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      Asbestos-related diseases

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          Abstract

          Knowledge of asbestos-related diseases has been accumulating for over one hundred years as the industrial value of asbestos was recognised for the strength of its fibres and their resistance to destruction, resulting in increasing production and use until the multiple health effects have become apparent. Deposition in the lung parenchyma results in an inflammatory/progressively fibrotic response, with impaired gas exchange and reduced lung compliance (‘asbestosis'), causing progressive dyspnoea and respiratory failure for which only palliation is indicated, although anti-fibrotic agents used for idiopathic usual interstitial pneumonitis remain to be evaluated. Benign pleural effusion, diffuse pleural fibrosis (occasionally with associated rolled atelectasis) and pleural plaques are the non-malignant pleural diseases that result from fibres reaching the pleura. But the main issues that led to the ban on asbestos in industry are those of malignancy: lung cancer, malignant mesothelioma (MM) of the pleura and MM of the peritoneum. Bronchogenic carcinoma risk from asbestos exposure is dose-dependent and multiplies the risk attributable to tobacco smoking. The principles of treatment are as for all cases of lung cancer. Low-dose computed tomography screening of exposed people can detect early-stage, non-small cell cancers, with improved survival. The amphibole varieties of asbestos are much more potent causes of MM than chrysotile, and the risk increases exponentially for 40–50 years following first exposure. As MM is non-resectable and poorly responsive to chemotherapy and radiotherapy, curative treatment is not possible and screening not justified.

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          Author and article information

          Journal
          The International Journal of Tuberculosis and Lung Disease
          int j tuberc lung dis
          International Union Against Tuberculosis and Lung Disease
          1027-3719
          June 01 2020
          June 01 2020
          : 24
          : 6
          : 562-567
          Affiliations
          [1 ]School of Population Health, University of Western Australia, Nedlands, WA
          [2 ]School of Population Health, University of Western Australia, Nedlands, WA, Telethon Kids Institute, University of Western Australia, Nedlands, WA
          [3 ]School of Public Health, Curtin University, Bentley, WA
          [4 ]School of Population Health, University of Western Australia, Nedlands, WA, Department of Diagnostic Genomics, PathWest Laboratory Medicine, Nedlands, WA
          [5 ]School of Medicine, Curtin University of Technology, Bentley, WA, Australia
          Article
          10.5588/ijtld.19.0645
          32553000
          5b05f2bb-6d50-4ab1-acdc-0d523934eab0
          © 2020
          History

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