Asbestosis: chronic lung scarring from asbestos inhalation

Characteristics and clinical features

Symptoms typically develop many years after exposure. Common findings and investigative features include:

• Progressive shortness of breath on exertion and a dry cough.
• Crackling sounds on chest auscultation and, in some cases, clubbing of the fingers.
• Imaging abnormalities: chest radiographs and especially high-resolution CT scans show interstitial fibrosis, often in lower lobes and subpleural regions.
• Pulmonary function tests demonstrating reduced lung volumes and impaired gas exchange.

Diagnosis and management

Diagnosis relies on a compatible exposure history, typical radiologic appearance, and exclusion of other causes of pulmonary fibrosis. Tissue biopsy is rarely required when imaging and history are clear. There is no cure that reverses established fibrosis; treatment focuses on symptom relief and slowing complications. Supportive care may include oxygen therapy, pulmonary rehabilitation, vaccinations, smoking cessation, and monitoring for complications such as respiratory failure or secondary infections.

History, regulation, and legal aspects

Commercial use of asbestos was widespread in the 19th and 20th centuries; recognition of health risks grew through industrial medicine and epidemiology in the mid-20th century. Many countries now restrict or ban certain asbestos uses and enforce workplace exposure limits. Because of the link between asbestos exposure and disease, lawsuits and compensation claims have been prominent; some specialists, including lawyers, focus on asbestos-related cases.

Distinctions and notable facts

Asbestosis should be distinguished from mesothelioma, a malignant tumor of the pleura or peritoneum, and from asbestos-related lung cancer and pleural plaques. Pleural plaques often indicate prior exposure but may be asymptomatic. Because of long latency and overlapping features, careful clinical and occupational history-taking is essential.