Materiały źródłowe

• #1 Asbestosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/asbestosis/diagnosis-treatment/drc-20354643

  Asbestosis can be difficult to diagnose because its signs and symptoms are similar to those of many other types of respiratory diseases. […] A variety of diagnostic tests might be needed to help pinpoint the diagnosis. […] These tests show images of your lungs: […] Advanced asbestosis appears as excessive whiteness in your lung tissue. If the asbestosis is severe, the tissue in both lungs might be affected, giving them a honeycomb appearance. […] Computed tomography (CT) scans combine a series of X-ray views taken from many different angles to produce cross-sectional images of the bones and soft tissues inside your body. These scans generally provide greater detail and might help detect asbestosis in its early stages, even before it shows up on a chest X-ray. […] Pulmonary function tests determine how well your lungs are functioning. These tests measure how much air your lungs can hold and the airflow in and out of your lungs.

• #2 Asbestosis Symptoms and Diagnosis | American Lung Association

  https://www.lung.org/lung-health-diseases/lung-disease-lookup/asbestosis/symptoms-diagnosis

  When asbestos fibers are inhaled, they can cause inflammation and scarring of lung tissues. […] Asbestosis is usually diagnosed by a careful medical history, exposure history and chest X-ray or CT scan that shows scarring of the lung tissues. […] If you have a history of exposure to asbestos and you’re experiencing increasing shortness of breath, you should contact your primary care doctor about the possibility of asbestosis. […] During the physical examination, your doctor will listen to your lungs to determine if the sounds are normal or not. Your doctor may then order the following tests: Chest X-ray, CT scan, Lung function test.

• #3 Asbestosis: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/22245-asbestosis

  Asbestosis is a type of lung disease caused by breathing in asbestos dust and fibers. […] Asbestosis is a lung disease that occurs in people who inhale asbestos fibers and dust over a long period of time. […] When asbestos fibers and dust get into your lungs, they can cause fibrosis (thickening and scarring of your lungs). […] In some cases, asbestosis can lead to life-threatening health complications. […] Because it takes a long time to develop symptoms, providers are still diagnosing many new cases of asbestosis. […] Your healthcare provider will examine you and ask about your medical history. […] Your healthcare provider may also order tests to complete the diagnosis. […] Treating asbestosis aims to manage symptoms and preserve function in your lungs. […] Treatment cant reverse lung damage from asbestos.

• #4 Asbestosis Workup: Approach Considerations, Chest Radiography, Computed Tomography

  https://emedicine.medscape.com/article/295966-workup

  The diagnosis of asbestosis is based on the following: A reliable and significant (ie, dose time) history of asbestos exposure and an appropriate latency period between exposure and detection of disease. Characteristic changes of pulmonary fibrosis on imaging studies. Absence of other fibrotic diseases that mimic asbestosis. Dyspnea upon exertion. Bilateral basilar inspiratory crackles. Restrictive pattern on pulmonary function studies associated with impaired gas exchange. […] Imaging findings can facilitate differentiation of asbestosis from other asbestos-related diseases. Computed tomography (CT) is useful in the delineation of pleural or pleura-based abnormalities. High-resolution CT (HRCT) is playing an increasingly important role in the diagnosis of diffuse interstitial lung disease. However, chest radiography remains the initial modality for detection and characterization of pleural and parenchymal disease.

• #5 Asbestosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555985/

  Asbestosis is often diagnosed based on a detailed occupational history, imaging studies, and lung function tests. […] The diagnosis of asbestosis is largely clinical. First, the history of asbestos exposure is central to the diagnosis. The overall clinical picture is characterized by progressive restrictive pulmonary disease with interstitial fibrosis on radiography. […] The pulmonary function test reveals characteristic restrictive disease. […] Chest radiograph shows diffuse reticulonodular infiltrates at the lung bases, causing shaggy heart borders. High-resolution computed tomography (HRCT) is often used to diagnose asbestosis. […] HRCT shows ground-glass opacities, along with diffuse interstitial fibrosis in asbestosis, whereas, in idiopathic pulmonary fibrosis (IPF), there is evidence of patches of opacities.

• #6 Asbestosis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/asbestosis/symptoms-causes/syc-20354637

  Asbestosis signs and symptoms may include: […] If you have a history of exposure to asbestos and you’re experiencing increasing shortness of breath, talk to your health care provider about the possibility of asbestosis. […] Risk of asbestosis is generally related to the amount and the duration of exposure to asbestos. The greater the exposure is, the greater the risk is of lung damage. […] Diagnosis treatment

• #7 Asbestosis Differential Diagnoses

  https://emedicine.medscape.com/article/295966-differential

  Determining the cause of asbestosis depends on the clinician’s assessment of the levels and duration of exposure and on knowledge of occupational epidemiologic studies. Assessment of impairment, which is a key ingredient in determining disability, is based mainly on pulmonary function studies. No evidence exists to confirm that small-airway disease, which is detected by flow volume curves, progresses to asbestosis. […] Clinicians should be aware of the variety of diseases that may coexist with asbestosis. Additionally, clinicians should keep in mind that the risk for bronchogenic carcinoma is increased with asbestos exposure and load, even without asbestosis. […] Conditions to consider in the differential diagnosis of asbestosis include collagen-vascular diseases and other interstitial pulmonary disorders. […] The diagnosis of asbestosis in the 21(st) century requires more than a chest radiograph. […] The clinical diagnosis of asbestosis in this century requires more than a chest radiograph.

