From the Guidelines
Asbestosis can cause obstructive airway disease, which may lead to asthma-like symptoms, but it does not directly cause asthma. According to a study published in the American Journal of Respiratory and Critical Care Medicine 1, asbestos exposure has been associated with an obstructive physiological abnormality, which may result in a reduction in the FEV1/FVC ratio and midexpiratory flow rates. This association may be due to the direct effect of asbestos on the airways, nonspecific effects of inorganic dusts, or confounding by tobacco smoking.
The study found that asbestos-related chronic airway obstruction may result in a reduction in FEV1/FVC ratio associated with reduced FEV1 1. Additionally, epidemiologic studies have demonstrated a significant association between asbestos exposure or asbestosis category and reduction in FEV1, FEV/FVC ratio, and midexpiratory flow rates 1.
Some key points to consider include:
- Asbestos exposure has been associated with an obstructive physiological abnormality 1
- Asbestos-related chronic airway obstruction may result in a reduction in FEV1/FVC ratio associated with reduced FEV1 1
- The presence of asbestosis could potentially worsen pre-existing asthma or make the lungs more sensitive to asthma triggers
- If you have been exposed to asbestos and are experiencing respiratory symptoms, it's crucial to consult with a pulmonologist who can properly diagnose your condition and recommend appropriate treatment 1
It's essential to note that the magnitude of the asbestos effect on airway function is relatively small, and this effect, by itself, is unlikely to result in functional impairment or the usual symptoms and signs of chronic obstructive pulmonary disease 1. However, if superimposed on another disease process, the additional loss of function due to the asbestos effect might contribute significantly to increased functional impairment, especially in persons with low lung function.
From the Research
Asbestosis and Asthma
- Asbestosis is a lung disease caused by the inhalation of asbestos fibers, which can lead to various respiratory diseases, including lung cancer, pleural plaques, and malignant mesothelioma 2.
- While asbestosis is a distinct lung disease, research suggests that asbestos exposure may also cause small airway obstruction, which is a characteristic of asthma 3.
- A study published in 2018 found that patients with asbestosis had significant small airway obstructive defects, which were associated with asbestos exposure 3.
- Another study published in 1993 found that asbestos directly increases lung epithelial permeability, which could contribute to lung scarring and potentially lead to asthma-like symptoms 4.
Key Findings
- Asbestos exposure is associated with an increased risk of developing small airway obstruction, which is a characteristic of asthma 3.
- The duration of exposure to asbestos is significantly associated with the forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) ratio and the predicted percentage of maximum expiratory flow between 25% and 50% of the forced vital capacity (MEF25-50) in non-smoking patients with asbestosis 3.
- Asbestos-related lung diseases, including asbestosis, can cause significant morbidity and mortality, and it is essential to be aware of the complications from asbestos exposure 5.
Asbestos-Related Lung Diseases
- Asbestos-related lung diseases include asbestosis, pleural plaques, diffuse pleural thickening, benign asbestos-related pleural effusions, and malignant pleural mesothelioma 5.
- The diagnosis of lung disease in asbestos-exposed individuals requires a detailed occupational and tobacco smoking history, correlation with physical signs, appropriate imaging, detailed lung function assessment, and histology/cytology when required 6.