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
How is asbestosis treated?
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 is pleural disease?
Another type of lung disease that is linked to asbestos exposure involves the lining of the lungs, called the pleura. Harmless disease of the pleura is often the only manifestation of asbestos exposure. There are a number of different changes that can occur in the pleura with asbestos exposure. Pleural plaques (described above) may develop from fibers that migrate out to the outside edge of the lungs and cause scarring of the pleura. Pleural "calcification" may occur from calcium deposits in areas of prior damage.
Fluid may accumulate around the lung. This fluid collection, called a pleural effusion, can be the first sign of asbestos-related disease. Often, these fluid collections have no associated symptoms, resolve on their own, and recur sporadically. However, some patients may experience pain or bleeding around their lungs. "Diffuse pleural thickening," which means a generalized thickening of the lining of the lung, can occur as well. The thickened pleura may form a peel of scar tissue and even affect the lung's ability to expand. This condition may cause a significant shortness of breath. Diffuse pleural thickening is considered a later-onset consequence of repeated fluid accumulations.
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