• #8 Scandinavian Journal of Work, Environment & Health – Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and…

  https://www.sjweh.fi/article/226

  Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution […] The requirement for diagnostic criteria was perceived in part because of new developments in diagnostic methods, with better identification of asbestos-related disorders. […] The clinical diagnosis of asbestos-related diseases is based on a detailed interview of the patient and occupational data on asbestos exposure and appropriate latency, signs and symptoms, radiological and lung physiology findings, and selected cytological, histological and other laboratory studies. […] The chest radiograph is the basic tool for identifying asbestos-related diseases such as asbestosis, pleural abnormalities, lung cancer, and mesothelioma. […] The recognition of asbestosis by chest radiography is best guided by standardized methods such as the classification of the International Labour Organisation (ILO) and its modifications.

• #9 Scandinavian Journal of Work, Environment & Health – Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and…

  https://www.sjweh.fi/article/226

  A histological diagnosis of asbestosis requires the identification of diffuse interstitial fibrosis in well inflated lung tissue remote from a lung cancer or other mass lesion, plus the presence of either 2 or more asbestos bodies in tissue with a section area of 1 cm2 or a count of uncoated asbestos fibers that falls into the range recorded for asbestosis by the same laboratory. […] In order to achieve reasonable comparability between different studies, a standardized system for the histological diagnosis and grading of asbestosis is required. […] The presence of asbestosis is an indicator of high exposure. Asbestosis may also contribute some additional risk of lung cancer beyond that conferred by asbestos exposure alone. Asbestosis diagnosed clinically, radiologically (including HRCT), or histologically can be used to attribute a substantial causal or contributory role to asbestos for an associated lung cancer. […] A minimum lag-time of 10 years from the first asbestos exposure is required to attribute the lung cancer to asbestos.

• #10 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease […] The publication in 2013 of the 3rd edition of the specific asbestos health monitoring protocol, together with the development of new diagnostic techniques, prompted the SEPAR EROM group to sponsor publication of guidelines, which review the clinical, radiological and functional aspects of the different asbestos-related diseases. Recommendations have also been made for the diagnosis and follow-up of exposed patients. […] Diagnostic Tests for Evaluating Asbestos-related Disease Employment History […] A full employment history must be collected (consistent recommendation, high quality of evidence). The patient must be asked about their employment, professional category, degree of protection, degree of exposure, and company medical check-ups during their working life.

• #11 Asbestosis | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/asbestosis

  In making a diagnosis of asbestosis, your doctor will start by taking a detailed medical and occupational history, then conducting a thorough medical examination, which includes listening to your lungs with a stethoscope for crackling or high-pitched sounds that may indicate asbestosis. […] The following tests may be conducted to make a definite diagnosis: […] A chest X-ray may be taken to look for any abnormalities in your lungs. Asbestosis appears as excessive whiteness in your lung tissue. […] This test involves a series of breathing maneuvers that measure the airflow and volume of air in your lungs, which allows your doctor to objectively assess the function of your lungs. […] This is a special type of CT scan that provides your doctor with high-resolution images of your lungs and the pleura that surrounds them. The pleura are often scarred following asbestos exposure. […] This test involves the passage of a flexible fiberoptic scope about the diameter of a pencil into the lungs to obtain fluid and sometimes tissue samples to aid in diagnosis.

• #12 Asbestosis | Symptoms, Diagnosis, Treatment, and Prognosis

  https://mesothelioma.net/asbestosis/

  Asbestosis is a chronic and incurable lung disease caused by asbestos exposure. Symptoms include shortness of breath, coughing, chest pain, and chest tightness. […] If you experience these symptoms, especially if you may have been exposed to asbestos, you should see your doctor for a diagnosis. […] Your doctor will begin with a physical exam, listening to your lungs and asking about your health history and any asbestos exposure. […] Next, they will likely request imaging scans. These include a chest X-ray to check for fluid in your lungs, which can rule out pneumonia. You may also get a CT scan for a clearer image of the lungs. […] Doctors may also perform a lung function test to determine how well your lungs are working. This involves blowing into a device called a spirometer. You might also need more thorough pulmonary tests to measure oxygen flow from your lungs to your bloodstream.

