January 23, 2018
The Debilitating Effects of Asbestosis
By Jonathan Damashek
Asbestosis is a lung scarring and inflammation disease suffered by construction and other workers who are exposed to asbestos-containing products and materials as part of their jobs. As defined by the Cleveland Clinic, asbestosis is not only chronic, meaning ever-present, but also progressive, meaning that it gets worse over time.
Occupational exposure to asbestos is the number one cause of asbestosis. While 55 countries have banned the use of asbestos, it is still legal in the United States. Even though its use has been greatly curtailed in the past 40 years, many building and industrial products still contain it because it is an excellent insulator and is highly resistant to heat and flame. Some of today’s products that contain asbestos are:
- Boiler insulation
- Electrical equipment
- Acoustic ceiling tiles
- Brake shoe linings
- Any type of fire-resistant material, including textiles
Over 10,000 Americans died of asbestosis between 1968 and 1992. Approximately 25 percent of them lived in New Jersey or California. Between 1999 and 2013, 20,317 asbestosis deaths were reported nationwide. The New York Department of Health reports that in 2014, 558 New York City and Long Island residents were hospitalized for asbestosis.
Asbestos.net reports that asbestosis is a major health problem for anyone exposed to asbestos. When a worker unknowingly inhales the microscopic fibers that asbestos produces when it breaks down, these fibers embed themselves in the worker’s lungs and resist his or her body’s natural attempt to expel them by coughing. In addition, asbestos fibers often lodge in the worker’s pleura, the outer lining of his or her lungs.
Over time, these asbestos fibers cause lung scarring, thickening of the pleura, and the buildup of fluid between the pleura and the lungs. All of these things make it progressively more difficult for the worker to breathe since the scarred lung tissue does not expand and contract normally. This restricted breathing ability reduces the amount of oxygen that goes to the worker’s vital organs.
Asbestosis also can lead to additional serious medical problems such as pulmonary hypertension, heart failure, collapsed lung, pleurisy, and chronic obstructive pulmonary disease. Should the worker be a smoker, this exacerbates the debilitating effects of asbestosis. Eventually the worker may become completely disabled and ultimately die.
Mount Sinai Hospital and others list the symptoms of asbestosis as:
- Coughing, often including coughing up blood
- Chest pain and/or tightening
- Shortness of breath that becomes worse over time
- Recurring respiratory infections
- Swelling and/or thickening of the feet, hands, ankles, fingers and/or toes
- Abnormalities of the fingernails and/or toenails
- Unexplained weight loss
- Sudden fever of 101 degrees or higher
- Generalized feeling of illness
How severe asbestosis can become depends on a variety of factors, including:
- How long the worker has been exposed to asbestos
- How much asbestos he or she breathed in
- If and to what extent the worker smoked or smokes cigarettes, cigars, or a pipe
It is not uncommon for asbestosis symptoms to take years, even decades, to appear, and a person’s lung capacity can be reduced by as much as 25 percent before the damage is observable. In general, symptoms tend to appear 15-20 years after initial asbestos exposure. It is rare, however, for someone to develop asbestosis if he or she has not been exposed to asbestos for at least 10 years. This includes workers’ families as well as workers themselves. Workers bring home the microscopic asbestos fibers on their clothes and shoes and it can disperse throughout the house.
In addition to hearing the crackling sound of rales when listing to a patient’s chest with a stethoscope, doctors usually recommend the following tests to determine if someone has asbestosis:
- A chest x-ray to show lung spots or shadows and/or a shaggy outline of the heart
- A CT scan to see if the lungs have any flat, raised patches
- Lung function tests to assess the patient’s ability to inhale and exhale
- Blood tests to measure the oxygen and carbon dioxide concentrations in the patient’s blood
Asbestosis cannot be cured, but its effects often can be reduced by a combination of treatments. The most important “treatment” is actually a lifestyle change. If the patient is a smoker, he or she must stop smoking. In addition, the patient should make every effort to eliminate his or her asbestos exposure, even if this means switching jobs.
Prescription bronchodilators, both aerosol and in pill form, can reduce the amount of mucus in a patient’s lungs and can thin lung fluids, making it easier to breathe and cough. As asbestosis progresses, many patients must receive supplemental oxygen from a portable machine. In the most severe cases of asbestosis, the patient may need to undergo a lung transplant.
There are many things a patient can do himself or herself to help alleviate the pain and discomfort of asbestosis, including the following:
- Getting regular doctor-supervised exercise
- Drinking plenty of fluids
- Getting annual flu shots to guard against respiratory infections
- Avoiding contact with people who are coughing, sneezing, or otherwise exhibiting symptoms of respiratory infection
Some doctors recommend the use of over-the-counter pain relievers to reduce the patient’s chest discomfort and/or pain. In addition, investing in an ultrasonic cool-mist humidifier to use at home often helps.