Asbestos-related diseases

What is asbestos?

Asbestos is a material that was used in the past in buildings. It is an insulating material that is both heat-resistant and fire-resistant. There are different types of asbestos: white, brown and blue.

It used to be thought that blue and brown asbestos were more harmful than white asbestos but it is now known that all three forms are linked to cancers. Although they are all harmful, blue and brown asbestos are the most strongly linked with cancers and they have not been imported into the UK since 1985. However, they are still present in some buildings and equipment produced before the ban. White asbestos has been banned in the UK since 1999.

Asbestos is more likely to be found in buildings built or refurbished before the year 2000. Anyone who is involved in building maintenance is potentially at risk if they disturb asbestos. The danger lies in any activity that disturbs the asbestos fibres, including removal, drilling, sanding and cutting. It is asbestos dust or fibres which cause the harm when they are breathed in (inhaled) or swallowed (ingested). Asbestos materials which are left undisturbed are probably safe.

Having a previous exposure to asbestos is associated with various different diseases. These mainly affect your lungs and include the following.

Lungs and airways with pleura

The pleura is a thin membrane with two layers. One layer lines the inside of your chest wall. The other layer covers your lungs.

Between the two layers of pleura (your pleural cavity) is a tiny amount of fluid. This acts like lubricating oil between your lungs and your chest wall as they move when you breathe.

Pleural plaques are small, raised areas or tissue which usually occur on your pleura. These are sometimes found when you have a chest X-ray for another condition. Pleural plaques are not usually associated with any symptoms but can occasionally cause chest pain. They are an indication that you have been exposed to asbestos at some time in your life. There is some evidence that people with pleural plaques are more likely to develop mesothelioma (see 'Mesothelioma', below). They are not, however, a risk factor for asbestosis (see 'Asbestosis', below).

Diffuse pleural thickening is a thickening of your pleura of either one or both lungs. It is sometimes associated with a build-up of fluid in between the two layers of pleura. It most commonly leads to worsening shortness of breath and also tightness in your chest, as your lungs cannot fully expand when you breathe in.

A chest X-ray may show the diffuse pleural thickening. A CT scan and breathing tests (spirometry) may also be performed.

There is currently no treatment for diffuse pleural thickening. However, the outlook (prognosis) is often good as, for many people, the condition does not worsen with time.

Asbestos pleurisy is inflammation of your pleura next to your lungs. This is often associated with a build-up of fluid around your lung (an effusion). This often leads to pain when you breathe in and also worsening shortness of breath.

A chest X-ray may show this condition. However, a sample of the fluid around your lungs is often taken to confirm the diagnosis. A small sample (biopsy) of your pleura may need to be taken to look at under the microscope to confirm the diagnosis.

The fluid is usually drained. It can sometimes come back (recur) in the future.

Asbestosis is a condition that causes scarring of your lungs. Asbestosis usually develops at least twenty years after being exposed to a large amount of asbestos. The most common symptoms are shortness of breath which progressively worsens with time. In addition, a cough may be present, which is usually a dry cough.

Asbestosis is usually diagnosed from the appearance of a chest X-ray and/or a CT scan of the chest. Breathing tests (spirometry) may also be done. Occasionally, a small sample (biopsy) of your lung may be needed to confirm the diagnosis.

Although asbestosis is incurable, there are different treatments available to help improve the symptoms it causes. Inhalers are often given to help with shortness of breath. It may sometimes be treated with steroid tablets and other medication.

Mesothelioma is a type of cancer that occurs in the tissues which cover your lungs or tummy (abdomen). The lining around your lungs is the pleura and in your abdomen it is called the peritoneum. See separate leaflet called Mesothelioma for more details.

Asbestos exposure is a risk for all types of lung cancer. This risk is increased further if you also smoke. See separate leaflet called Lung Cancer for more details.

Most cases of cancer of the larynx occur in people who smoke. However, a previous exposure to asbestos may be a risk factor for cancer of the larynx. See separate leaflet called Laryngeal (Throat) Cancer for more details.

People with asbestos-related lung disease may be eligible for compensation through the following:

• Industrial Injuries Disablement Benefit (IIDB) from the Department for Work and Pensions (see references below).

• A civil law claim for damages from the employer at the time of asbestos exposure.