• #13 Asbestos Toxicity: Clinical Assessment | Environmental Medicine | ATSDR

  https://archive.cdc.gov/www_atsdr_cdc_gov/csem/asbestos/clinical_assessment.html

  Upon completion of this section, you will be able to […] Describe the most typical finding on examination of asbestosis patients. […] Early and accurate diagnosis is important to choosing the most appropriate care strategies, even if the patient is not exhibiting symptoms. […] An assessment of clinical presentation, […] A medical history, […] A physical examination, and […] A chest radiograph or other imaging and pulmonary function tests. […] The most common abnormal finding with significant asbestosis is bibasilar end-inspiratory rales (i.e., crackles) on auscultation. […] Patients with asbestosis present to the clinician with the chief complaint of insidious onset of dyspnea on exertion. […] Asbestos-related non-malignant pleural abnormalities typically do not cause symptoms, although some patients experience progressive dyspnea and chest pain. […] Lung cancer can be asymptomatic, but in the later stages patients experience fatigue, weight loss, chest pain, dyspnea, or hemoptysis. […] Mesothelioma can be asymptomatic, but patients usually present in later stages of the disease, at which point dyspnea and chest pain are common.

• #14 Asbestosis Symptoms: First Signs, Diagnosis & Relieving Symptoms

  https://www.asbestos.com/asbestosis/symptoms/

  Asbestosis symptoms include dry cough, shortness of breath and swelling in the face or neck. These typically emerge after 20 years, complicating diagnosis. Doctors use medical history, tests and scans to diagnose asbestosis. It requires expertise to confirm the disease and plan treatment. […] Common signs and symptoms of asbestosis affect a persons ability to breathe, including chest pain and shortness of breath. A crackling sound in the lungs that doctors can listen for with a stethoscope is another symptom for determining a diagnosis. The severity and frequency of asbestosis symptoms can vary. […] Asbestosis is diagnosed through your work history, medical records and a series of tests and imaging scans. Examples include X-rays, CT scans and pulmonary function tests. […] Asbestosis is diagnosed with lung function tests and imaging scans that detect irregularities. The patient must have a history of asbestos exposure. Doctors use the test results in tandem with your asbestos exposure history to make a diagnosis.

• #15 Asbestosis: Causes, Symptoms, and Diagnosis

  https://www.healthline.com/health/asbestosis

  Your doctor will perform several tests to learn whether you have asbestosis and to rule out other conditions that have similar symptoms. […] First, your doctor will usually use a stethoscope to listen for abnormal breath sounds as part of a physical exam. Your doctor may also order X-rays to look for a white or honeycomb appearance on your lungs or chest. […] Pulmonary (lung) function tests may be used to measure the amount of air you can inhale and the airflow to and from your lungs. […] Your doctor might also test to see how much oxygen is transferred from your lungs to your bloodstream. CT scans can be used to examine your lungs in more detail. […] Your doctor might also order a biopsy to look for asbestos fibers in a sample of your lung tissue.

• #16 Asbestosis: Causes, Symptoms, Diagnosis, Risk Factors and Treatment

  https://www.shekhawatihospital.com/asbestosis/

  Diagnosing asbestosis typically involves a combination of medical history review, physical examination, imaging studies, pulmonary function tests, and sometimes a biopsy. Here’s an overview of the diagnostic process: […] Medical History and Physical Examination: The doctor will inquire about the patient’s occupational history, including any known exposure to asbestos. They will also ask about symptoms such as shortness of breath, cough, and chest pain. A physical exam may reveal signs such as clubbing of the fingers and toes, and crackling sounds in the lungs (Velcro rales). […] Imaging Studies: Chest X-ray: This is often the first imaging test performed. It may show characteristic findings such as linear streaks or small, irregular opacities in the lower lobes of the lungs. High-Resolution Computed Tomography (HRCT) Scan: HRCT provides more detailed images of the lungs and can detect early signs of fibrosis and scarring associated with asbestosis.

• #17 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  Chest radiograph (Rx) is the basic tool for identifying asbestos-related diseases (consistent recommendation, moderate quality of evidence). […] Computed tomography (CT) is a more sensitive diagnostic tool. […] Lung function testing is mandatory in the diagnosis and follow-up of asbestos-related diseases. […] Spirometry is the initial procedure; forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC can be used to detect and quantify obstructive ventilatory defects, and alert to a restrictive defect. […] Asbestos can be detected in respiratory samples on optical microscopy, in the form of asbestos bodies (AB), also known as ferruginous bodies, formed after the fibers are coated with proteic material within the macrophages. […] Several blood and pleural fluid markers of malignant pleural mesothelioma have been studied, such as hyaluronic acid, carcinoembryonic antigen or CA 125, but none has been shown to be useful.

• #18 Asbestosis – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/environmental-and-occupational-pulmonary-diseases/asbestosis

  Asbestosis is a form of interstitial pulmonary fibrosis caused by asbestos exposure. Diagnosis is based on history and chest x-ray or CT findings. […] Diagnosis of asbestosis is based on history of exposure to asbestos and chest x-ray or high-resolution CT. History should include onset, duration, and type and intensity of the patient’s exposure. […] Chest x-ray shows bilateral, linear reticular opacities signifying fibrosis, usually in the peripheral lower lobes, with or without pleural changes. Chest CT offers higher sensitivity in identifying pleural and parenchymal abnormalities, and typically shows a usual interstitial pneumonia pattern of pulmonary fibrosis. […] The International Labor Organization system (International Classification of Radiographs of Pneumoconioses) is used to characterize the presence and severity of pneumoconioses based on size, shape, location, and profusion of opacities. Asbestosis produces reticular opacities with a lower lobe predominance.

