What is Asbestosis?

Asbestosis is a lung disease caused by inhalation of asbestos fibres over a long period of time, and their accumulation within the lungs. Despite the dangers of asbestos being known since the early 1900s, Asbestosis remains an enormous public concern globally in developed and developing countries alike. The World Health Organization estimates that 125 million people worldwide are exposed to asbestos in the workplace.¹ There is currently no specific treatment for Asbestosis, and as such the best way to prevent it is to minimise the risk of asbestos exposure.

What is Asbestos?

Asbestos² is a fibrous mineral that is found naturally in rocks and soil. Asbestos is strong and long-lasting, with high heat resistance, low electrical conductivity and low cost – which meant that historically it was a popular material for use in construction and engineering.³ Throughout much of the 20^th century asbestos was used in areas such as insulation, roofing, tiling, walling, paints, textiles, roads, cars, shipping, mining and even aerospace engineering.² Its popularity sharply declined in some countries from the 1980s onwards as the health risks became better understood – although many developing countries still rely on it to this day.

Disturbing asbestos scatters asbestos fibres into the air, which are so small they cannot be seen, and are unknowingly breathed in. They are odourless and do not cause irritation either. Once breathed in, these fibres can lodge themselves within the lungs and over a long period of repeated exposure can cause Asbestos-related Diseases, one of which is Asbestosis.

Does Asbestos cause other diseases?

There are 3 main types of Asbestos-Related Diseases (ARDs) caused by repeated exposure to and inhalation of asbestos:

• Asbestosis
• Mesothelioma⁴ – a cancer of the thin tissue lining that covers the lungs
• Lung Cancer⁵

Asbestos was officially considered carcinogenic (cancer-causing) in the 1980s by the U.S. National Toxicology Program.⁶ In the following decades, this has been studied in-depth, and it is now known that repeated asbestos inhalation directly causes Mesothelioma and multiple forms of Lung Cancer. There is also evidence to suggest that asbestos may be linked to stomach cancer, although this is still being studied³. The increased risk of life-threatening diseases caused by asbestos exposure shows that its prevalence in the modern world needs to be taken seriously.

What are the symptoms of Asbestosis?

Once asbestos fibres are lodged in the lungs, they can remain there forever. The gradual build-up of these fibres means that most of the symptoms of Asbestosis often develop years after the initial exposure². These symptoms include the following:⁷

• Dry cough
• Chest discomfort
• Breathlessness
• Loss of weight and appetite
• Clubbing – swelling of the toes/fingers
• Asbestos warts – warts caused by asbestos fibres lodged in the skin
• Pulmonary hypertension and heart failure⁸ (in advanced Asbestosis)

The severity of Asbestosis symptoms depends on the duration and intensity of exposure to asbestos fibres⁷. Increased exposure also increases the risk of developing other Asbestos-Related Diseases, such as Mesothelioma and Lung Cancer.

Treatment of Asbestosis

No specific treatments currently exist for Asbestosis. Therefore, the best way to prevent this disease is to minimise the risk of exposure to asbestos.

Some treatments that may be administered to an Asbestosis sufferer in hospital are:⁷

• Drug therapy – steroids to suppress the release of toxins that exacerbate inflammation. This is not fully understood in relation to Asbestosis, and success rates are low
• Oxygenation – supplementing patients with oxygen, to aid rehabilitation of the heart
• Surgery – removal of the thin tissue lining surrounding the lungs is possible to improve its functionality, but this is only a short-term solution
• Lung transplant – only performed in severe Asbestosis

In most cases Asbestosis symptoms are reversible and the disease can be relieved if exposure to asbestos is eliminated.

Where are you most at risk of Asbestos exposure?

There are 3 main routes of exposure to asbestos. These are:

• Occupational exposure
• Community exposure
• Environmental exposure

Occupational exposure

The level of asbestos exposure is greatly increased for people whose job involves regularly working with or around asbestos. This is known as occupational exposure, and high-risk jobs include construction and engineering-based roles. The World Health Organization estimates that 125 million people are currently exposed to asbestos in the workplace and that there are at least 90,000 deaths per year related to occupational asbestos exposure.¹ Unfortunately, despite the known dangers of asbestos, it is so deeply ingrained in many workplaces that it can take a long time to translate scientific understanding into meaningful preventative measures.

