II. Background

  1. Smallest, naturally occurring fiber
  2. Asbestos used industrially until 1970s in U.S.
    1. Aeronautics materials
    2. Electrical product lining
    3. Shipping materials
    4. Brake linings and clutch pads
    5. Building materials
  3. Asbestos Exposures continue today
    1. Building demolition and Asbestos removal
    2. Asbestos or vermiculite mines
  4. Asbestos risks have been known for >100 years
    1. First linked to lung disease in 1890
    2. Exposure legislation in United Kingdom as of 1931
    3. Exposure legislation in United States as of 1971

III. Pathophysiology

  1. Exposure occurs with Asbestos fiber inhalation
  2. Consequences of Asbestos Exposure delayed 10-40 years

IV. Complications

  1. Asbestosis (fibrotic lung disease)
  2. Mesothelioma
  3. Pleural Plaques
  4. Pleural Effusions
    1. Unilateral, exudative Pleural Effusions
    2. Asbestos-related is diagnosis of exclusion
      1. Consider Tuberculosis, Mesothelioma, Lung Cancer
  5. Lung Cancer
    1. Tobacco use increases risk dramatically
    2. Asbestos-related Lung Cancer deaths: >2000/year U.S.
    3. Observe for non-calcified lesions on XRay
    4. Types
      1. Non-small cell and small cell
      2. Mesothelioma (appears same as Lung Cancer on XRay)

V. Risk factors: Asbestos related disease

  1. Several months of significant Asbestos Exposure and
  2. Clinical presentation at least 10 years later

VI. Management

  1. No specific management
  2. Tobacco Cessation

VII. Monitoring

  1. ATS recommends repeat Chest XRay every 3-5 years

VIII. Resources

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