• #19 Asbestosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/asbestosis?lang=us

  Asbestosis is an occupational fibrotic lung disease associated with high levels of asbestos fiber inhalation. Fibrosis is lower lobe predominant and can progress. Even without progression the risk of lung cancer is increased. The presence of pleural plaques is variable. […] Clinical presentation is insidious and nonspecific with shortness of breath prompting imaging. Alternatively, the presence of asbestosis may become evident when a patient presents with other asbestos related diseases. […] There are no pathognomonic radiological features specific for asbestosis. Chest radiograph may show irregular opacities with a fine reticular pattern. Additional evidence of asbestos exposure such as calcified or noncalcified pleural plaques may be evident. […] Progression of disease is variable and appears related to the degree of exposure. Some patients remain stable for many years whereas other progress to end-stage pulmonary fibrosis rapidly.

• #20 What Is Asbestosis? | Causes, Symptoms, & Treatment

  https://www.mesotheliomahope.com/asbestosis/

  Doctors diagnose asbestosis by reviewing a patient’s medical history and performing several tests. Discussing a patient’s potential asbestos exposure is typically the first step. […] Most doctors rely on these tests to diagnose asbestosis: Basic chest exam: A medical professional may hear a crackling sound when using a stethoscope to listen to a patient’s breathing. Chest X-rays: Advanced asbestosis shows up as excessive whiteness in lung tissue. In severe cases, the lungs look like honeycombs. CT scans: These scans are more detailed than standard X-rays. A CT scan can detect asbestosis before it appears on a chest X-ray. Lung function tests: These tests can help determine how well the lungs are working. […] Once the diagnosis has been confirmed, doctors can recommend a treatment plan to help the patient live as long as possible.

• #21 Asbestosis diagnosis | asbestosis lawsuit settlements | National Asbestos Helpline

  https://www.nationalasbestos.co.uk/asbestos-diseases/asbestosis/diagnosis/

  The first diagnosis of Asbestosis was made in the UK in 1924. A diagnosis of Asbestosis will exclusively apply to pulmonary interstitial fibrosis which is asbestos induced. Asbestosis will usually be diagnosed based on the following findings: An exposure to asbestos that is considered moderate to heavy; Clinical signs of interstitial fibrosis; X Ray finding opaque masses in the lung fields; Impairment of the lung function. Diagnosing a person can take a significant period of time as the treating doctor will want to rule out all possible lung conditions such as lung scarring, rheumatoid arthritis: It will begin with a doctor, usually your GP, taking your medical history and carrying out a physical examination. Depending on the outcome of the physical examination and the findings from the medical history, your GP may request one or more of the following tests: X-Ray of the Chest and/or Abdomen, Computerised Tomography (CT) Scan, Lung Function Tests, MRI. When an X Ray is performed Asbestosis will appear as shadowing in the lower parts of the lungs however if a person is suffering with a minor level of Asbestosis then it will be likely that a CT Scan will be required too, as it is more sensitive because it takes cross sectional images of the lungs. Once the above investigations have been carried out then the doctor, usually the treating respiratory consultant, may decide that it is necessary to carry out a biopsy to confirm the diagnosis. A biopsy is when a sample of cells or tissue is removed to be examined under a microscope. To determine if a person has Asbestosis, a biopsy will be used to detect if there are any asbestos fibre and/or cancer in the lungs. The finding of asbestos bodies alone in the lungs is insufficient to lead to a diagnosis of Asbestosis as this only indicates an exposure to asbestos however it will assist in differentiating between the various Pneumoconiosis. A diagnosis of Asbestosis is likely to follow excessive exposure to asbestos a diagnosis of Asbestosis requires exposure of a minimum dose of 25 fibre mil years. In most Asbestosis diagnosis, Pleural Plaques will also be visible from the radiography. When a diagnosis of Asbestosis is being given it needs to be distinguished between other types of Pneumoconiosis such as: Anthracosis (miners lung) from exposure to coal dust; Silicosis exposure to silica and sometimes known as Potters rot or Grinders disease; Siderosis, from exposure to iron; Silicosiderosis exposure to both iron and silica. A more difficult distinction which needs to be made when diagnosing Asbestosis is between a diagnosis of Idiopathic Pulmonary Fibrosis and one of Asbestosis, (also known as Pulmonary Fibrosis of Asbestosis). The presence of asbestos bodies in the lung will generally assist in making a diagnosis of Asbestosis over another lung condition.

