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Asbestos and related lung conditions

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					Asbestosis and related lung conditions.
Dr Leena Deol

What is asbestos
 Asbestos is a naturally occurring fibre which is mined in

various parts of the world, notably South Africa and Canada.
 There are two families of asbestos, the Amphibole

family and the Serpentine family, which differ based on the structure of their mineral crystals.

• (British Lung Foundation)

What is asbestos
 There are five different types of Amphiboles: Amosite

("brown asbestos"), Crocidolite ("blue asbestos"), Anthophyllite, Tremolite, and Actinolite.
 Serpentine Asbestos  The most common type of asbestos, it is also known as

"white asbestos,"

Asbestos fibres
 Crocidolite (blue)  Amosite (brown)

 Chrysotile (white)

What is asbestos
 It can be processed in several ways for industrial use.

 Its properties of resistance to heat, electricity and sound,

make it useful for a variety of purposes, particularly brake linings and insulation.

• (British Lung Foundation)

Where can it be found in the home
 Exterior

 1) Roof garage and shed sheets, tiles or roof felt

 2) Gutters and down pipes
 3) Fascia

Where can it be found in the home
 Interior
 4) Partition walls  5) Panels beneath windows  6) Cupboards around domestic  10) Bath panels  11) Floor titles  12) Textures coatings (artex)  13) Gaskets and rope seals inside

boilers

gas appliances

 7) Panels behind electrical

equipment

 14) Cold water storage tanks

 8) Panels behind fires or heaters

 9) Panels on or inside fire doors

Where can it be found in the home

An example of asbestos slate
 Asbestos slate

When is it dangerous
 Discovery of asbestos in a building often causes alarm among

people living and working in it.
 It is only the inhalation of loose asbestos fibres which causes

disease.

• (British Lung Foundation)

Exposure to asbestos causes 5 types of lung disease
 Pleural Plaques

 Diffuse Pleural Thickening
 Asbestosis  Asbestos-related Lung Cancer  Mesothelioma

 www.asbestos-victims-support.org/diseases.

Lung diagram

lung

•www.asbestos-victims-support.org/diseases.

Pleural plaques
 Pleural plaques are localised, well-defined areas of

pleural thickening, rather like calluses on other parts of the body.  They are patches of tough tissue formed on the pleura on the chest wall.  The pleura is a two-layered membrane surrounding the lungs, shown on the diagram. Sometimes these plaques are „calcified‟ and may be referred to as „calcified pleural plaques‟.
 www.asbestos-victims-support.org/diseases.

Pleural plaques
 Usually, you will not experience any symptoms of

breathlessness or discomfort because of pleural plaques and it is unlikely that you will know that you have them.  Pleural plaques are seen as the least serious form of asbestos disease and are not in themselves dangerous.

Pleural plaques
 They are seen as an indicator of exposure to asbestos and

there is a small chance, because of that exposure, that you may develop one of the other types of asbestos disease in the future.

 You cannot claim Industrial Injuries Disablement

Benefit for pleural plaques.

 www.asbestos-victims-support.org/diseases.

Pleural plaques

Diffuse pleural thickening
 Pleural thickening: The pleura is a two-layered

membrane which surrounds the lungs and lines the inside of the rib cage.  Some asbestos fibres inhaled into lungs work their way out to the pleura and may cause fibrosis or scarring to develop there.  This causes the pleura to thicken and this may show up on a chest X-ray.
 www.asbestos-victims-support.org/diseases.

Diffuse pleural thickening

Diffuse pleural thickening
 Sometimes a build up of fluid in the pleural cavity occurs

before diffuse pleural thickening develops.

 This condition is called a „pleural effusion‟ and can cause

breathlessness and, in some instances, pain.

 It can take up to 10 to 20 years to develop pleural plaques

and pleural thickening after exposure to asbestos

Diffuse pleural thickening
 You can claim Industrial Injuries Disablement Benefit

from the Dept. for Works and Pension for diffuse pleural thickening if you were exposed to asbestos at work.  You can also claim compensation from your employer through the courts if you were negligently exposed to asbestos, or from the DWP if your employer is no longer trading .

Asbestosis
 Asbestosis is a type of scarring of the lung caused by asbestos

fibres which have lodged in the lungs after being inhaled from the air.
 The scarring causes the lungs to shrink  Symptoms of asbestosis include breathlessness, especially on

exertion, a dry cough, and chest tightness

Abestosis
 Asbestosis develops in some people who have breathed in a

substantial amount of asbestos dust in the course of their work.
 It usually shows itself a long time after dust inhalation, often

twenty or thirty years after exposure.

Asbestosis
 You can claim Industrial Injuries Disablement Benefit from

the Benefits Agency for asbestosis if you were exposed to asbestos at work.

 www.asbestos-victims-support.org/diseases.

Asbestosis

Symptoms of asbestos related disease
 Shortness of breath, wheezing, or hoarseness.  A persistent cough that gets worse over time.  Blood in the sputum (fluid) coughed up from the lungs.  Pain or tightening in the chest.  Difficulty swallowing.

 Swelling of the neck or face.
 Loss of appetite.  Weight loss, fatigue or anaemia.

Findings on clinical examination
 Often there is very little to find on chest examination.

Investigations
 GP may want to carry out a Chest Xray, however in the

early stages of the disease there is little to find.

 GP will then refer to a Chest Consultant who may want to

do the following tests

 CT Scan  Spirometry  Broncoscopy and Biopsy

Treatment
 This will be determined by the disease process.  Oxygen /Inhalers  Regular monitoring.

