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Men's Health

Asbestos exposure

by Nancy Farm Mannikko, PhD, Michael A. Buratovich, PhD

Category: Diseases/Disorders

Key terms:

asbestos: a naturally occurring mineral fiber composed of silica compounds

asbestosis: a type of pneumoconiosis caused by the inhalation of asbestos fibers, commonly found in construction materials, that can lead to lung scarring and inflammation

mesothelioma: a specific type of cancer occurring when asbestos fibers irritate the pleural lining of the lungs

metastasis: the migration of cancer from its original location in the body to other organs

pleura: the thin membrane that lines the interior of the chest walls and covers the lungs

pneumoconiosis: lung disease caused by the inhalation of various types of mineral dust over an extended period

silicon dioxide: a compound formed when silica is exposed to air

CAUSES AND SYMPTOMS

Asbestos is a naturally occurring mineral fiber whose fire-resistant properties have been known since antiquity. Although there are a variety of forms of asbestos, with some being more associated with occupational illness and disease than others, all asbestos shares a common characteristic: Because asbestos consists of silica crystals, the fibers are inherently irritating to human tissue. On the skin’s surface, they can become embedded and lead to calluslike growths, termed “asbestos warts,” as the body attempts to encapsulate the irritating fibers.

ASBESTOSIS

Asbestos minerals are used in plumbing, roofing, shipbuilding, and textile industries. Asbestosis risk depends on the type, length, and thickness of inhaled asbestos fibers and the duration and intensity of asbestos exposure. Historically, certain occupations with a higher risk of asbestos exposure were more commonly held by men. Industries such as construction, shipbuilding, insulation work, and mining have traditionally employed a larger number of male workers, and these occupations were associated with a higher risk of asbestos exposure. Consequently, most reported cases of asbestosis have historically occurred in men.

Asbestosis is a type of pneumoconiosis or a lung disease caused or aggravated by asbestos, silica, or coal dust inhaled at work. Normally, alveolar macrophages phagocytose all foreign particles under 2 micrometers that fall into the lungs to protect the alveoli. Unfortunately, the macrophages fail to clear these inhaled particles because they are toxic or just plain hard to digest. Some taxed macrophages die, activating the remaining macrophages, which release inflammatory cytokines and growth factors. Cytokines damage the lungs, induce inflammation, and attract macrophages and fibroblasts that divide and make collagen. Over time, persistent inflammation and fibroblast-based collagen deposition thicken the alveolar walls.

Initially, asbestosis causes no symptoms but may cause a dry cough, fatigue, and progressive trouble breathing (dyspnea). Advanced asbestosis may cause dry crackles at the base of the lungs, nail clubbing, poor oxygen levels in the blood (hypoxemia), and, in severe cases, symptoms of cor pulmonale (a condition characterized by enlargement and dysfunction of the right ventricle of the heart, usually resulting from long-term pulmonary hypertension), like chest pain, fast breathing (tachypnea), and shortness of breath upon exertion. Asbestosis exposure significantly increases the risk of mesothelioma, an aggressive cancer originating from the mesothelium, a thin epithelial membrane that lines the pleural cavity. Asbestos exposure also causes an even higher risk of bronchogenic carcinoma.

Figure 1. Ferruginous bodies in a sputum sample.

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Photo by Nephron, via Wikimedia Commons.

Diagnosis relies on a personal history of asbestos exposure, pulmonary function tests that show a restrictive pattern, and chest x-ray or high-resolution CT that usually shows pleural thickening and calcified plaques. Collagen deposits cause thickened pleural plaques, and they are a hallmark of asbestos exposure. If someone consistently exposed to asbestos coughs up a sputum sample, staining it with a Prussian blue stain reveals asbestos (ferruginous) bodies that look like golden-brown, dumbbell-shaped, segmented rods (Figure 1).

There is no specific treatment for asbestosis. Early detection of complications can prevent them from getting worse. Pulmonary rehabilitation, including exercise training, health education, and breathing techniques, can help reduce symptom severity.

Asbestosis and mesothelioma may take many years, with some not developing mesothelioma until as many as forty years after the initial exposure. On the other hand, there have been cases of adolescents developing mesothelioma within only a few months of initial asbestos exposure.

TREATMENT AND THERAPY

Localized “asbestos warts” on the skin may be unattractive but generally benign. The lung diseases associated with asbestos exposure, however, are progressive and ultimately fatal (Figure 2). In asbestosis, the scarred lung tissue becomes increasingly stiff, and the person cannot breathe sufficient oxygen.

Mesothelioma has a high mortality rate, as it is rarely detected in its early stages. Symptoms like shortness of breath are attributed to more common diseases such as asthma. As the cancer spreads, lung capacity is diminished, and the victim eventually dies from the inability to take in sufficient oxygen if they have not already succumbed to other organs failing after the cancer metastasizes.

