Diagnosis and Treatment of
Asbestos-Related Illnesses

Diagnosis

Note: The Agency for Toxic Substances and Disease Registry (ATSDR) does not provide medical diagnosis or treatment. If you have a concern about asbestos exposure or a related illness, consult a physician with expertise in the evaluation and management of asbestos related diseases.

Ways to Detect Lung and Pleural Disease include

1. Physical Examination
2. Chest X-ray
3. Pulmonary function tests
4. Biopsy/Bronchoscopy
5. Computed Tomography Scans

4. Biopsy/Bronchoscopy.  A lung biopsy to detect asbestos fibers in pieces of lung tissue, while not needed to make a clinical diagnosis, is the most reliable test to determine the presence of asbestos-related effects. Less invasive tests (e.g. bronchoscopy) can detect asbestos fibers or asbestos bodies in bronchoalveolar lavage fluid or in sputum. These tests, however, do not reliably indicate how much asbestos a person may have been exposed to or predict whether disease will develop.

5. Computed Tomography Scans (CT Scans)

Over the past 20 years, several investigators have evaluated the potential of conventional scans for detecting abnormalities in asbestos-exposed workers. During 2001, ATSDR completed a study examining the effectiveness of CT-scans in detecting asbestos-related lung abnormalities as a part of a medical testing program conducted in Libby, Montana, where asbestos exposure occurred. Click here to read the protocol for the ATSDR study. A CT scan is an image produced by an X-ray source that rotates around the patient. The beams pass through the patient and are detected on the other side. This information is analyzed by computer to generate a cross-sectional view of the patient at that level. Studies have shown that CT offers several advantages over routine chest radiography (X-ray). First, the use of cross-sectional images often makes it possible to distinguish between densities that would be superimposed on plain radiographs. Second, CT is far better than routine radiographic studies at characterizing tissue density, distinguishing subtle differences in density between adjacent structures, and providing accurate size assessment of lesions. 

Treatment for Asbestos-Related Diseases

Treatment for Nonmalignant-Illnesses

Unfortunately, no cure exists for asbestosis or other lung or pleural diseases caused by chronic exposure to asbestos. Treatment involves preventing further complications and treating symptoms. 

Preventing further exposure and ceasing any tobacco smoking activities are the most important steps individuals can take to minimize development of health problems. Once established, these diseases can remain stable or progress in severity in the absence of further exposure. The diseases rarely regress.

Treatment for Malignant Illnesses

Treatment options for patients diagnosed with asbestos-related cancer of the lung or pleura are limited to resection (surgical removal of a part), chemotherapy, or both.

Future research could help to develop therapeutic methods to interfere with the development of asbestos-induced lung and pleural disorders to cause the disorders to regress once they are established.

The National Jewish Medical and Research Center partnered with ATSDR in its asbestos investigations in Libby, Montana. The center treats asbestos-related illnesses. To learn more about the center and how to access its services, visit their Web site.

The National Cancer Institute web site also offers more information on treatment.

Recommendations

The following are important steps for minimizing risks of asbestos-related disorders:

• Minimize or avoid further exposure to any form of asbestos;
• Stop smoking and avoid tobacco smoke (second hand) and other pulmonary sensitizers and irritants;
• Get regular medical care;
• Consider appropriate vaccines (such as influenza and pneumonia) based on physician recommendations to prevent other pulmonary infections.

ATSDR expects people who were exposed to asbestos and who smoke to be unusually susceptible to asbestos-related lung cancer and asbestosis. Studies of asbestos workers indicate that asbestos-exposed smokers have greater than additive risks for lung cancer and asbestosis than asbestos-exposed nonsmokers. These people are strongly encouraged to quit smoking.

Individuals living or working in buildings with vermiculite insulation or other building materials that could contain asbestos are encouraged to ensure that the insulation material is in good repair and not disturbed in order to prevent the release of asbestos fibers. If the material is to be removed or disturbed for any reason, special procedures to minimize the generation of dust and specify appropriate locations for disposal must be followed. Individuals can obtain information about asbestos removal and disposal procedures from the 10 regional offices of the EPA.