More information
 http://www.hse.gov.uk/asbestos/  Contact no 0845 345 0055

Break

Mesothelioma
 Mesothelioma used to be a relatively rare cancer. It is also

known as “diffuse” or “malignant mesothelioma”.
 It can affect the pleura (the lining of the lungs), and less

commonly, the peritoneum (the lining of the abdomen).
 It can also affect the pericardium (the area around the heart).

Mesothelioma

Mesothelioma
 The connection between mesothelioma and asbestos was

discovered in 1960. By 1960, the production and use of all forms of asbestos had increased world-wide. It continued to grow for at least 15 more years. This has been reflected by widespread cases of mesothelioma, 30 to 40 years later.
 Asbestos is the cause of over 90 per cent of cases of

mesothelioma.
 (British Lung Foundation

Mesothelioma
 All types of asbestos can cause mesothelioma if you breathe

in or swallow the fibres.

 Blue and brown asbestos are known to be the most

dangerous.

 White asbestos does increase the risk of mesothelioma, but

is not as strong.

 Another fibre called tremolite may also be a cause.

Who is at risk
 Initially mesothelioma mainly affected:  laggers  thermal insulation engineers  shipyard workers  asbestos manufacturing workers

 women who assembled gas masks during the war

Who is at risk
 However, recent cases show that:  building workers  plumbers  gas fitters  carpenters

 electricians
 are now the largest high-risk group.

Who is at risk
 People who come across asbestos while doing DIY (getting

rid of an old boiler, for example), are also at risk.

Who is at risk
 Some other people have a lower risk of mesothelioma, if

they have come into contact with asbestos, but not directly in their work.  For example:  People working in places where other workers are handling asbestos  People who have washed worker's overalls  People who lived and played near asbestos factories when they were children

Fibres

Symptoms
 The most common symptoms are:  Breathlessness due to build-up of fluid  Chest pain  Weight loss/loss of appetite  Fever/night sweats

 Pain and/or swelling in their abdomen
 Unexplained tiredness

How is it diagnosed?
 If you have been in contact with asbestos, and a chest x-ray

shows a build-up of fluid, then you will probably have further tests to confirm (or rule out) that you have mesothelioma.  It can be difficult to be certain of a diagnosis of mesothelioma. The doctor will need to examine some fluid and/or tissue.

How is it diagnosed?
 Bronchoscopy

 CT scan and /Biopsy

Ct scanner

How does mesothelioma develop?
 Mesothelioma usually spreads slowly, taking the path of

least resistance.  This is initially within the space between the layers of the lining of your chest/abdomen.  In later stages, the tumour can grow to be very large.  Mesothelioma does not usually spread around the body like other cancers sometimes do.

Treatment
 SYMPTOM CONTROL  Treatment with steroids  Painkillers  Drugs to improve appetite  Laxatives

 Drugs to improve the breathing

Treatment
 The fluid that can build up in your chest can be removed on a

regular basis.  Pleuradesis

Treatment
 Surgery to remove tumours has had varying success.  Trials are underway at the moment for an operation that

would remove the whole of the affected lung
 This operation is only suitable for a very small number of

people

Radiotherapy

 Radiotherapy treats cancer by using high-energy x-

rays to destroy cancer cells.  Radiotherapy is given there to stop the tumour growing through your chest wall and into your skin  Radiotherapy can be aimed directly at the tumour to try and make it smaller.  This will help reduce pain and discomfort, and possibly breathlessness.

Radiotherapy

Chemotherapy
 This is treatment with drugs; directly into your veins

and/or in pill form.  The aim is to kill or control the growth of cancer cells, which would help with your symptoms and improve your quality of life.  Doctors use a variety of drugs in chemotherapy - and there is one drug, Alimta (Pemetrexed), that has been licensed to treat mesothelioma in particular.
 (British Lung Foundation

Chemotherapy
 But chemotherapy will not benefit everyone, and will

usually only be considered if you are generally fit and strong.

 No cure for mesothelioma has yet been found but the

search goes on and new drugs and new combinations continue to be tested.

Take care of your feelings
 If you are diagnosed with mesothelioma, it can be traumatic.

 Being treated for mesothelioma, as with other cancers, can

be difficult too.

 (British Lung Foundation

Take care of your feelings
 You may feel shock, fear, disbelief, anger, loneliness or

resentment.

 You may find it hard to accept that you have

mesothelioma at all.  You may feel angry and bitter that you have a disease just because of where you worked. If you are a friend, relative or family member of someone who has been diagnosed with mesothelioma, you may feel many of the same emotions.
 (British Lung Foundation

Compensation and benefits
 It is a good idea to seek advice quickly, either from the

British Lung Foundation helpline on 08458 50 50 20
 Citizens Advice Bureau, or from a specialist solicitor (call the

Law Society).

 (British Lung Foundation

Compensation and benefits
 Industrial Injuries Disablement Benefit (IIDB)  To claim IIDB You should contact your local Jobcentre Plus,

or ring the DWP enquiry line (0800 88 22 00) and ask to be sent form B1 100PN.

 (British Lung Foundation

Compensation and benefits
 Other Benefits  Statutory Sick Pay or Incapacity Benefit  Constant Attendance Allowance  Severe Disablement Allowance  Disability Living Allowance (mobility)

 Income Support
 Housing Benefit/Council Tax
 (British Lung Foundation

More information
 British Lung Foundation  Asbestos Victim support  Heath and Safety Executive  Occupational health services

End
 Many thanks to  Mr Holden  PPG members  Participants.  Questions


				
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