Overview

Asbestosis is a severe and rare lung condition affecting people who have been exposed to asbestos.¹ Asbestos is a building material used from the 1950s to the 1990s,as it had several advantageous properties, including:²

• Heat resistant
• Fire resistant
• Chemical degradation resistant
• Biology degradation resistant
• Mechanically strong

However, due to health risks associated with inhalation exposure, blue and brown asbestos was banned in the UK from 1985. In 1999, white asbestos was banned from the UK.² Although, it is possible to be exposed to asbestos today if your occupation involves working with old buildings such as construction, demolition of buildings, and plumbing. Unfortunately, there is no cure for asbestosis, however, treatment options such as symptom management and lifestyle changes could alleviate symptoms.¹

What are the symptoms of asbestosis?

Asbestosis mainly affects the respiratory system due to inhalation exposure; symptoms include:¹

• Fatigue
• Wheezing
• Persistent cough
• Shortness of breath
• Pain in your chest or shoulder
• In more advanced cases, clubbed (swollen) fingertips

According to the NHS, symptoms of asbestosis can take 20 to 30 years to appear after asbestos exposure. If you are experiencing any of these symptoms it is vital to see a medical professional, such as your GP. Unfortunately, in some cases, some individuals do not experience any symptoms of asbestosis making it difficult to diagnose.¹

Diagnosis for asbestosis

Primary diagnosis will involve your GP asking questions concerning your work history. They will also listen to your lungs. If symptoms are related to asbestosis, you will be referred to the hospital to see a specialist in lung diseases. The specialist will conduct further tests to confirm the asbestosis diagnosis. Tests would include CT scans and X-rays.^{1, 3-4}

Treatment options for asbestosis

Unfortunately, there is no cure for asbestosis because it is not possible to reverse the damage that asbestosis causes to the lungs. However, there are treatment options that help such as symptom management and lifestyle changes.¹

Symptom management

Symptom management can help manage and alleviate symptoms and includes the use of pulmonary rehabilitation, oxygen therapy, and a steroid inhaler.¹

Pulmonary rehabilitation

Pulmonary rehabilitation involves exercises and education programmes to help manage asbestosis symptoms, especially breathlessness or shortness of breath.⁵ Individuals are referred to receive bespoke treatment programmes suited to alleviating their symptoms.⁶ Asbestosis falls under a respiratory disease; it is also a clinical priority to be treated and managed immediately. The bespoke programmes can last up to eight weeks, and group sessions can include:^5-6  

• Assessment of your health and what you are physically able to do
• Exercise classes are designed at the right level for people with long-term lung conditions
• Detailed content on how to look after your body and lungs
• Advice on managing your lung condition
• Techniques to manage breathlessness

Occupational therapists, physiotherapists, and nurses are some of the medical professionals who are involved with the programmes, and they typically take place in health centres, community halls, and local hospitals. But there is also the opportunity to have digital pulmonary rehabilitation programmes.⁵

It has been shown that 90% of patients found that completing the programmes helped them have higher activity and exercise levels, as well as an improved lifestyle. This has also helped the NHS as individuals can self-manage their symptoms and therefore, reduce acute and emergency admissions and primary care appointments.⁵ According to Asthma and Lung UK, pulmonary rehabilitation can:⁶

• Contribute to increasing your muscle strength. This ensures effective use of the oxygen you breathe, making you less breathless. 
• Help you cope better with feeling out of breath
• Increase fitness levels and boost self-confidence to do everyday tasks
• Improve your mental wellbeing
• Help you feel less tired
• Reduce your risk of being admitted to hospital with a chest infection or flare-up
• Help you understand and manage your condition better

But also, it is a great educational programme to help those experiencing breathlessness. Individuals can also improve their self-esteem and provide a community in which individuals can support those who are also experiencing a similar situation. It is important to continue using the techniques learned during the pulmonary programme. This could happen by:⁶

• A referral to a follow-up exercise programme
• Going to the gym
• Carrying on at home using the techniques learned during the programme

Oxygen therapy

An oxygen sensor and blood test are used to determine blood oxygen levels. You could also be asked to do a walking test or an exercise to confirm whether oxygen therapy would be the best treatment option to help improve your breathlessness. If you have low blood oxygen levels, oxygen therapy can supply oxygen-rich air from a machine or tank through a mask or tube.^1,7 This will help those who experience breathlessness. One must be referred by a GP and prescribed by a specialist to use oxygen therapy. It is dangerous to use un-prescribed oxygen therapy, as it can significantly affect the brain, heart, and lungs or can even lead to death.⁷

 be used to receive oxygen-rich air:⁷

• An oxygen concentrator: recommended for those who need oxygen supplementation for most of the day, even when you are asleep.
• Large oxygen cylinders: prescribed to individuals who only need oxygen for short periods.
• Portable cylinders: You can be supplemented with oxygen-rich air outside your house or when moving around at home. It is also referred to as an ambulatory oxygen. Potable oxygen cylinders are often designed to be placed in a small backpack or shopping trolley for ease of movement. According to the NHS website, each cylinder holds up to three hours’ worth of oxygen.

Installation of these devices at home will require a specialist engineer who will also explain how to use the devices safely.⁷ More information on oxygen therapy can be found on the NHS website. Some individuals might need to use a portable oxygen cylinder while attending a pulmonary rehabilitation programme.⁶

Steroid inhaler

If you are experiencing mild symptoms, a steroid inhaler can help to ease breathing. Steroid inhalers are known as preventer inhalers. For Individuals with asbestosis, steroid inhalers prevent the lungs from inflammation and swelling via the inhaling of low doses of steroid medicine. These steroids are not to be confused with the steroids used by bodybuilders, as they are a copy of steroids that the body produces naturally.^8-9 While using an inhaler it is important to make sure that you are:¹⁰

• Using the preventer inhaler every day, as prescribed to stay healthy
• Using the right inhaler technique to prevent you from using a reliever or rescue inhaler to deal with symptoms that have worsened due to not correctly using your inhaler
• Discussing with a medical professional whether to change to a lower carbon inhaler, to be more environmentally friendly
• Taking your used inhalers back to your local pharmacy for disposal as this is more environmentally friendly

More information on preventer inhalers can be found on the Asthma and Lung UK Website.⁹

Lifestyle changes

It is also important to consider the following lifestyle changes to help with symptom management as well as reduce your chances of getting infections:^1,8,11

• Quit smoking if you smoke: smoking could make symptoms worse if you have asbestosis but can also increase your chance of having lung cancer
• Get the flu and pneumococcal vaccination as this will prevent an infection that might be detrimental to your lungs

In extreme cases, where symptoms of asbestosis are extremely severe, a lung transplant might be necessary. And in this case, you will be referred to a lung transplant specialist.^11,12 

Summary

Asbestosis is a severe and rare lung condition that can be detrimental to the respiratory system. Thus, affecting the lungs and surrounding areas. Symptoms of asbestosis can include fatigue, shortness, and wheezing. Symptoms can appear after 20 to 30 years of inhalation exposure to asbestos. Although, it is possible for individuals to not show any symptoms at all. Diagnosis can be confirmed by a lung specialist via the use of X-ray and CT scans. Although there is no cure, there are treatment options available such as pulmonary rehabilitation programmes, oxygen therapy, and steroid inhalers. Moreover, individuals can improve the quality of their lives by implementing lifestyle changes. Both symptom management and lifestyle changes can be beneficial in managing and alleviating symptoms of asbestosis. Therefore, it is important to seek medical help if you are experiencing symptoms of asbestosis.