About asbestos related disorders
What is asbestos related disorders?
What is the definition of asbestos?
Asbestos is a family of naturally occurring silica compounds (similar to, but not the same as, the silica of window glass and computer chips). These substances form fibers with varying shapes and sizes and are found throughout the earth. There are three commonly available types of asbestos:
- chrysotile (white asbestos),
- amosite (brown asbestos), and
- crocidolite (blue asbestos).
All three have been associated with cancerous and non-cancerous lung disease.
Asbestos has been used frequently in a variety of building materials for insulation and as a fire retardant, and in brake pads in cars. Today, it is found most commonly in older homes - in pipes, furnaces, roof shingles, millboard, textured paints, coating materials, and floor tiles.
What are the types of asbestos-related lung disease?
Lung disease from exposure to asbestos can be divided into three main types: 1) asbestosis, 2) disease of the lining of the lung (pleura), and 3) lung cancer.
- Asbestosis is a process of widespread scarring of the lungs.
- Disease of the lining of the lungs, called the pleura, has a variety of signs and symptoms and is the result of inflammation and the hardening (calcification) and/or thickening of the lining tissue.
- Lung cancer, either of the internal portions of the lungs or the outer lining (pleura).
All of the commonly available commercial forms of asbestos have been linked to cancerous and non-cancerous lung disease.
Asbestos-related lung disease occurred at very high rates toward the middle of the 20th century, when patients who were exposed decades earlier to asbestos eventually developed disease. British asbestos workers were among the first who were observed to have lung cancer related to asbestos.
Most current patients were once exposed to asbestos in:
- factories, or
- homes with asbestos, either in the process of carrying, installing, or removing asbestos, or while cleaning items laden with asbestos dust.
Some workers have been exposed to high concentrations of asbestos in:
- automotive repair,
- launderers of asbestos-containing clothing.
Continuing sources of exposure are asbestos removal and general construction industries. The delay between exposure to asbestos and the development of cancer can be anywhere from 10 to 40 or more years.
Despite not using asbestos in construction materials for the last 30 years, the number of deaths from asbestosis has increased over the past two decades. A 2009 study to assess the incidence of asbestos-related deaths concluded that the death rate is not expected to decrease sharply in the next 10 to 15 years. The World Health Organization reported in 2010 that more than 107,000 people die each year from asbestos-related lung cancer, mesothelioma, and asbestosis resulting from exposure at work.
Cases of asbestos exposure have been seen in the World Trade Center rescue and recovery workers.
What are the types of asbestos fibers?
There are two major groups of fibers, the amphiboles and chrysotile fibers. Chrysotile (white asbestos), also called "Serpentine" fibers, are long and curled. The amphiboles, long straight fibers (including actinolite, amosite, anthrophyllite, crocidolite, and tremolite) are much more likely to cause cancer of the lining of the lung (mesothelioma) and scarring of the lining of the lung (pleural fibrosis). Either group of fibers can cause disease of the lung, such as asbestosis.
The risk of developing asbestos-related lung cancer varies between fiber types. Studies of groups of patients exposed chrysotile fibers show only a moderate increase in risk. On the other hand, exposure to amphibole fibers or to both types of fibers increases the risk of lung cancer by two fold. Although the Occupational Safety and Health Administration (OSHA) has a standard for workplace exposure to asbestos (0.2 fibers/milliliter of air), there is debate over what constitutes a safe level of exposure. While some believe asbestos-related disease is a "threshold phenomenon," which requires a certain level of exposure for disease to occur, others believe there is no safe level of asbestos.
In most buildings, asbestos does not become airborne. However, surfaces that are damaged or disturbed can cause asbestos to become inhalable. High concentrations can occur after cutting, sanding, or remodeling asbestos- containing materials.
Reducing asbestos exposure involves either the removal or sealing of asbestos-containing materials. Inexperienced attempts to remove asbestos can release dangerous levels of the fibers.
What does fiber size have to do with asbestos-related lung disease?
Depending on their shape and size, asbestos fibers deposit in different areas of the lung. Fibers less than 3 mm easily move into the lung tissue and the lining surrounding the lung (pleura). Long fibers, greater than 5 mm (1/5 inch), cannot be completely broken down by scavenger cells (macrophages) and remain in the lung tissue. These asbestos fibers can cause inflammation. Substances damaging to the lungs are then released by the cells of inflammation that are responding to the foreign asbestos material. The persistence of these long fibers in the lung tissue and the resulting inflammation seem to initiate the process of cancer formation.
As inflammation and damage to tissue around the asbestos fibers continues, the resulting scarring can extend from the small airways to the larger airways and the tiny air sacs (alveoli) at the end of the airways. Some of these fibers can move to the surface of the lung where they form plaques (white-gray regions of scarred tissue) in the tissue lining of the lung (pleura). In severe cases of asbestosis, scarring of both the lung and its lining tissue can occur.
