Asbestosis is a chronic (long-term) lung condition caused by prolonged exposure to asbestos. Asbestos is a soft, greyish-white material that does not burn. In the past it was often used in building construction to protect against fire and as a form of insulation (see below).

Breathing in asbestos dust can scar the lungs, which can lead to:

• shortness of breath
• cough

The interval between exposure to asbestos and the onset of symptoms varies, but it can be several decades.

Asbestosis means that the lung tissue has become scarred due to previous asbestos exposure. Pleural plaques or pleural thickening caused by asbestos are not the same as asbestosis. In these conditions, the lining of the lung is damaged by asbestos, but the lungs themselves are unharmed.

Asbestos

Asbestos is a general term that refers to a group of minerals made of long, crystalline fibres. Asbestos fibres are very strong and resistant to heat, electricity and chemicals. In the past, asbestos was widely used in industries such as:

• insulation
• shipbuilding and railways
• electricity generation
• building and construction

There are three main types of asbestos:

• crocidolite – ‘blue asbestos’
• amosite – ‘brown asbestos’
• chrysotile – ‘white asbestos’

All types of asbestos are hazardous, but blue and brown asbestos are much more dangerous than white asbestos. 

The most commonly used type of asbestos for industrial use was white chrysotile asbestos. Amosite and crocidolite were banned in the 1980s, although voluntary bans on the industrial use of both these materials came into force earlier than this. No crocidolite was imported into the UK after 1970. Chrysotile was not banned until 1999.

How common is asbestosis?

Asbestosis is a relatively rare condition because the amount of exposure required to cause it is fairly considerable, and regulations to restrict the intensity of exposure have been in place for over 40 years. Since 2004, the number of people developing asbestosis has decreased. In 2008, there were 127 deaths caused by asbestosis. During that year 1,110 people were awarded industrial injuries disablement benefit for the condition.

In contrast with the decrease in the number of cases of asbestosis, cases of mesothelioma are increasing and are not expected to reach their peak until 2013-2016. Mesothelioma is cancer of the mesothelial cells, the cells that make up the lining that covers the outer surface of most of the body’s organs, including the lungs.

This difference in the number of cases of asbestosis and mesothelioma is explained by the fact that mesothelioma can be caused by relatively small amounts of asbestos exposure, but asbestosis cannot. This shows that the legislation introduced in 1970 to prevent high levels of asbestos exposure in the workplace helped to reduce the risk of asbestosis.

See the Health A-Z topic about Mesothelioma for more information about the condition.

Outlook

There is no cure for asbestosis once it has developed because it is not possible to repair lung damage caused by asbestos. Some people with asbestosis find that their condition progresses over time, although many do not.

The most important thing someone with asbestosis can do is to stop smoking (if they smoke). This is because the progression of asbestosis is more common in smokers compared to non-smokers.

People with asbestosis have a higher risk of developing other serious conditions, such as:

• lung cancer – one of the most common and serious types of cancer
• mesothelioma – a type of cancer that affects the membranes that cover many of the body’s organs, including the lungs
• pleural disease – the membrane that covers the lungs (pleura) becomes thicker. If the thickening is localised to a few patches, the condition is known as pleural plaques, which do not cause symptoms. However, if the thickening becomes generalised, it is known as diffuse pleural thickening. This can contribute to breathlessness and chest discomfort. Most people (about 95%)  with asbestosis also have pleural thickening or pleural plaques

Very severe cases of asbestosis can place a significant strain on a person’s health and shorten their life expectancy. However, in many cases, the condition does not progress. More people with asbestosis die as a result of one or more of the cancers mentioned above rather than from asbestosis itself.

Treatment can significantly improve the quality of life of someone with asbestosis. See Asbestosis - treatment for more information about how the symptoms of asbestosis can be managed.

There are also a number of measures in place to help prevent future exposure to asbestos in the workplace. See Asbestosis - prevention for more details about this.

The symptoms of asbestosis usually begin 15-20 years after the initial exposure to the material. Symptoms usually begin gradually before becoming more noticeable and troublesome over the space of many years.