• #22 :: KJR :: Korean Journal of Radiology

  https://www.kjronline.org/DOIx.php?id=10.3348/kjr.2016.17.5.674

  The 2014 Helsinki criteria require the patient to have a work history compatible with significant asbestos exposure. This may be documented via a structured interview and/or by identifying asbestos fibers in lung tissue and bronchoalveolar lavage fluid. […] For radiologic diagnosis, chest radiographs revealing small opacities (ILO grade 1/0) are considered to indicate early-stage asbestosis. […] The characteristic chest radiographic findings of early asbestosis are small irregular or reticular opacities, located predominantly in the lung bases and show honeycombing in advanced stages. The characteristic CT findings of asbestosis are subpleural dot-like or branching opacities, parenchymal bands, parenchymal changes adjacent to pleural plaques, subpleural curvilinear lines and plaques. […] CT plays a key role in the diagnosis of asbestosis in Korea. Thus, knowledge of the characteristic CT findings of asbestosis can guide the diagnosis and management of patients.

• #23 Asbestos Toxicity: Clinical Assessment – Tests | Environmental Medicine | ATSDR

  https://archive.cdc.gov/www_atsdr_cdc_gov/csem/asbestos/clinical_assessment-tests.html

  CT and HRCT scans are more sensitive and specific than chest radiographs. HRCT scans can be used particularly when abnormalities on a conventional chest radiograph are equivocal or when a conventional chest radiograph is normal in the face of unexplained lung function abnormalities in a patient with significant asbestos exposure. They are especially useful in detecting […] Early parenchymal abnormalities of asbestosis, […] Early pleural disease, such as plaques and rounded atelectasis, […] The difference between asbestos-associated pleural plaques and extra-pleural fat, and […] Mesothelioma. […] Lung biopsy is a definitive test used in the histopathological confirmation of asbestos-associated diseases. Lung biopsies are rarely used to diagnose asbestosis or pleural plaques, because diagnosis of these conditions is usually based on medical and exposure histories, findings from the physical examination, and other tests.

• #24 Asbestosis Workup: Approach Considerations, Chest Radiography, Computed Tomography

  https://emedicine.medscape.com/article/295966-workup

  In most cases, asbestosis is diagnosed without a histopathologic examination of lung tissue. A pathologic diagnosis of asbestosis requires visualization of both fibrosis and asbestos bodies through light microscopy or of a significant quantity of asbestos fibers observed through electron microscopy. […] According to the 2014 Helsinki guidelines for the diagnosis of asbestos-related disorders, asbestosis is defined as diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos dust. […] The guidelines recommended the use of CT imaging in the diagnosis of asbestos-related diseases in the following circumstances: Borderline finding of lung fibrosis (International Labour Organization [ILO] 0/1-1/0) is detected. Discrepancy exists between a lung function finding of restriction and radiographs interpreted as normal. Widespread pleural changes severely hamper the radiographic visibility of the lung parenchyma.

• #25 Asbestosis | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/asbestosis?lang=us

  In the absence of pleural plaques or diffuse pleural thickening the differentiation may not be possible on imaging alone. Presence of centrilobular dot-like or branching opacities, subpleural lines and parenchymal bands may be helpful, as they are more common in asbestosis than in idiopathic pulmonary fibrosis.

• #26 Asbestos-related diseases – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/asbestos-related-diseases/

  Asbestosis is a type of pneumoconiosis caused by the inhalation of asbestos fibers. After a long latency period of 20 years, asbestosis manifests with nonspecific respiratory symptoms such as coughing and dyspnea. […] Diagnosis is primarily based on history of exposure, clinical and imaging findings, and, in some cases, histopathology. […] Obtain HRCT and PFTs in patients with dyspnea and a history of significant asbestos exposure. […] Diagnosis is based on a history of asbestos exposure, clinical features, and radiological findings; histopathology is not routinely required. […] Chest x-ray is often performed as part of a routine workup for respiratory symptoms, however, HRCT has higher sensitivity and specificity (especially in early disease stages). […] PFTs typically show a nonspecific restrictive lung disease pattern; results are used to determine disease severity.

• #27 Asbestosis Workup: Approach Considerations, Chest Radiography, Computed Tomography

  https://emedicine.medscape.com/article/295966-workup

  The criteria for diagnosis of asbestosis on CT were as follows: Sum grade of 2-3 bilateral irregular opacities in the lower zones according to the reference film, or bilateral honeycombing (sum grade 2) – This would be sufficient to represent fibrosis, according to the ICOERD system (International Classification of HRCT for Occupational and Environmental Respiratory Diseases) system. […] In asbestosis, a reduction in diffusing capacity precedes lung volume changes, but findings from a diffusing capacity measurement are not specific. Besides reduced diffusing capacity, the earliest physiologic abnormality is exertional hypoxemia. Total lung capacity is reduced in asbestosis, as in other restrictive disorders. […] BAL has only limited application in the diagnosis and management of asbestosis. It is helpful in diagnosing infections that may present with diffuse infiltrates and simulate asbestosis, and it may aid in the diagnosis of a coexisting bronchogenic carcinoma. In workers who are exposed to asbestos, BAL can provide quantitative information through asbestos fiber counts. The presence of more than one asbestos body (ie, coated asbestos fiber) per 1 mL of lavage effluent suggests significant exposure.

