Clinical consequences of asbestos-related diffuse pleural thickening: a review

Asbestos-related diffuse pleural thickening (DPT), or extensive fibrosis of the visceral pleura secondary to asbestos exposure, is increasingly common due to the large number of workers previously exposed to asbestos. It may coexist with asbestos related pleural plaques but has a distinctly different pathology.

The pathogenesis of this condition as distinct from pleural plaques is gradually becoming understood. Generation of reactive oxygen and nitrogen species, profibrotic cytokines and growth factors in response to asbestos is likely to play a role in the formation of a fibrinous intrapleural matrix.

Benign asbestos related pleural effusions commonly antedate the development of diffuse pleural thickening. Environmental as well as occupational exposure to asbestos may also result in pleural fibrosis, particularly in geographic areas with naturally occurring asbestiform soil minerals.

Pleural disorders may also occur after household exposure. High resolution computed tomography (CT) is more sensitive and specific than chest radiography for the diagnosis of diffuse pleural thickening, and several classification systems for asbestos-related disorders have been devised.

Magnetic resonance imaging and fluorodeoxyglucose positron emission tomography (PET) scanning may be useful in distinguishing between DPT and malignant mesothelioma. DPT may be associated with symptoms such as dyspnoea and chest pain.

It causes a restrictive defect on lung function and may rarely results in respiratory failure and death. Treatment is primarily supportive.

Author: Susan E Miles, Alessandra Sandrini, Anthony R Johnson and Deborah H Yates
Credits/Source: Journal of Occupational Medicine and Toxicology 2008, 3:20

Published on: 2008-09-08

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Comments Page 1 of 1

Faye

Posted 1354 days ago

Despite all the problems associated with asbestos, it is still imported and used in the U.S. According to the U.S. Geological Survey, the U.S. imported and used an estimated 1,820 tons. http://minerals.usgs.gov/minerals/pubs/commodity/a sbestos/mcs-2008-asbes.pdf
The U.S. House of Representatives is considering a bill to ban asbestos (it is already banned in 40 countries) and provide funding for medical research into effective treatments for asbestos-related diseases. You can read about it at http://www.banasbestos.us

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