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Pursuing the Correct Diagnosis with Asbestos-related Diseases

By Michael Bartlett

Posted on March 14th, 2019

The medical history of a patient is often the first requirement that needs to be addressed when the physician tries to establish a diagnosis and it becomes especially important to include a thorough and attentive look at the occupational history of the individual in question in case in there is a reason to suspect exposure to asbestos.

As medical records are able to currently show it can be a matter of decades, even up to 50 years, before the person that has been in contact with asbestos at some point in their life begins to be suspicious of certain symptoms.

Primarily affecting the respiratory system, more or less indistinct signs such as a cough or a sensation of tightness and pain in the chest area are generally not enough to alert the patient or the primary care physician of the gravity of the situation. Therefore, pulmonary issues of any kind should be immediately presented to the doctor if there is a history of asbestos exposure on the part of the patient so as to guide all efforts in the right direction.

The Threat of Asbestos Exposure

Each person that has interacted with asbestos has a unique experience with the exposure, meaning that there are many factors that need to be considered in order to assess the particular circumstances of an individual ranging from their overall health to how much time they spent in mediums contaminated by the toxic mineral to the density of the asbestos concentration in a given space and time interval.

In the United States, the substance was heavily used until regulations started being implemented in the late 1970s. In the period prior to the general ban on asbestos, however, all the leading industries acquired large quantities of the mineral, thus exposing millions of workers to its damaging effects. As an ironic twist of fate, manufacturers would pour asbestos fibers into equipment and protective clothing with the intention of increasing the safety of the employees, as the mineral was discovered to have an impressive resistance to fire, as well as being non-corrosive and easy to mix in with other compounds. Asbestos would also be present at the workplace in the form of insulation, covering wirings and pipes or turbines, but it would just as much be in the flooring or in the paint covering the walls.

When encased in a compound, asbestos does not pose a threat to anyone's health, however, when it becomes airborne, as it would usually happen in a workspace in which materials would be constantly disturbed as part of the daily activities, especially in occupations that involved the repairing, the renovations or the maintenance of asbestos-containing products, the tiny fibers are easily inhaled and can cement themselves in the lungs. The human organism has no natural defense against the substance and cannot expel it, meaning that irritation of the lungs begins as soon as the first exposure occurs.

Diagnosing an Asbestos-related Disease

Asbestos-related diseases are mainly associated with the area of the thorax and it is often the case that an X-ray will detect scarring, pleural effusion or some sort of nodules, all of which can be linked to an illness caused by asbestos. The X-ray cannot provide an image of asbestos fibers, it can only show abnormalities in the lung that could have a connection to asbestos exposure. Since asbestos-related diseases have symptoms that match the ones of many other possible conditions, reaching a diagnosis can be slow and deceiving which is why the occupational history of the patient is a valuable piece of information that could speed up the process. Imaging technology also becomes a key component during the examination.

An X-ray is usually the first type of scan that is recommended as a noninvasive way of investigation and so many patients that have admitted to having been exposed to asbestos are sent to have one for the doctor to have more ground to establish a diagnosis. Medical specialists, however, note on the limitations of an X-ray with its biggest impediment being that it is only able to present a two-dimensional image of the internal organs, meaning that there is always room for miscalculation, and consequently, for misdiagnosis. The thing an X-ray can tell with certainty is the state of healthy lungs for these should appear black on the scans; anything else would require interpretation on the part of the doctor based on the previous information offered by the patient.

Any sort of abnormalities or distorted shapes or masses should legitimately be considered as the consequences of asbestos exposure if the individual has been in the position of working with the material. If there is scarring of the lungs, pleural effusion or unexplained nodules appearing on an X-ray and yet the physician does not attribute them to asbestos in the case of a patient with a history of exposure, it would be best for them to get a second and even a third opinion just to make sure that the conditions are not asbestos-related. They could have their X-ray looked at again and have their medical and occupational history related to another doctor if they feel like their diagnosis was not right, especially since the chances of misdiagnosis are so high in these scenarios and the signs can be easily overlooked for years.

If the X-ray shows the accumulation of fluid in the chest, otherwise known as pleural effusion, the patient might be suffering from an asbestos-related disease. Only detected by an X-ray but often announced by a feeling of pain in the chest, pleural effusion is shown to be occurring a lot earlier than other illnesses caused by asbestos. At the same time, however, the condition can be the warning sign of the more serious mesothelioma. A background of asbestos exposure might prompt your doctor to follow up with more tests in order to identify the exact reason that has led to the build-up of the fluid.

It is generally the case that a disease like mesothelioma will first show up in the form of nodules but pleural effusion can often accompany them. Any masses that are of a round shape reaching up to three centimeters in size are commonly referred to as lung nodules and they can suggest the early stages of cancerous tumors. More opaque shapes on the X-ray typically point to a form of scarring of the lung and it could represent the early development of a condition like asbestosis. Already far advanced asbestosis would appear like a honeycomb on the scan clearing all doubts for the pulmonologist.

Current medicine does not have any solutions that could heal the damage caused by asbestos, but there exist treatment options that can help manage the conditions in more or less comfortable ways. With regulations on asbestos usage having been implemented in the 1970s and their known long latency periods, medical specialists anticipate that asbestos-related diseases will only become more prevalent in the following years.

It is important that the individuals that are experiencing pulmonary issues and that have been exposed to asbestos in a work setting to get checked up and eliminate the probability of asbestos-related illnesses definitively. If diagnosed with a disease caused by asbestos, then they might be eligible for compensation and they can pursue it in order to find ways to deal with the costs and the overall toll the condition will take on their life and the lives of their loved ones.