Asbestos and Mesothelioma Asbestosis The severity of asbestosis is related to the length of exposure. This is in contrast to mesothelioma where even very limited exposure can cause disease. The latent period is typically 15-30 years. Asbestosis typically causes lower lobe fibrosis. As with other forms of lung fibrosis the most common symptoms are shortness- of-breath and reduced exercise tolerance. Pleural plaques Pleural plaques are benign and do not undergo malignant change. They are the most common form of asbestos related lung disease and generally occur after a latent period of 20-40 years. Pleural thickening Asbestos exposure may cause diffuse pleural thickening in a similar pattern to that seen following an empyema or haemothorax. The underlying pathophysiology is not fully understood. Mesothelioma Mesothelioma is a malignant disease of the pleura. Crocidolite (blue) asbestos is the most dangerous form. Possible features progressive shortness-of-breath chest pain pleural effusion Patients are usually offered palliative chemotherapy and there is also a limited role for surgery and radiotherapy. Unfortunately the prognosis is very poor, with a median survival from diagnosis of 8-14 months. Diagnosis Pleural tap has about a 60% sensitivity for pleural malignancy, whereas thoracoscopic biopsy will make the diagnosis in 98% of cases. Lung cancer & Mesothelioma Asbestos exposure is a risk factor for lung cancer and also has a synergistic effect with cigarette smoke.