The pleura are two thin membranes surrounding the lungs. The outer membrane lines the inside of the ribcage. It is called the parietal pleura. The inner membrane covers the lung. It is called the visceral pleura. In a healthy body these membranes are right next to each other. A tiny amount of fluid lubricates their surfaces and this assists breathing because the two membranes slide over each other with the expansion and contraction of the chest.
Asbestos is one of a number of causes of excessive fluid developing between the parietal and visceral pleura. Sometimes this excessive fluid causes symptoms of chest pain and breathlessness ("pleurisy") but in many cases it does not. The body can re absorb the fluid but inflammation can leave behind damage to the pleura. The visceral pleura thickens. This can have several effects.
First, the excess fluid itself, as well as pleural thickening, may cause permanent compression and distortion of the neighbouring lung tissue reducing the volume of healthy lung.
Secondly, thickening of the lung can have a tethering effect on the underlying lung reducing the elasticity of the lung and making breathing more difficult.
Thirdly, the two layers of pleura can fuse, stiffening the chest wall and making breathing more difficult.
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