• #28 Asbestos Toxicity: Clinical Assessment – Tests | Environmental Medicine | ATSDR

  https://archive.cdc.gov/www_atsdr_cdc_gov/csem/asbestos/clinical_assessment-tests.html

  The most important tests in diagnosing asbestos-associated disease are […] Chest radiographs and […] Pulmonary function tests. […] Screening pulmonary function tests are useful for finding restrictive deficits most commonly associated with asbestosis. Findings may include a reduction in forced vital capacity (FVC) with a normal forced expiratory volume (FEV) in one second FEV1/FVC ratio. Some sources report abnormal pulmonary function tests in 50% to 60% of patients with asbestosis. […] Diagnosis of asbestosis should mostly but not totally be based on radiographic findings, per the diagnostic criterion of the American Thoracic Society. In 10% to 15% of cases, an asbestos-associated pulmonary function abnormality can occur without definite radiologic change. The association of pleural thickening and calcification with interstitial changes enhances diagnostic accuracy of asbestosis.

• #29 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  Lung function testing is mandatory in the diagnosis and follow-up of asbestos-related diseases. […] The measurement of diffusing capacity (DLCO) is a sensitive test, but it lacks specificity in the detection of interstitial lung disease and has a greater coefficient of variation than spirometry. […] Asbestos can be detected in respiratory samples on optical microscopy, in the form of asbestos bodies (AB), also known as ferruginous bodies, formed after the fibers are coated with proteic material within the macrophages. […] The current legal framework is based on RD 1299/2006. […] The law also demands that companies provide information, which has led to each autonomous community setting up lists of companies in which asbestos has been used. […] In view of this, the SEPAR EROM group recommends that the tests performed in the first and successive visits and the visit intervals should be as follows:

• #30 Asbestosis – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/asbestosis/diagnosis-treatment/drc-20354643

  A spirometer is a diagnostic device that measures the amount of air you’re able to breathe in and out. […] In some situations, your health care provider might remove fluid and tissue for testing to identify asbestos fibers or abnormal cells. Tests may include: […] A thin tube (bronchoscope) is passed through your nose or mouth, down your throat and into your lungs. […] In this procedure, your doctor injects a local anesthetic and then inserts a needle through your chest wall between your ribs and lungs to remove excess fluid for lab analysis and to help you breathe better.

• #31 Asbestosis – Lung and Airway Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/lung-and-airway-disorders/environmental-and-occupational-lung-diseases/asbestosis

  Asbestosis is widespread scarring of lung tissue caused by breathing asbestos dust. […] Diagnosis is usually made with chest x-rays and computed tomography. […] Diagnosis of asbestosis is based on history of exposure to asbestos and chest imaging, such as chest x-ray or high-resolution computed tomography (CT). […] Bronchoalveolar lavage (a minimally invasive procedure that involves instilling sterile salt water into the lungs, then removing the fluid for analysis) or lung biopsy is potentially useful when the diagnosis is uncertain. […] The demonstration of asbestos fibers and/or asbestos bodies can help support the diagnosis but is not necessary. […] A lung biopsy is rarely needed to make the diagnosis.

• #32 Asbestos exposure diagnosis in pulmonary tissues | Pathologica – Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology

  https://www.pathologica.it/article/view/695

  The diagnosis of asbestosis requires different criteria depending on whether it is in a clinical or medical/legal setting. In the latter context, only when a diffuse interstitial fibrosis associated to asbestos bodies (ABs) is present, it can be said to be asbestosis. […] The diagnosis generally requires: clinical, radiological images, and histopathology with mineralogical analysis. […] The demonstration of ABs inside sputum or BAL liquid correlates with a strong exposure and the asbestosis degree, but the presence of these exposure markers alone cytological samples is not sufficient to render a diagnosis of asbestosis. […] Histological diagnosis is therefore essential by identifying the lung fibrosis with typical asbestos fibres or bodies inside the lung. […] Asbestosis diagnosis is confirmed when there is the characteristic fibrosis and the presence of typical ABs on the routine 3-5 m thick sections.

• #33 Asbestosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK555985/

  Lung biopsy shows interstitial fibrosis with characteristically peribronchial fibrosis. The distribution of fibrosis in asbestosis is from the center to the periphery, ie, centrifugally. […] The endobronchial biopsy is done with ultrasound-guided bronchoscopy to visualize the airway and adjacent structures. This technique has been routinely used in many centers due to its high diagnostic value and low risk. […] The absence of asbestos bodies in chrysotile asbestosis leads to false-negative results. […] The diagnosis of asbestosis requires the exclusion of these differentials.