PERSPECTIVE AND PROSPECTS

The ancient Romans mined asbestos for use in manufacturing fireproof mats and garments, as did various other cultures throughout recorded history. During the nineteenth century, asbestos became a popular material for lamp wicks, as it could convey the lamp oil without being consumed by the flame. As industrialization progressed, asbestos became widely used in such applications as brake shoes for automobiles, oven linings in electric stoves, and building materials. Asbestos was impregnated into siding and shingles for exterior walls and roofs, insulation for attics and walls, and ceiling and floor tiles. By the mid-twentieth century, asbestos had become ubiquitous in society, from the materials on which people walked to the roofs over their heads. The Romans recognized that mining asbestos was effectively a death sentence, as enslaved people working in asbestos production quickly developed coughs and wasted away from lung diseases. As mining was generally a dusty and dangerous occupation, the special risks that asbestos presented were not well recognized. For centuries, many physicians assumed that all miners’ lung ailments were forms of consumption (tuberculosis), when in fact, tuberculosis was an opportunistic infection that followed after a miner became weakened by disorders such as silicosis and asbestosis.

Asbestosis

Figure 2. Asbestosis—the progressive destruction of respiratory tissues via inhalation of dust-sized asbestos fibers that attach to the walls of the lung and then spread outward—is often the result of prolonged exposure to asbestos- containing materials (in shipyards, office buildings, manufacturing plants); it is one of a wide variety of environmental diseases.

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©EBSCO

INFORMATION ON ASBESTOS EXPOSURE

Causes: Irritation of tissue of skin or lungs by silica fibers

Symptoms: For skin, calluslike growths; for lungs, scarring resulting in asbestosis and mesothelioma (cancer)

Duration: Chronic and progressive

Treatments: None; support for symptoms

By the 1930s, researchers had established that asbestos presented especially high risks of causing lung diseases in miners, shipyard workers, and others who either manufactured or worked with materials incorporating asbestos, such as insulation. By the mid-twentieth century, it had become evident that extremely small amounts of asbestos exposure could lead to asbestos-related disorders. Miners’ spouses developed mesothelioma after being exposed to asbestos through doing laundry, for example, while children became victims through exposure to their parents’ work clothes in the home.

The widespread use of asbestos fibers in multiple applications means that exposure remains a concern in the twenty-first century. Although asbestos is no longer as widely used in industry, reducing the prevalence of workplace exposures, people can still risk asbestos exposure when engaging in home improvement projects as they rip out old flooring or replace ceiling tiles.

For Further Information

1 

“Asbestos Exposure and Cancer Risk,” National Cancer Institute, 29 Nov. 2021, www.cancer.gov/about-cancer/causes-prevention/risk/substances/asbestos/asbestos-fact-sheet.

2 

“Asbestosis.” American Lung Association, n.d., www.lung.org/lung-health-diseases/lung-disease-lookup/asbestosis.

3 

“Asbestosis.” U.S. National Library of Medicine, 1 Sept. 2021, medlineplus.gov/ency/article/000118.htm.

4 

“Asbestosis and Asbestos-Related Pleural Diseases.” National Institute for Occupational Health and Safety, 26 Apr. 2023, www.cdc.gov/niosh/learning/b-reader/clinical/lung/4.html.

5 

Bowker, Michael. Fatal Deception: The Terrifying True Story of How Asbestos Is Killing America. New York: Touchstone, 2003.

6 

Grippi, Michael, et al., eds. Fishman’s Pulmonary Diseases and Disorders, 6th ed. New York: McGraw-Hill, 2022.

7 

Hammer, Gary, and Stephen McPhee. Pathophysiology of Disease: An Introduction to Clinical Medicine, 8th ed. New York: McGraw-Hill, 2018.

8 

Kumar, Vinay, et al., eds. Kumar and Robbins Basic Pathology, 11th ed. Philadephia: Elsevier, 2022.

9 

Loscalzo, Joseph, et al., eds. Harrison’s Principles of Internal Medicine, 21st ed. New York: McGraw-Hill, 2022.

10 

Selby, Karen. “What is Asbestosis?” Asbestosis.com, 17 Jan. 2024, www.asbestos.com/asbestosis.

Citation Types

Type
Format
MLA 9th
Mannikko, Nancy Farm, and Michael A. Buratovich. "Asbestos Exposure." Men's Health, edited by Michael A. Buratovich, Salem Press, 2024. Salem Online, online.salempress.com/articleDetails.do?articleName=MenHealth_0051.
APA 7th
Mannikko, N. F., & Buratovich, M. A. (2024). Asbestos exposure. In M. A. Buratovich (Ed.), Men's Health. Salem Press. online.salempress.com.
CMOS 17th
Mannikko, Nancy Farm and Buratovich, Michael A. "Asbestos Exposure." Edited by Michael A. Buratovich. Men's Health. Hackensack: Salem Press, 2024. Accessed December 14, 2025. online.salempress.com.