Occupational exposure is not limited to professionals who work directly with asbestos as a construction material. There is also bystander exposure which occurs when workers are exposed to asbestos indirectly – at-risk jobs include electricians, masons, and painters.⁷

Community exposure

Industrial usage of asbestos has since been banned in over 50 countries.⁹ As such, community exposure has become a prominent focal point in the battle to reduce asbestos-related deaths. Community exposure arises from sources of asbestos that are intrinsically linked to the way of life of a community. For example, from high-footfall areas such as roads and playgrounds that were built with asbestos or living in the vicinity of asbestos waste. The highest concentrations of airborne asbestos in a community setting are found in densely built-up urban areas, particularly in countries that saw an industrial boom in the mid-to-late 20^th century (post-World War II).¹⁰ Communities such as these are still affected by asbestos exposure decades later. Community exposure is therefore a significant public health issue and, notably, it results in a higher proportion of young adults and women developing Asbestosis in comparison to occupational exposure.⁹

The specific routes of asbestos exposure within communities are often multi-faceted and highly specific to an individual community’s way of living. This makes reducing community exposure a huge challenge, both at the grassroots level and at a policymaking and governmental level. This challenge is further exacerbated since many affected countries are still developing economically. However, developed countries should not become complacent because asbestos exposure is an important issue worldwide.

Additionally, community exposure to asbestos may even be known and understood by the people living within a community, but they feel helpless to avoid it. The social and psychological impact of community exposure cannot be underestimated and is currently a point of anthropological research.³

Environmental exposure

Asbestos is found naturally in certain types of rocks and soil. Asbestos fibres are released from these sources very easily if they are disturbed, such as broken rocks or stirred-up soil.¹¹ Some communities are built in and around these natural reserves of asbestos, such as places where the native soil contains a high concentration of asbestos.¹² Unfortunately, even without intentionally disturbing asbestos deposits, these are eroded due to natural weathering and asbestos fibres will still disperse into the air. Environmental exposure can be thought of as a type of community exposure.

How to reduce the risk of Asbestos exposure

What you can do to minimise exposure to Asbestos?

It is crucial to minimise the risk of exposure to asbestos, as the severe symptoms of Asbestosis may only present themselves years or decades after being initially and repeatedly exposed.

If you or someone you know works in an industry such as construction or engineering that has an increased exposure risk to asbestos, be sure to raise this concern immediately and escalate the issue if necessary. If not already in place, proper training at work should be carried out to ensure that all employees can recognise asbestos-containing materials and understand the risks and handling procedures.

If your house was built before the 1980s and you suspect asbestos, hire a professional to carry out an inspection. Do not attempt to remove asbestos yourself, as this will only increase the risk to you and the people you encounter. Avoid disruptive forms of DIY around suspected asbestos, such as drilling, sanding, and cutting – if asbestos is left undisturbed it will not cause an immediate risk to your health. Asbestos removal should only be carried out by professionals.

If you come into contact with asbestos fibres, such as on your clothing or skin, do not shake or brush them off as this only disperses them into the air. Instead, use wet wipes in a gentle patting motion, and place any contaminated clothes securely in a bag.¹³ Contact your local authority so they can carry out proper disposal.

Minimising Asbestos exposure at a governmental level

Local authorities and larger governmental bodies need to put in place better regulations regarding asbestos safety, especially in high-risk communities. This includes wider availability and greater accuracy of screening and diagnostic tests, as well as better social and psychological treatment for currently exposed or retired asbestos workers.⁹ The earlier the risk can be mitigated, with improved monitoring and preventative strategies in place, the lower the chance of developing Asbestosis and other Asbestos-Related Diseases. More governmental transparency and a better understanding of asbestos amongst the public are important too.

Summary

Asbestosis is a lung disease caused by long-term inhalation of asbestos fibres that accumulate in the lungs. Asbestos is a strong and highly resistant natural fibrous mineral that was used extensively in construction and engineering globally throughout the 20^th century. Many people worldwide are still exposed to asbestos fibres at their place of work, local community, and natural environment. The symptoms of Asbestosis, such as a cough and breathlessness, or more severe pulmonary complications, often appear years after exposure. There is no specific treatment for Asbestosis, so minimising and preventing exposure to airborne asbestos is vital. Methods to minimise risk include awareness through proper workplace training and hiring trained professionals to carry out inspections and removal of suspected asbestos. Do not attempt to handle asbestos yourself and minimise disruptive DIY in high-risk areas. More effective government regulation is needed worldwide to properly eradicate the risks of asbestos.