Diagnosing Asbestosis

The word "asbestosis" is sometimes used as meaning any asbestos related disease. This can lead to confusion. Properly, asbestosis only means pulmonary fibrosis caused by asbestos.

Pulmonary Fibrosis is the name given to a number of diseases which affect the lung by damaging the internal structures of the lung. The natural tissue is altered, causing it to become scarred and fibrous.

Typical symptoms will be shortness of breath and persistent coughing.

To diagnose asbestosis, the doctor has to identify a number of important features. Other causes of pulmonary fibrosis have to be excluded.

The chest physician will require to perform a number of tests. These are likely to include:

• Discussing work history or other sources of asbestos exposure
• X-ray
• CT scan
• Spirometry - air flow measurements
• Pulmonary function tests - more complex breathing tests measuring lung volumes and transfer of gas

The features that would point the chest physician towards a diagnosis of asbestosis are:

• A history of substantial exposure to asbestos
• Pleural Plaques visible on x-ray or CT scan
• Fibrosis visible on x-ray or CT scan, predominately affecting the lower parts and the edges of the lungs
• Crackles heard by the doctor when listening to the patient's chest through a stethoscope
• Shortness of breath which the breathing tests show to be the result of reduced lung volumes or reduced gas transfer or a combination of these (as opposed to reduced air flow)
• Relative stability or only gradual progression of symptoms over a period rather than rapid deterioration.

The presence of substantial numbers of asbestos fibres in the affected lung would be regarded as a cast iron criterion for diagnosis but biopsies are almost never performed for this purpose in the UK.

 

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