Radiological characteristics of asbestos-related pulmonary disorders

By Treven Pyles

Posted on April 22nd, 2020

A radiology report includes complex medical terms that radiologists use to describe chest X-rays. These terms are often found in a report and are used to describe several different processes in the lungs. You can check out these terms for a more complete review of the asbestos-related pulmonary abnormalities.

Because of its affordability, tensile strength, and resistance to heat and chemical damage, asbestos has been used in the making of more than 3,000 industrial applications or products. These products contained the mineral in proportions ranging from 1% to almost 100%, depending on the particular use. After inhalation, asbestos fibers can easily enter the lungs and become trapped in the tissue where they cause a chronic persistent inflammatory process as they cannot be removed.

The inhalation of asbestos fibers may lead to a number of pulmonary disorders that can be divided into:

Who are the people most likely to be affected by asbestos?

Workers who handled several different asbestos materials in order to make these products, and veterans who have been exposed to these dangerous products through their military service, should inform their physicians of their exposure history and any symptoms. A thorough physical exam, a chest X-ray, and lung function tests are necessary to complete a diagnosis. The chest radiograph is the basic tool used to help diagnose - or rule out - the causes of shortness of breath, persistent cough, or chest pain - the most common signs of asbestos exposure. Interpretation of the chest X-ray may require the competency of a B-reader who is certified in reading chest X-rays for asbestos-related illnesses by the National Institute for Occupational Safety and Health.

The following data will also be collected if there is any known exposure to asbestos:

  • Age at first exposure, duration, and end of the exposure
  • The intensity under which the exposure occurred
  • Type of exposure: occupational exposure, military exposure, environmental exposure based on residence in close proximity to industrial or mining sources of asbestos

Radiological features frequently seen in patients heavily exposed to asbestos

The clinical examination begins with a thorough review of the patient's medical history to learn more about the possible risk factors, especially asbestos exposure. People with asbestos-related lung diseases have decreased lung function, and the medical practitioner listening with a stethoscope placed over the lungs can usually hear abnormal high-pitched sounds that are generally associated with pulmonary disorders.

In people who have a history of exposure to asbestos, doctors can diagnose an asbestos-related disease with a chest X-ray that shows characteristic changes. Radiological findings frequently seen in patients with a history of asbestos exposure, include:

  • Abnormal thickening of the pleura
  • Interstitial opacities consistent with fibrosis
  • Linear lesions in the diaphragmatic pleura
  • Rounded opacity of the pleural base
  • Translucent white deposits on the lungs
  • Increased hazy opacity within the lungs

In evaluating occupational diseases, chest X-rays are normally interpreted using the ILO classification - a system for recording abnormalities in chest X-rays resulting from the inhalation of hazardous dust, including asbestos dust. The ILO classification system is used to describe the size, shape (regular: p,q,r or irregular: s,t,u) and degree of involvement of radiographic abnormalities indicated by the term "profusion". The category of profusion is based on the assessment of the concentration of opacities in the affected zone and is numbered from absent or less profuse (or 0) to increasingly abnormal (1, 2, and 3).

The dimension used for rounded opacities can be roughly divided into three types:

  • s - fine irregular, or linear, opacities
  • t - medium irregular opacities
  • u - coarse irregular opacities

The radiographic opacities are classified according to the greatest diameter of predominant opacities:

  • p - small rounded opacities < 1.5 mm in diameter
  • q - small rounded opacities > 1.5 mm and up to about 3 mm in diameter
  • r - small rounded opacities > 3 mm and up to about 10 mm in diameter

The system is also used to address which of the lung zones are involved - upper, middle, and lower. For example, asbestosis is characterized by parenchymal fibrosis. In its simplest sense, fibrosis means a build-up of scar tissue in the lungs. On a chest X-ray, this parenchymal fibrosis shows up as small irregular opacities (s, t, or u), primarily in the lower lobes of the lungs.

The chest X-ray of a 72-year-old patient diagnosed with interstitial lung disease consistent with asbestosis shows interstitial opacities on both mid and lower lung fields. The diagnosis was based on the history of substantial exposure to asbestos, the corresponding period of latency, the radiographic evidence of bilateral diffuse irregular opacities, the absence of cardiopulmonary disease that could cause these abnormalities, and the presence of inspiratory crackles.

Our attorneys have helped a number of clients make successful compensation claims for their asbestos-related diseases

Lack of perceivable symptoms in the early stages of asbestos-related lung diseases contributes to a tardy diagnosis. Undergoing a routine chest X-ray especially if there is a well-traced history with relevance in asbestos exposure, is a very effective measure against the late diagnosis of a potential asbestos-related illness.

If you or a loved one has been exposed to asbestos and suffered health complications you may be entitled to compensation. To make sure that your case meets the basic eligibility requirements for compensation benefits, the diagnosis requires confirmation by further testing.

If you've been diagnosed with an illness that stems from asbestos exposure while in the military, and wish to access a free confirmatory asbestos screening procedure you can travel to Birmingham, Alabama for pulmonary function tests and chest X-rays.