nose to enable examination of the main airways and other areas of the lungs. The procedure is performed under mild sedative and/or local anaesthetic and allows for the collection of tissue samples and/or respiratory secretions to help make a diagnosis. The procedure might be uncomfortable and is likely to prompt occasional coughing but should be completed within 20-30 minutes after which you will be observed for a short while until the effects of local anaesthetic have worn off. After 24 hours you should be able to resume normal activities which might include driving, returning to work and drinking alcohol.
Initial diagnosis of asbestosis can be overwhelming, both physically and emotionally not only for the sufferer but their loved ones and friends and the enormity and implication of such a diagnosis cannot be overstated. Given the prognosis, sufferers might feel burdened by the responsibility of getting their affairs in order whilst acknowledging the effect this could have upon their lifestyle and life expectancy.
Sufferers will deal with their diagnosis in different ways but in most instances there will be fundamental steps one could take to make dealing with their situation that much easier.
Speak with your Specialist – understand what to expect next – living with asbestosis is likely to require lifestyle changes and understanding more about treatment options, prognosis and availability of any clinical trials available is likely to assist. You might wish to consider obtaining a second opinion, if so, is there somebody who can be recommended by your specialist or GP? You might wish to discuss the prospect and your suitability for a lung transplant which is infrequently used in the UK and only in the most severe cases where other treatments have proved unsuccessful.
Finding support – Discuss your condition with family and friends and wherever necessary ask your GP or practice nurse to introduce you to local support networks.
Smoking can exacerbate your condition and should be avoided. It is proven that smoking can increase your chances of developing more serious lung diseases such as mesothelioma and lung cancer. Your GP can help you to give up smoking and can advise regarding replacement nicotine therapies and prescription medicines which increase your prospects of quitting successfully.
Learn to reduce stress levels which can be achieved by certain enjoyable activities such as reading, aromatherapy, yoga or indeed any other activity which uplifts you mentally, spiritually or physically. Reducing stress will help you to focus upon the management of your condition.
Improve your health and manage your symptoms – Wherever possible you should consider improving your health including diet which can help to maintain your immune system. Maintain a low salt intake. Poor eating habits result in smaller muscle mass which can be unhelpful to sufferers of respiratory disease.
Consider gentle exercise – Exercise is important to increase the strength and endurance of respiratory muscles and there are exercises you can do which can help you relax and breathe more easily. Your Doctor can advise you in this regard and is likely to discuss the benefits of pulmonary rehabilitation (PR). Pulmonary Rehabilitation is available through the NHS and offers a programme of exercise and education for all, regardless of age and health which is designed to help manage the symptoms of your condition, including breathlessness.
Take several short rests during the day, learn to conserve your energy and try to sleep well.
Discuss flu and pneumonia vaccinations with your GP.
Maintain a diary – This will help you to chart your breathing and could be helpful to recognise and avoid certain ‘events’ which trigger breathing difficulties. Avoid situations which could expose you to respiratory infection ie. visiting unwell friends/family members or large crowds and wash your hands regularly. Learn to breathe slowly and in colder weather, breathe through your nose and cover your mouth and nose with a scarf. Avoid going outdoors when air pollution and pollen counts are high.
Contact us immediately – Asbestosis can be a debilitating condition and in more severe cases can be life threatening. In most instances exposure to asbestos fibres will have occurred in the workplace and through no fault of your own. We are a leading NO WIN NO FEE provider of asbestosis and other asbestos-related legal services and would seek to recover for you and your family the maximum compensation available. We can also assist you with appropriate benefit entitlement with The Department for Work and Pensions (DWP). Call us today on FREEPHONE 0808 164 6018.
Unfortunately asbestosis is incurable albeit there is a range of palliative options which can help reduce symptoms and improve your quality of life. The outlook for asbestosis can vary significantly from case to case depending upon the extent of damage to the lungs and other facts such as the age, health and general fitness of the sufferer.
Asbestosis can deteriorate over time and in severe instances will inevitably place strain upon a person’s health and shorten their life expectancy. In other cases the condition might remain static and not progress at all. Statistically a sufferer is at higher risk of developing other serious and potentially life threatening conditions such as pleural disease, mesothelioma and lung cancer.
Avoid smoking – Smoking can aggravate symptoms of breathlessness and increase the risk of developing lung cancer. Your GP will help you to give up and there are numerous prescriptions and replacement therapies which can help to achieve this goal. Seek out local support groups for further help.
Medication – There are medicines available to help reduce symptoms of breathlessness, coughing and chest pain, some of which can be taken in the form of an inhaler which help to relax the airways and reduce pain.
Vaccinations – Asbestosis weakens your lung making them more susceptible to infection and your GP can arrange for you to have vaccinations for protection against influenza (flu) and other bacteria which cause serious conditions such as pneumonia.
Pulmonary rehabilitation – It is important to note that you can still exercise with a lung condition which you should discuss this with your GP, practice nurse or member of your respiratory team. Pulmonary rehabilitation combines physical exercise with education and is designed to help people manage symptoms of their condition in particular breathlessness which can be frightening.
Regardless of age and severity of condition pulmonary rehabilitation can be tailored to meet specific needs which can help to improve muscle strength, enable easier breathing and improve general fitness. Learning to cope and manage ‘living out of breath’ is important and taking part in a course with others in similar situations can be enjoyable and will help to increase confidence levels.
Long-term oxygen therapy – In severe cases of asbestosis when the body might not be getting sufficient oxygen to function properly ‘oxygen therapy’ might be recommended. Oxygen therapy is supplied by a machine called an ‘oxygen concentrator’ which purifies oxygen from the surrounding air and is taken through a mask or soft plastic tube (nasal cannula) which is fitted inside the nostrils. Oxygen can be taken in the house or via a portable concentrator. You must not smoke whilst operating an oxygen concentrator due to the high flammability of oxygen which would be ignited by the naked flame of a cigarette.