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Asbestosis is also known as diffuse pulmonary fibrosis. It is a chronic lung condition caused by exposure to asbestos. Breathing in asbestos can lead to fibers and particles becoming lodged in the tissues of the lungs. This can cause irritation and inflammation over time, which can cause scar tissue that leads to asbestosis. Frequent symptoms associated with asbestosis include a dry, persistent cough, chest pain and shortness of breath. Although asbestosis is not a type of cancer, it presents a higher risk of asbestos-related cancer, such as mesothelioma or lung cancer.

Overview of Asbestosis

Asbestosis is a long-term inflammation and scarring of the lungs. Diffuse pulmonary fibrosis is a lung disease caused when lung tissue becomes damaged and develops scar tissue. Scar tissue is thicker and stiffer than normal lung tissue. This can impact the function of the lungs, such as by preventing their full expansion. As pulmonary fibrosis gets worse, it can cause further problems, such as making it progressively harder for a patient to breathe.

There is no known cure for asbestosis and no way to reverse the damage done to the lungs by asbestos particles and scar tissue. A patient who is diagnosed with asbestosis will always have this disease. However, there are ways to address the symptoms caused by asbestosis and improve a patient’s overall quality of life.

What Are the First Signs of Asbestosis?

It can take many years for the first signs of asbestosis to appear after the date of exposure to asbestos. This is common among all asbestos-related diseases. Asbestosis has a long latency period, or the amount of time that passes between asbestos exposure and the development of scarring in the lungs. The average latency period for asbestosis is typically 10-30 years, which is shorter than the latency period for mesothelioma (20-60+ years).

Common early symptoms associated with asbestosis include:

  • Dry cough
  • Cough that won’t go away
  • Chest pain
  • Chest tightness
  • Shortness of breath
  • Uncomfortable breathing
  • Crackling noise when breathing
  • Fatigue
  • Loss of appetite
  • Sudden weight loss
  • Pulmonary hypertension
  • Clubbing of the fingers and toes

Clubbing means that the tips of the fingers and toes appear wider and rounder than normal. This can happen due to a lack of oxygen in the body’s extremities. Chronic respiratory problems can also lead to fatigue and weight loss, as the body relies on oxygen for energy. In the more advanced stages, scar tissue can restrict the flow of blood through the arteries, making it more difficult for the heart to pump blood. This can result in coronary artery disease and congestive heart failure.

What Causes Asbestosis? 

As the name implies, asbestosis is caused by exposure to asbestos. Asbestos is a group of six naturally occurring minerals that were widely used for manufacturing purposes prior to the 1980s, at which time the International Agency for Research on Cancer confirmed that all six types of asbestos were carcinogenic, meaning they can cause cancer in humans. At this time, asbestos use became regulated. However, millions of buildings and products already contained asbestos.

If someone is exposed to asbestos, they may breathe in microscopic fibers or particles. The asbestos fibers can get stuck in the lung tissue, such as in the mesothelium or protective membrane that lines the lungs. This can cause health problems such as malignant mesothelioma. If the particles get lodged elsewhere in the lungs, it can cause an interstitial lung disease such as asbestosis.

Asbestos causes damage to the lungs when the fibers and particles rub and irritate the surrounding tissues. This can result in inflammation and a buildup of scar tissue in the lungs, otherwise known as pulmonary fibrosis. When dust that contains asbestos causes this disease, it is also known as pneumoconiosis – a disease of the lungs due to inhalation of dust.

Can You Prevent Asbestosis?

Since there is no cure for asbestosis, prevention is always best. Asbestosis can be prevented by avoiding exposure to asbestos. If an older home or building is being demolished or renovated, for example, a licensed asbestos professional should be called in to supervise the project and safely contain or remove asbestos, as necessary. 

During any type of project involving a home built before the 1980s, dust that may contain asbestos should not be touched or disturbed. This could emit asbestos particles into the air for them to be breathed in. If an individual works in an occupation that involves asbestos exposure, he or she should communicate with the employer to ensure proper worker protection.

Who Is Most at Risk of Asbestosis? 

The National Cancer Institute states that there is no acceptable level of asbestos that is deemed safe for exposure. Even a single incident of asbestos exposure could potentially lead to health problems, including asbestosis. However, overall evidence suggests that most people do not become ill from a single exposure. Asbestos-related diseases are much more common among those who are exposed to asbestos on a regular basis, such as through an occupation that requires employees to work directly with asbestos or has substantial environmental contact. 

Occupations that put workers at a higher risk of developing asbestosis and other illnesses related to asbestos include:

  • Construction and building
  • Demolition and renovation work
  • Contracting
  • Painting
  • Excavation jobs
  • Building inspections
  • Cement and mortar work
  • Tile setting
  • Manufacturing asbestos-containing materials
  • Auto mechanic
  • Shipyard work
  • Firefighting
  • Asbestos abatement and removal

Anyone who works in an occupation that comes with an asbestos hazard should be provided with the personal protective equipment (PPE) to help prevent asbestos exposure. People who live with someone who works with asbestos could also be at risk of asbestosis due to secondary exposure. This occurs when a worker brings home particles of asbestos on his or her clothing, skin or hair.