Symptoms of asbestosis include:

• shortness of breath (initially after physical activity, but eventually while resting as well),
• cough, and
• chest pain.

A less common symptom of asbestosis is the ends of the fingers become swollen, misshapen, and red, as a result of a build-up of fluid in the tissue of the fingers. This is known as finger clubbing.

Glossary

Pain

Pain is an unpleasant physical or emotional feeling that your body produces as a warning sign that it has been damaged.

Lungs

Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.

Oxygen

Oxygen is an odourless, colourless gas that makes up about 20% of the air we breathe.

Asbestos fibres

Asbestosis is caused by asbestos fibres. Usually, when you breathe in a foreign body, such as a particle of dust, or metal, small cells, known as macrophages, will break down these particles before they reach your lungs.

However, asbestos fibres are too tough for the macrophages to break down. In an attempt to break down the asbestos fibres, the macrophages release substances that are designed to destroy the fibres. These substances damage the tiny air sacs in your lungs which are known as alveoli.

Alveoli

When you breathe in, the alveoli help transfer oxygen from your lungs into your blood. Also, when you breathe out, the alveoli help to transfer carbon dioxide out of your blood, through your lungs, and out of your mouth.

If you have experienced a prolonged exposure to asbestos fibres lasting for many years, the damage to the alveoli becomes more severe and causes scarring. This scarring is known as fibrosis.

Once the alveoli become scarred, their ability to inhale oxygen, and exhale carbon dioxide, becomes adversely affected, resulting in the symptoms of breathlessness.

Occupational risk factors for asbestosis

The use of asbestos significantly increased after World War Two, peaked during the 1970s and then slowly declined during the 1980s and 1990s. If, during this time, you worked in an industry, or occupation, that used asbestos, you may have been exposed to it.

Occupations that are known to be associated with exposure to asbestos during these times include:

• insulation workers,
• boilermakers,
• plumbers, pipefitters, and steamfitters,
• shipbuilders,
• sheet metal workers,
• plasters,
• chemical technicians, and
• heating, air-conditioning, and refrigeration mechanics.

Industries that are known to have used asbestos during these times include:

• construction,
• shipbuilding and repair,
• chemical manufacturing,
• non-metallic mineral stone production,
• railways,
• yarn, thread, and fabric mills,
• rubber and plastic production, and
• trucking services.

Glossary

Tissue

Body tissue is made up of groups of cells that perform a specific job, such as protecting the body against infection, producing movement or storing fat.  

Oxygen

Oxygen is an odourless, colourless gas that makes up about 20% of the air we breathe.

Blood

Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.

Lung

Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.

Before confirming a diagnosis of asbestosis, your GP will ask you about your symptoms and listen to your lungs with a stethoscope. If your lungs have been affected by asbestosis, when you breathe they will make a distinctive crackling noise.

Your GP will require details of your work history, including any times when you may have been exposed to asbestos, the length of any possible exposure, and whether you were issued with any safety equipment, such as a face mask.

If your GP suspects asbestosis, a diagnosis can usually be confirmed by running a series of additional tests. These tests are described below.

Spirometer

A spirometer is a machine that measures how much oxygen you can breathe in, and how much carbon dioxide you can breathe out. These measurements can be used to assess how effective your lungs are.

X-rays

X-rays can detect abnormalities in the structure of your lungs that are caused by asbestosis.

CT scans

CT scans are more detailed than X-rays and can often be used to detect asbestosis in its earliest stage.

There are no available treatments to cure asbestosis. However, you can take steps to relieve your symptoms and improve your quality of life. These are outlined below.

Not smoking

If you have been diagnosed with asbestosis and you smoke, it is very important to give up as soon as possible.

Smoking will make your symptoms of breathlessness worse, and significantly increase your risk of developing lung cancer. Your asbestosis is more likely to get worse if you smoke as well.

Smoking and asbestosis are thought to have a synergistic effect on a person’s risk of developing lung cancer. This means that the combined risk associated with smoking and asbestosis is far greater than the sum of their individual risks.

Speak to your GP for help with giving up smoking. They can advise you about nicotine replacement therapies and prescription medicines, such as bupropion, which can greatly increase your chances of quitting successfully. Your GP can also put you in touch with local support groups in your area.