• #34

• #35 Asbestosis | Cause, Symptoms & Treatment

  https://www.maacenter.org/asbestos/cancer/asbestosis/

  Asbestosis can be difficult to diagnose early on, especially if a patient has a history of smoking. Its symptoms are similar to those of other diseases, such as chronic interstitial pneumonia, which can lead to misdiagnosis. […] Confirming this exposure to asbestos can help medical professionals avoid misdiagnoses and more accurately diagnose an asbestos-related disease. Assessing a patient’s symptoms, in combination with confirming asbestos in the lungs, can help medical professionals diagnose the disease early on in order to improve quality of life and extend survival.

• #36 Asbestos-Related Lung Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2007/0301/p683.html

  The presence of asbestosis is an independent risk factor for the development of lung cancer. Thus, the appearance of symptoms such as dyspnea, cough, chest discomfort, or weight loss necessitates a prompt and full assessment. […] Given a history of significant occupational asbestos exposure and typical high-resolution CT findings, surgical lung biopsy rarely is needed to establish a diagnosis. […] Asbestosis is a fibrotic lung disease, or pneumoconiosis, resulting from the inhalation of asbestos fibers. […] Complaints of exertional dyspnea associated with auscultatory crackles on physical examination should prompt further investigation. […] Chest radiography typically demonstrates increased interstitial markings, usually more prominent in the lower lobes, and often pleural plaques. […] In many respects, asbestosis is clinically similar to idiopathic pulmonary fibrosis, but asbestosis usually progresses slowly, whereas idiopathic pulmonary fibrosis has a rapidly progressive course. […] No current treatment effectively alters the natural course of asbestosis.

• #37 SciELO Brazil – Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals

  https://www.scielo.br/j/jbpneu/a/x3dvJJySp5Z7vXq7qrgCbTD/

  Individuals exposed to asbestos at the workplace for 1 year or those with a history of environmental exposure for at least 5 years, all of those with a latency period 20 years from the date of initial exposure, should initially undergo HRCT of the chest for investigation. […] Individuals with pleural disease and/or asbestosis should be considered for regular lung cancer monitoring. […] There are no serological markers nor other types of markers for the early diagnosis of the diseases related to asbestos exposure mentioned above. For pleuropulmonary diseases, the object of the present document, chest imaging is the detection method used globally. […] It is well established that chest CT is more sensitive for the diagnosis of diseases related to asbestos exposure. […] HRCT, including low-dose CT of the chest, provides a more accurate diagnosis of interstitial lung diseases, such as asbestosis, and that of pleural thickening, such as pleural plaques.

• #38 SciELO Brazil – Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals Brazilian Thoracic Society recommendations for the diagnosis and monitoring of asbestos-exposed individuals

  https://www.scielo.br/j/jbpneu/a/x3dvJJySp5Z7vXq7qrgCbTD/

  Specialty societies in the thoracic area have long been indicating the use of chest HRCT to diagnose interstitial lung diseases. […] The identification of nonmalignant abnormalities, especially asbestosis, but also pleural plaques, enables to evaluate the inclusion of these individuals in the high-risk group for developing lung cancer and to ensure that they are monitored. […] Chest LD-HRCT screening should be performed in individuals with a history of occupational exposure to asbestos who meet the criteria described above if their lung cancer risk estimate is at least 1.5% according to Liverpool Lung Project or CanPredict calculators. […] The diagnosis and registration of occupational diseases have historically been inadequate and limited for many reasons, such as the deficient education of health professionals and the lack of specialized services in Brazil. Respiratory diseases deriving from asbestos exposure are included in this context. Diagnosing asbestos-related diseases is necessary to enhance the monitoring of patients’ health.

• #39 Diagnosing Malignant Mesothelioma | NYU Langone Health

  https://nyulangone.org/conditions/malignant-mesothelioma/diagnosis

  Thoracoscopy is a procedure used to determine whether and how far the cancer has spread in the chest. […] A laparoscopy is similar to a thoracoscopy, except doctors make small incisions in the abdomen through which they pass a laparoscope. […] Our surgeons may perform an endobronchial ultrasound-guided needle aspiration to determine whether the mesothelioma has spread to lymph nodes in the center of the chest. […] Another procedure for determining whether mesothelioma has spread to the lymph nodes in the center of the chest is a mediastinoscopy. […] NYU Langones Thoracic Oncology Research Program is recognized as a Biomarker Discovery Laboratory by the National Cancer Institute. […] Doctors at NYU Langone are studying certain proteins in the blood in the hopes of distinguishing people who may have been exposed to asbestos from those who actually have mesothelioma. […] Researchers are also using these biomarkers to help diagnose mesothelioma early in people who are at high risk of developing the condition because of prior exposure to asbestos.

