Asbestos-Related Disorders (cont.)
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.
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.
In this Article
- Asbestos-related disorders facts
- What is the definition of asbestos?
- What are the types of asbestos-related lung disease?
- What are the types of asbestos fibers?
- What does fiber size have to do with asbestos-related lung disease?
- What is asbestosis?
- What are symptoms and signs of asbestosis?
- What tests and studies are used to evaluate asbestosis?
- How is asbestosis treated?
- What is pleural disease?
- Does asbestos exposure cause lung cancer?
- What is malignant mesothelioma?
- What other cancers have been linked to asbestos exposure?
- How can exposure to asbestos be reduced?
- What kind of asbestos is used today?
- Find a local Pulmonologist in your town
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.
Next: What is asbestosis?
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