By Jane Yepez
Most people in the construction industry know of someone who has been diagnosed with an occupational lung disease due to exposure to asbestos. It is a diagnosis hoped to become less frequent thanks to federal government guidelines that were put into place in the 1970s to regulate the use of asbestos and asbestos products. But since symptoms can take 20 to 40 years from time of exposure to appear, it may be some time before industry occupational related cases disappear altogether. However, acquiring lung disease is less likely if safety precautions — like using ventilators — are followed.
There are two diseases that most commonly occur from asbestos exposure: asbestosis and mesothelioma. According to Allen Salm, M.D., pulmonologist and medical director at Virtua’s Marlton Hospital, people diagnosed with asbestosis can live with this chronic condition for decades. “It can be a non-progressive, slow-moving disease that is best managed by a pulmonologist,” says Dr. Salm. “Patients must regularly be monitored with x-ray, pulse oximetry and pulmonary function testing. In the most severe cases or as the disease progresses, the patient will be forced to use an oxygen tank system to keep their oxygen levels normal.”
More worrisome, says Dr. Salm, is a diagnosis of mesothelioma, a type of cancer that develops from the thin layer of tissue that covers many of the internal organs such as the lungs and chest wall. A diagnosis of mesothelioma can be confirmed with a chest x-ray or CT scan. Treatment may include surgery, radiation therapy and chemotherapy, but the prognosis is not hopeful. The percentage of people that survive five years following diagnosis is on average 8 percent in the United States. Mesothelioma patients are referred for treatment to medical oncologists.
Asbestosis and mesothelioma are mostly found among people who have been exposed to asbestos through their work in building construction, shipyards, railroads, aircraft and auto manufacture, roofing, asbestos mines, asbestos removal and in the manufacture of products like vinyl flooring and sheeting, cement board, cement pipes and flues, stucco and drywall joint compound. Exposure can also come from living near a manufacturing facility using asbestos or from washing the clothes of an asbestos worker.
Diagnosis generally occurs around the age of 65, says Dr. Salm. “Symptoms can include shortness of breath, a consistent dry cough, loss of appetite with weight loss, fingertips and toes that appear wider and rounder than normal and chest tightness or pain. One of the first questions your doctor will ask you is what you do for a living or what your parents did for a living.”
What happens to workers exposed to asbestos is that the airborne fibers can become lodged within the alveoli, the tiny sacs inside the lungs where oxygen is exchanged for carbon dioxide in the blood. The asbestos fibers irritate and scar the lung tissue, causing the lungs to become stiff. This makes it difficult to breathe.
Smoking cigarettes appears to increase the retention of asbestos fibers in the lungs, and often results in a faster progression of the disease.
“Although there is no cure for asbestosis,” says Dr. Salm, “there are several things we can do to help the patient breathe easier like nebulizer treatments that help open up the airway. If it’s one thing I tell people, whether they work in a high-risk industry or not, is stop smoking. It’s your best defense against a variety of diseases and to have a long, healthy life.”