• #40 Asbestos exposure diagnosis in pulmonary tissues | Pathologica – Journal of the Italian Society of Anatomic Pathology and Diagnostic Cytopathology

  https://www.pathologica.it/article/view/695

  A histological diagnosis for asbestosis requires the identification of a bronchiolar/interstitial fibrosis and the presence of typical ABs in histological sections (more than 1 per cm2). This is at least the criterion required for the recognition of asbestosis as an occupational disease. Clinical/radiological diagnosis alone is not sufficient to respond to medico-legal questions. […] The diagnosis of that is accepted in legal questions depends by ABs or asbestos fibres in the lung. For this reason, it is necessary to obtain sufficient tissue sample for analysis. It must be representative of the lesion to identify both specific asbestos fibrosis and ABs within the lung tissue. […] Therefore, some methodologies and techniques (LM, SEM/EDS, and micro-Raman spectroscopy) can be applied and the techniques that maintain the structure of the lung parenchyma should be preferred.

• #41 Diagnosing Asbestosis: A Clinical Approach – Klarity Health Library

  https://my.klarity.health/diagnosing-asbestosis-a-clinical-approach/

  Imaging tests are a cornerstone in the diagnosis of asbestosis. […] By employing a combination of chest X-rays and, when necessary, CT scans, doctors can gain valuable insights into the health of a patient’s lungs. […] Pulmonary function tests (PFTs) are a set of specialized examinations used to evaluate how well your lungs are working. […] While PFT results alone cannot definitively diagnose asbestosis, they provide crucial information about the functional capacity of the lungs. […] Early detection of asbestosis is critical for managing the disease and improving patients’ quality of life. […] Each of these diagnostic tools plays a critical role. While no single test is definitive, a combination approach offers a comprehensive picture of the disease. By piecing together the information gleaned from physical examination, imaging, and PFTs, healthcare professionals can confidently diagnose asbestosis and guide patients towards optimal treatment options.

• #42 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  If the probability of exposure is zero or unclear from the patient’s employment history and test results are normal, the follow-up will terminate at this point. […] Changes in symptoms, in lung function tests, or in radiological studies may call for a repeat CT. […] Attributing a disease to asbestos has a diagnostic significance that will affect subsequent monitoring and may also have legal and economic implications, since mesothelioma, asbestosis, lung cancer, and pleural fibrosis associated with ventilatory restriction are recognized as occupational diseases.

• #43 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  Changes in symptoms, in lung function tests, or in radiological studies may call for a repeat CT. […] Attributing a disease to asbestos has a diagnostic significance that will affect subsequent monitoring and may also have legal and economic implications, since mesothelioma, asbestosis, lung cancer, and pleural fibrosis associated with ventilatory restriction are recognized as occupational diseases.

• #44 Recommendations for the Diagnosis and Management of Asbestos-related Pleural and Pulmonary Disease | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-recommendations-for-diagnosis-management-asbestos-related-articulo-S1579212917301945

  The current legal framework is based on RD 1299/2006 (supplementary material, available online, Annex I). […] Article 16 of RD 396/2006, dated 31 March 2006, setting down the minimum provisions for health and safety applicable to jobs with risk of exposure to asbestos, states that taking into account the long period of latency of the pathological manifestations of asbestos exposure, any worker with a history of exposure to asbestos who ceases their working relationship with the company in which the situation of exposure arose, whether due to retirement, change of company, or any other reason, will continue to undergo preventive medical check-ups. […] In view of this, the SEPAR EROM group recommends that the tests performed in the first and successive visits and the visit intervals should be as follows:

• #45 Imaging and imagination in the diagnostics of asbestosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7809973/

  The two cases demonstrate how a diagnosis of asbestosis formulated in patients with suggestive working history, but in the absence of indicative radiological signs and histopathological findings, cannot find confirmation in the autoptic examination. Therefore, in clinical practice, this diagnosis must be made with caution, following the criteria consolidated in the scientific literature. Any diagnostic errors can have serious consequences in the forensic field.

• #46 Asbestosis – Causes, Symptoms, Treatment, Diagnosis – MedBroadcast.com

  https://medbroadcast.com/condition/getcondition/asbestosis

  Asbestosis is a harmful lung condition that develops in people who have inhaled asbestos dust. […] Once someone develops asbestosis, there is no cure. […] If you experience symptoms of asbestosis, this may well mean that many scars have formed in your lungs. […] If you suffer from a cough and habitual shortness of breath, you should tell a doctor about any possible exposure to asbestos. […] Only when there is clear evidence of asbestosis will a doctor assume that asbestos exposure played a role. […] There is currently no specific treatment for asbestosis. […] Asbestosis is preventable, mainly through reducing the amount of asbestos dust in the workplace. […] If you have asbestosis, you must immediately stop all exposure to asbestos. […] Employers must provide mandatory medical examinations at specified intervals for workers who are exposed to asbestos.

• #47 Notification of an asbestosis diagnosis | SafeWork NSW

  https://www.safework.nsw.gov.au/legal-obligations/medical-practitioners-obligation-to-notify-of-a-disease/notification-of-an-asbestosis-diagnosis

  Early abnormalities of asbestosis are difficult to detect in a lung X-ray, however, as the disease progresses the X-ray is characterised by a cloudy, ground glass appearance. […] When SafeWork NSW or another relevant WHS regulator is notified of an asbestosis diagnosis, they may investigate the workplaces where asbestos exposure may have occurred.

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