People in the worker’s household could breathe in these particles and suffer damage or scarring of the lungs.

How Is Asbestosis Diagnosed? 

It can be difficult to diagnose asbestosis. The long latency period associated with this disease can make it hard to associate a patient’s condition with asbestos exposure. In addition, many common symptoms of asbestosis could be attributed to other health conditions, such as emphysema and asthma, especially if the patient is a smoker. This makes it a commonly misdiagnosed disease.

If a patient presents symptoms of asbestosis during a physical exam, a doctor should use a chest x-ray or CT scan to look for signs of scarring and damage. The doctor should ask about any potential exposure to asbestos in the patient’s history, as well. If fibrosis is present, the doctor may then use a biopsy of the lung tissue to differentiate asbestosis from other diseases and make a definitive diagnosis.

Three Stages of Asbestosis

Imaging scans for asbestosis can also help a doctor identify the stage of the disease at the time of diagnosis. This can determine how greatly the disease will affect the patient and the treatment options available. 

There are three stages of asbestosis progression, with Stage I being the least severe and Stage III the most severe:

  • In Stage I, asbestosis appears in a fine reticular pattern, normally at the base of the lungs.
  • In Stage II, there may be irregular spots seen in connective tissue. 
  • In Stage III, a scan will show a coarse pattern in connective tissue.

Asbestosis is often a progressive lung disease, meaning it can worsen over time. The progression of asbestosis is often open to interpretation and requires multiple types of scans to refine the diagnosis.

What Is the Life Expectancy of Asbestosis?

Unlike cancers caused by exposure to asbestos, such as mesothelioma, asbestosis is not terminal and does not always result in the death of a patient. Although the damage caused to the lungs by asbestos is irreversible, with no known cure, patients can take steps and receive treatments to relieve symptoms and improve their long-term quality of life. 

Every patient’s asbestosis prognosis is different. According to one study that looked at mortality data from the National Center for Health Statistics from 1999 to 2010, the number of deaths listed as being associated with asbestosis was 6,290. The median age at the time of death was 79 years old.

Even if asbestosis is not the cause of a patient’s death, it can increase the odds of developing other illnesses. Complications connected to asbestosis include respiratory failure, pleural effusions, pleural plaques, lung cancer, mesothelioma, cardiovascular problems and heart failure (source: the National Library of Medicine). Asbestosis may also be related to cancers of other organs, such as the ovaries, kidneys, adrenals and gastrointestinal tract.

Treatments for Asbestosis

Treating asbestosis typically begins with the patient going through breathing and lung function tests to assess the level of damage to the lungs. These tests focus on how well the lungs are working, how much oxygen is getting to the blood, and how the lungs work during periods of exercise and rest. Together with chest x-rays and scans, lung function tests can allow a doctor to determine the appropriate treatment plan for a patient.

Common treatments for asbestosis include:

  • Drug therapy – e.g., steroids to suppress inflammation of the lungs, immunosuppressive drugs to reduce exacerbation of asbestosis and antibiotics to combat respiratory infections.
  • Oxygenation – oxygen therapy, or a treatment that provides a patient with extra oxygen to replace oxygen lost due to a respiratory problem.
  • Pulmonary rehabilitation – a program that may involve exercise training, nutritional counseling and breathing techniques to improve lung function and reduce symptoms.
  • Surgery – some patients may qualify for surgeries to relieve symptoms, such as thoracentesis. This drains fluid from the lungs to make it easier for a patient to breath
  • Lung transplantation – in severe cases, a doctor may recommend a lung transplant for patients who are qualified candidates. However, most treatments are focused on relieving symptoms rather than curing asbestosis.

Unlike asbestos-related cancers, treatment options for asbestosis typically rely on a combination of drugs rather than surgery and chemotherapy. Since asbestosis cannot be cured, supportive and palliative care are the only available options. Treating asbestosis early, after the first signs or symptoms, comes with the best odds of a positive patient outcome. As the condition progresses, it can result in further health complications.

Living With Asbestosis

Many patients live with asbestosis for many years. Effectively managing asbestosis requires ongoing treatments and programs to alleviate symptoms and improve the patient’s quality of life. Asbestosis victims are often encouraged to improve their lung health and function as much as possible by monitoring air quality conditions, staying indoors if there is air pollution present, avoiding exposure to fumes and toxins, and quitting smoking.

Doctors often recommend that patients with asbestosis receive regular x-rays of their lungs to track the progression of the disease. This can help the patient receive the proper treatments and make necessary lifestyle changes. These changes may include eating a well-balanced diet and staying hydrated to help fight this chronic disease. Light to moderate exercise that does not overexert the patient can also improve pulmonary function and energy levels.

Getting adequate sleep each night and taking rests during the day can help regulate a patient’s energy and prevent exhaustion or fatigue. Patients should also receive all of their recommended pneumonia vaccines and seasonal flu shots to reduce the risk of strain on the respiratory system. Avoiding crowds and frequent handwashing can help a patient avoid illnesses that could further impact lung function.