What is asbestosis?
Asbestosis is a process of lung tissue scarring caused by asbestos fibers. Because many other diseases also lead to lung scarring, other causes must be excluded first when a patient is found to have lung scarring (pulmonary fibrosis). Patients with particular X-ray findings or biopsy results must also have a remote history of asbestos exposure and a characteristically delayed development of the condition in considering asbestosis as a diagnosis. Smoking appears to increase the frequency and/or the rate of progression of asbestosis, possibly by preventing the efficient elimination of inhaled fibers from the airways.
What are the symptoms for asbestos related disorders?
These characteristics have led the industry and construction sectors to adopt asbestos for:
- Strengthen plastics and cement.
- Construct insulation.
- Buildings, clothing, and military vehicles that are fireproof.
- Absorb sound.
- Siding, roofing, and cement shingles all contain asbestos.
- Electrical wire casings.
- A joint compound and patching.
- Insulation for pipes, ducts, and furnaces.
- Adhesives and floor tile.
- Acoustic insulation.
- Respiration difficulty.
- The emergence of a Cough or a modification in coughing habits.
- Blood in the mucus (sputum) that the lungs Cough up.
- Abdominal or chest pain.
- Swallowing difficulties or persistent hoarseness.
- Significant loss of weight.
- Swells in the face or neck.
- Decrease in appetite.
- Unless they are discharged into the air, asbestos fibers are not dangerous.
- The fibers disintegrate into small pieces as they are released.
- We breathe in the airborne particles that assemble in the lungs, resulting in inflammation and scarring.
What are the causes for asbestos related disorders?
Chemically speaking, asbestos materials are silicates, and these fibers are not harmful unless they are released into the air.
- When asbestos fibers are released into the air, they break down into tiny particles and become airborne; we inhale them causing asbestos-related disorders.
- These tiny particles collect in the lungs, causing scarring and inflammation.
- Some of the airborne fibers from prolonged exposure to high quantities of asbestos dust may lodge in your alveoli, the tiny sacs in your lungs where oxygen is exchanged for carbon dioxide in your blood.
- The irritation and scarring caused by the asbestos fibers make the lung tissue inflexible. Breathing becomes challenging as a result.
- Scarring of lung tissue increases as asbestosis worsens. Your lung tissue eventually stiffens to the point that it is unable to contract and expand correctly.
- Occupations that have a high risk of asbestos exposure such as shipbuilding and naval service, railway construction, asbestos mining and milling, manufacture of chemicals, flooring, plastics or rubber, etc.
- People who do laundering work containing asbestos fibers or live in areas with high levels of airborne asbestos can also develop asbestos-related disorders.
- Smoking frequently causes the disease to advance more quickly and seems to enhance the retention of asbestos fibers in the lungs."
What are the treatments for asbestos related disorders?
Patients with asbestosis, like others with chronic lung disease, are at a higher risk of serious infection, low oxygen levels in the blood, and heart failure. These patients also may not recover as quickly from viral and bacterial infections. In addition, they may be at increased risk for certain fungal and unusual infections that take advantage of diseased or scarred lung tissue. The medical management of these patients should focus special attention on preventing and rapidly treating these infections. Flu and pneumococcal vaccinations are a part of routine care for these patients. There is, however, no treatment or cure for asbestosis. In particular, steroid and immune-based therapies have not been shown to benefit these patients.
Other key elements in treating patients with asbestosis are smoking cessation, early detection of worsening disease or cancer, and avoidance of further exposure to asbestos. Supplemental oxygen during exercise or at rest (depending on the need) may be provided to improve daily function.
What are the risk factors for asbestos related disorders?
Everyone has some level of asbestos exposure. However, people who work directly with asbestos are at a higher risk of developing asbestos-related disorders. The risk factors of asbestos-related disorders depend on the exposure to them.
- The architecture and construction sectors use asbestos for insulation, roofing, fireproofing, and sound absorption, in addition to reinforcing cement and plastic.
- Boilers, steam pipes, and hot water pipes have all been insulated with asbestos in the shipbuilding sector.
- Vehicle clutch pads and brake shoes both contain asbestos, thanks to the automobile industry.
- Besides being utilized in plastics, paints, varnishes, and adhesives, asbestos has also been employed in ceiling and floor tiles. In addition, several talcs- and vermiculite-containing garden goods, as well as crayons, have been found to contain asbestos.
- Occupations that have a high risk of asbestos exposure are shipbuilding and naval service, railway construction, Asbestos mining and milling, construction and building trades, manufacture of chemicals, flooring, plastics or rubber, auto industry (specifically brake repair), fabric milling, building demolition, etc.
- Also, those who are involved in rescue, recovery and cleanup are at higher risk for developing asbestos-related disorders.