You can also call the NHS smoking helpline (0800 022 4332) to get more help and advice about quitting smoking. Also, see the Health A-Z topic about Smoking (quitting) for more information.

Vaccinations

If you have asbestosis, your lungs will be more vulnerable to the effects of infection. Therefore, it is recommended that you receive the influenza vaccination and a vaccination against the pneumococcus bacterium, which can cause serious conditions such as pneumonia. Your GP can arrange for you to have these vaccinations.

You will need to have the influenza vaccine every year. Most people only require one dose of the pneumococcus vaccine, although additional booster shots may be recommended if your general health is poor.

See the Health A-Z topic about Pneumococcal infections for more information.

Medicines

The aim of treating asbestosis is to improve symptoms, such as shortness of breath, and to improve the person’s overall quality of life. Most people who are diagnosed with asbestosis will not benefit from any specific medication for the condition. More severe cases may benefit from medicines, such as morphine, to reduce breathlessness and cough. Extra oxygen can also be given to someone if their blood oxygen levels are low.

Morphine

Morphine in small doses is often used for patients with severe asbestosis. It has two main benefits:

• reducing the sensation of breathlessness
• suppressing the urge to cough

The dose required to achieve these benefits is usually small. Serious side effects are uncommon. The most common problem is constipation, therefore a laxative will usually be given at the same time.

Long-term oxygen therapy

If you have severe asbestosis, your body may not be getting all of the oxygen that it needs to function properly. If this is the case, oxygen therapy may be supplied through a machine called an oxygen concentrator. This form of treatment may be recommended if you have low levels of oxygen in your blood.

An oxygen concentrator is plugged into a mains socket. It purifies oxygen from the air in the room, which produces a more oxygen-rich supply of air. The oxygen-rich air can then be breathed in through a mask. The oxygen is breathed through a small, soft plastic tube (nasal cannula), which is placed just inside your nostrils.

Do not smoke when you are using an oxygen concentrator. It produces an increased level of oxygen that is highly flammable, and a lit cigarette or flame could cause a fire or an explosion.

Ambulatory oxygen

In addition to the oxygen concentrator, you may be given a small, portable oxygen tank and mask, which you can use when you leave your house. This is known as ambulatory oxygen.

Corticosteroids

Corticosteroid is a naturally occurring hormone produced by the adrenal gland, or a synthetic hormone having similar properties. It is used to reduce inflammation, so reducing swelling and pain.

Lung

Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.

Oxygen

Oxygen is an odourless, colourless gas that makes up about 20% of the air we breathe.

While the use of asbestos has now been banned, any building that was built, or refurbished, before the year 2000 could contain asbestos.

Under the terms of the Control of Asbestos Regulations (2006), materials that contain asbestos have been divided into unlicensed and licensed materials.

Unlicensed asbestos materials

Unlicensed asbestos materials are not thought to be dangerous, but you should not work with them unless you have received adequate training and have the right protective equipment, such as a face mask.

Examples of unlicensed asbestos materials include:

• asbestos cement wall panels,
• asbestos cement roofs,
• asbestos floor tiles, and
• asbestos fire blankets.

Licensed asbestos materials

Licensed asbestos materials are thought to be dangerous, and only people who have obtained a licence from the Health and Safety Executive (HSE) are authorised to work with them.

Examples of licensed asbestos materials include:

• asbestos insulation on pipes,
• asbestos lagging on pipes,
• asbestos insulating board panels,
• asbestos insulated board ceiling tiles,
• sprayed asbestos coating on walls, ceilings, beams, and columns.

If you are unsure about whether the asbestos materials that you are working with might pose a risk to your health, you should stop working and seek advice from your employer.

If you are still concerned after speaking with your employer, contact the Health and Safety Executive (HSE), or your Trade Union representative (if you have one).

See the ‘useful links’ section for more information and advice about asbestos in the workplace.

Glossary

Lungs

Lungs are a pair of organs in the chest that control breathing. They remove carbon dioxide from the blood and replace it with oxygen.