Overview
Definition
A chronic interstitial lung disease caused by the inhalation of asbestos fibers, leading to diffuse pulmonary fibrosis.
Epidemiology
Typically presents 15-20 years after prolonged occupational exposure (shipbuilding, construction, insulation, plumbing).
Etiology & Risk Factors
- Inhalation of asbestos fibers which macrophages attempt to engulf, leading to chronic inflammation and fibrosis.
Clinical Symptoms
- Progressive dyspnea on exertion
- Dry cough
- Inspiratory crackles (rales) on auscultation
- Digital clubbing
Clinical Approach
Diagnosis
- Chest X-ray / HRCT: Lower lobe predominant fibrosis, pleural plaques (pathognomonic hallmark of asbestos exposure)
- PFTs: Restrictive pattern (Decreased FVC, TLC, and DLCO)
- Lung biopsy (rarely needed): 'Asbestos bodies' or 'Ferruginous bodies' (iron-coated asbestos fibers)
Management
- No specific cure
- Smoking cessation (CRITICAL, as smoking + asbestos multiplies lung cancer risk astronomically)
- Supportive care (Oxygen, pulmonary rehab)
Complications
- Bronchogenic Carcinoma (most common malignancy)
- Malignant Mesothelioma (pleural cancer strongly linked to asbestos, though much rarer than lung cancer)
- Cor Pulmonale