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Asbestosis

Asbestosis is a chronic inflammatory medical condition affecting the parenchymal tissue of the lungs. It occurs after long-term, heavy exposure to asbestos, e.g. in mining. Sufferers have severe dyspnea (shortness of breath) and are at an increased risk regarding several different types of lung cancer.

As clear explanations are not always stressed in non-technical literature, care should be taken to distinguish between several forms of relevant diseases. According to the World Health Organisation (WHO), these may defined as; asbestosis (the subject of this article), lung cancer, and mesothelioma (generally a very rare form of cancer, but increasing in frequency as people exposed to asbestos age).

Signs and symptoms
The primary symptom of asbestosis is generally the slow, insidious onset of shortness of breath on exertion. In severe, advanced cases, this may lead to respiratory failure. Coughing is not usually a typical symptom, unless the patient has other, concomitant respiratory tract diseases.

People with extensive occupational exposure to the mining, manufacturing, handling or removal of asbestos are at risk of developing asbestosis. There is also an increased risk of lung cancer and mesothelioma. Asbestosis and lung cancer require prolonged exposure to asbestos. However, cases of mesothelioma have been documented with even 1-3 months of exposure, and only indirect exposure (through air ventilation system.)

Pathogenesis
Asbestosis is the scarring of lung tissue (around terminal bronchioles and alveolar ducts) resulting from the inhalation of asbestos fibers. When such fibers reach the alveoli (air sacs) in the lung, where oxygen is transferred into the blood, the foreign bodies (asbestos fibers) cause the activation of the lung's local immune system and provoke an inflammatory reaction. Macrophages phagocytose (ingest) the fibers and stimulate fibroblasts to deposit connective tissue. The result is interstitial fibrosis. The fibrotic scar tissue causes alveolar walls to thicken which reduces elasticity and gas diffusion, reducing oxygen transfer to the blood, as well as the removal of carbon dioxide. The total lung capacity (TLC) may be reduced through the alveolar walls thickening. In the more severe cases, the drastic reduction in lung function due to the stiffening of the lungs and reduced TLC may induce heart failure (cor pulmonale).

Prevention
Reducing your exposure to asbestos may reduce your risk of mesothelioma. Most people with mesothelioma were exposed to the asbestos fibers at work. Workers who may encounter asbestos fibers include:

  • Miners
  • Factory workers
  • Insulation manufacturers
  • Railroad workers
  • Ship builders
  • Gas mask manufacturers
  • Construction workers

Follow all safety precautions in your workplace, such as wearing protective equipment. You may also be required to shower and change out of your work clothes before taking a lunch break or going home. Talk to your doctor about other precautions you can take to protect yourself from asbestos exposure.

Older homes and buildings may contain asbestos. In many cases, it's more dangerous to remove the asbestos than it is to leave it intact. Breaking up asbestos may cause fibers to become airborne, where they can be taken into your body as you breathe. Consult experts trained to detect asbestos in your home. These experts may test the air in your home to determine whether the asbestos is a risk to your health. Don't attempt to remove asbestos from your home — hire a qualified expert.

Coping skills
Shock. Anger. Sadness. Despair. Confusion. You may be feeling one or all of these emotions after receiving a mesothelioma diagnosis. A cancer diagnosis is devastating not only to you, but to your family and loved ones. Take time to experience the sadness and despair and to grieve. As you're shuffled between appointments with various doctors and specialists, know that you can take control of the time you have remaining. You decide how you'll spend your time and whom you'll spend your time with. Along with your doctor, you determine which treatments you'll undergo.

In order to regain a sense of control, try to:

  • Learn everything you can about mesothelioma. Write down a list of questions to ask your doctor. Ask your health care team for reading materials and other resources to help you better understand your disease. Consult the National Cancer Institute (NCI) and the American Cancer Society (ACS) for more information. Both organizations can provide you with information through their Web sites or toll-free telephone information lines. Call the NCI at 800-4-CANCER, or 800-422-6237. Call the ACS at 800-ACS-2345, or 800-227-2345. Information may help you feel more confident in your treatment decisions, and it may help you better understand what's going on inside your body.
  • Surround yourself with a support network. Whether it's close friends or family or a combination of both, surround yourself with people who love you. These people can help you with the everyday tasks, such as getting you to appointments or treatment, and they can help support you by providing someone to talk to or to reassure you. If you have trouble asking for help, learn to be honest with yourself and accept help when you need it — your friends and family feel helpless too, and they want to help you.
  • Seek out other people with cancer. Ask your health care team about cancer support groups in your community. Sometimes there are questions that can only be answered by other people with cancer. Support groups offer a chance to ask these questions and receive support from people who understand your situation. Online support message boards can offer similar benefits while allowing you to remain anonymous.
  • Plan for the unknown. Ask your health care team about advance directives that give your family guidance on your medical wishes in case you can no longer speak for yourself. Talk to a lawyer about your will, if you haven't already done so.

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