Challenges in the Diagnosis of Asbestos-Related Lung Diseases

coughing asbestosis lung cancer

Asbestosis Legal expert Gregory A. Cade explains why diagnosis of asbestos-related illnesses can be challenging – and why getting the right diagnosis is critical for patients

The World Health Organization estimates that 125 million people around the world are exposed annually to asbestos at the workplaces, and more than 107,000 workers die each year from an asbestos-related ailment.

Asbestos, a prolific natural mineral, has long been the cause of fatal cancers and medical conditions worldwide.  It was widely used in construction of workplaces and homes.  Older buildings built before 1980 in the UK commonly contain asbestos in old floor tiles, ceiling tiles, roof shingles and flashing, siding, insulation (around boilers, ducts, pipes, sheeting, fireplaces), pipe cement, and joint compound used on seams between pieces of sheetrock.

Most exposures come from inhaling asbestos particles in the air, as older buildings suffer wear or damage such as tears, abrasions, or water damage, or are being replaced – damaged material may release asbestos fibers. This is particularly true if you often disturb it by hitting, rubbing or handling, or if it is exposed to extreme vibration or air flow.

When asbestos fibers become lodged in the lungs, they may cause inflammation, scarring and eventually genetic damage to the body’s cells.  The major asbestos-related pulmonary diseases can be divided into malignant and benign inflammatory-fibrotic disorders, and they usually occur decades after exposure to the toxic mineral. Establishing the diagnosis of asbestos-related diseases is not always a facile practice.

A misdiagnosis is quite common and is more likely to happen, especially when both the patient and the doctor ignore the past history of asbestos exposure. Early detection of asbestos lung-related ailments is vital, as most of the illnesses caused by asbestos exposure may metastasize, spreading to other parts of the body and negatively impacting the patient’s prognosis.

Another reason why asbestos-related illnesses are often misdiagnosed is that they have symptoms similar to those of other lung diseases, which can lead to a significant amount of patients being initially misdiagnosed with other respiratory conditions like chronic obstructive pulmonary disease (COPD), or asthma, among other diseases. A significant number of people with a history of asbestos exposure develop COPD, which in the future, might lead to more serious disease like pleural mesothelioma, pleural thickening, pleural plaques, and lung cancer. The two most common conditions of COPD are emphysema and chronic bronchitis. Bronchitis is an inflammation of the bronchial tubes, which carry air to your lungs. Bronchitis can be either acute or chronic. Chronic bronchitis is a more serious condition in which the bronchial tubes are constantly irritated and inflamed. It’s characterized by breathing difficulties and increased mucus in the lungs. Many patients who have chronic bronchitis ultimately develop emphysema. According to the results of several scientific studies, a significant number of cases of chronic bronchitis have been reported in people exposed to asbestos. A Swedish study of 316,729 construction workers found the mortality rate due to COPD was more than two and a half times higher in workers who had been exposed to airborne toxins, including asbestos dust and fibers, than in workers who had not been exposed to toxic chemicals. Emphysema is a chronic obstructive lung condition in which the alveoli at the end of the smallest air passages of the lungs are destroyed as a result of damaging exposure to irritating gases, vapors and particulate matter, or exposure to asbestos and other toxic workplace dust. When asbestos fibers enter the alveoli, they can cause cancer and prevent the exchange of oxygen between the lungs and red blood cells.

For a better understanding of chronic obstructive pulmonary disease after a history of asbestos exposure, we consider the following similarities essential in establishing an accurate diagnosis and improved life expectancy:

        COPD                                                                               Asbestos-related disease

Symptoms:                                                                                  Symptoms:

Shortness of breath                                                                      Wheezing

Persistent cough                                                                           Difficulty breathing

Fatigue                                                                                          Persisting cough

Frequent respiratory infections                                                     Tightness in the chest

Loss of weight                                                                               Weakness

Reduced breath sounds/wheeze                                                   Unintentional weight loss

 

Consequently, asbestos-related diseases are often misdiagnosed as emphysema or chronic bronchitis, leading to incorrect treatment and substandard patient outcomes.

Living with either an asbestos-related illness or COPD has a substantial impact on the quality of your life. Your health is valuable and this should empower you to seek a second opinion.  It is imperative to ensure you get the most accurate diagnosis, so you can get the correct treatment that will lengthen your life and help you to handle your symptoms.

Statistics show that roughly 12 million adults are misdiagnosed every year, leaving patients with serious health complications. A variety of diagnostic tests might be needed to help identify the diagnosis. Multiple procedures and screening tests should be taken into account by doctors for the accuracy of the diagnosis:

  • Chest X-Ray enables visibility of scarred lung tissue. The X-Ray must be checked by a B-Reader who is trained and certified in asbestos-related lung X-Rays
  • CT and MRI scans detect abnormalities within the lungs considerably better than X-Ray
  • Pulmonary function tests like plethysmography test, diffusion capacity test, and spirometry
  • Blood tests, which are not conclusive for all types of cancer, but sufficiently effective in mesothelioma cases detection
  • A biopsy is also recommended when there is a suspicion of mesothelioma or lung cancer.

In cases where there is a well-traced history with relevance in asbestos exposure, the overall situation is becoming clearer. It is essential to keep in mind that a misdiagnosis can delay proper treatment, limiting the treatment options and reducing their effectiveness. A second opinion from a pulmonologist who specializes in asbestos-related diseases improves diagnostic accuracy and is therefore recommended.

 

About the author:

Gregory A. Cade is the principal attorney at Environmental Litigation Group, P.C., with a scientific and legal approach in environmental law. As an attorney with over 20 years of experience in the field, Gregory A. Cade is reliable and dedicated – on a personal level, in helping injured victims. He is using his Industrial Hygiene degree in handling personal injury cases resulting from exposure to asbestos, coke emissions, PCBs, and other known toxicants.