Asbestos Related Disorders

  • Medical Author:
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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What tests and studies are used to evaluate asbestosis?

Breathing abnormalities can be identified with lung function tests (pulmonary function tests or PFTs) or exercise tests that are performed at specialized laboratories. Asbestosis can produce both obstruction of airflow and restriction of lung inflation. In addition, the disease can affect the ability to transfer oxygen into the blood. With advanced disease, patients may have markedly reduced blood oxygen at rest and may need supplementary oxygen.

X-ray abnormalities include thickening of the lining of the lungs and tiny lines marking the lower portions of the lungs. However, up to 20% of patients have completely normal-appearing chest X-rays. These patients may demonstrate more subtle changes on computerized X-ray studies (computerized tomography, or CT scans). Up to 30% of patients with a normal chest X-ray who have been exposed to asbestos will have an abnormal high resolution (high definition) CT. The CT scan may be very useful in separating true asbestosis from other conditions that may have similar findings. However, even a CT scan may not identify disease of the lining of the lung (pleural disease) in patients with asbestosis. The proper role of CT scanning has not been fully established.

Laboratory testing studies may be abnormal (certain antibodies and markers of inflammation), but they do not specifically suggest asbestosis.

Occasionally, a biopsy and microscopic examination of the lung is used to diagnose asbestosis. Under microscopic examination, certain coated fibers (asbestos bodies) can be seen in association with a pattern of scarring. The amount of both coated and uncoated (transparent) asbestos has been linked to the severity of asbestosis. Because other particles may resemble asbestos, a conclusive identification may require scanning electron microscopy. Currently, detection of asbestos fibers in the lung tissue and fluids (sputum, secretions) can be used to make the diagnosis, along with a history of asbestos exposure and characteristic X-ray or CT results.

The currently available commercial form of asbestos, chrysotile, does not form asbestos bodies as easily as previously used fibers.

Medically Reviewed by a Doctor on 4/7/2015

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