Asbestos and the lung in the 21st century: an update

Abstract

The asbestos-related disorders (ARDs) are currently of significant occupational and public health concern. Asbestos usage has been banned in most developed countries, but asbestos is still used in many developing countries and the number of cases of ARDs worldwide is rising. Many countries are now experiencing an epidemic of ARDs that is the legacy of occupational exposure in the 1960s-1980s because of the long latency period between asbestos exposure and manifestation of disease. It is likely that asbestos-related mortality and morbidity will continue to increase. Although the most feared complications of asbestos inhalation are the malignant conditions such as mesothelioma and lung cancer, asbestos inhalation more frequently results in benign conditions such as pleural plaques, diffuse pleural thickening, and asbestosis (pulmonary fibrosis due to asbestos exposure). Over recent years, there have been changes in the epidemiology of mesothelioma, in clinical management of ARDs and developments in new techniques for early detection of malignancy. This review provides an update on the respiratory manifestations of asbestos exposure and also considers advances in screening methods that may affect future management in the workplace.Please cite this paper as: Prazakova S, Thomas PS, Sandrini A and Yates DH. Asbestos and the lung in the 21st century: an update. Clin Respir J 2014; 8: 1-10.

Non-neoplastic asbestos-related respiratory diseases: what relationship with other lung diseases?

“…In particular interstitial lung fibrosis other than asbestosis have a very uncertain relationship with occupational exposure to asbestos. On the other hand, a number of studies demonstrated no significant association between PPs and lung function impairment, although there is still debate on this issue [19]. Data in the literature very often are conflicting and to date there are few certainties in the specific field.…”

“…In various articles in literature an association between PPs and a slight degree of lung function impairment without clinical relevance was observed. However, most studies have demonstrated no significant association between PPs and abnormal pulmonary function tests [19]. Spanish guidelines for the diagnosis and management of asbestos-related pleural and pulmonary disease consider that PPs in general do not cause a decrease in pulmonary function and when it appears, it would be due to other concomitant causes, such as the onset of interstitial fibrosis or smoking [20].…”

Pleural plaques: markers of asbestos exposure or independent risk factor for pleural mesothelioma? A case report of mesothelioma developed on a pleural plaque in a worker with occupational asbestos exposure

“…They demonstrated that the level and localization of pleural irregularities significantly differed between patients with benign asbestos pleural effusion and PM. In this sense fluorodeoxyglucose PET/CT has been shown to be a useful diagnostic tool for differentiate PM from benign PPs [7]. Probably these difficulties have affected research in the specific field.…”

Mesothelin (MSLN) methylation and soluble mesothelin-related protein levels in a Chinese asbestos-exposed population

“…The awareness of potential asbestos hazards needs to be increased because of the long latency period between asbestos exposure and manifestation of ARDs [23]. Many efforts had been paid on the updated evidence-based methodology of an appropriate health surveillance program for asbestos-exposed population [24].…”