Asbestosis is caused by inhalation of asbestos fibers. Unlike other forms of asbestos disease, such as mesothelioma, asbestosis is not cancerous. The process of getting asbestosis is not yet fully understood, but it seems that asbestos fibers in the lungs cause irritation and inflammation. The body attempts to defend itself from these foreign fibers in various complex ways, and some or all of these defense mechanisms lead to further inflammation and cell damage. Eventually a fibrosis (excessive fibrous connective tissue) or scar tissue develops in the small narrow spaces around the airways and alveoli (air sacs in the lung). The thickening and scarring prevents oxygen and carbon dioxide from traveling between the alveoli and the blood cells, so breathing becomes much more difficult.

Asbestosis often exists without any symptoms, and is found only by x-ray findings. The symptoms that do exist typically include shortness of breath and coughing, which are often mistaken to have other causes. As the disease progresses the symptoms can worsen. Asbestosis can be a progressive disease, meaning that it continues to develop even after exposure to asbestos has stopped. Though unusual, asbestosis can be fatal.

Only x-rays and CT scans can show scarring and thickening of lung tissue. If the scar tissue reduces the functioning of the lungs, asbestosis can also be detected by a breathing or pulmonary function test (PFT). Diagnosis can be made when there is a history of asbestos exposure and positive results from chest x-rays or CT scans. A clinical exam, a pulmonary function test and/or other clinical findings can aid in the diagnosis. It can be conclusively determined that asbestosis exists through a biopsy.

Asbestosis is bilateral, meaning that it affects both lungs. It is mainly in the lower fields of the lungs, but it usually diffuses to be widespread.

Asbestosis is caused by exposure to asbestos. Those who had sustained exposure over a period of years or intense exposure during a shorter a period are at risk for developing asbestosis. Not everyone who has been exposed to asbestos gets asbestosis, but it has been found that everyone who has gotten asbestosis was exposed to asbestos fibers.

The specific type of asbestos fiber that the worker was exposed to does not seem to be significant in the development of asbestosis. At the moment there is no cure or effective treatment for asbestosis. People who have asbestosis are also at high risk for developing lung cancer or mesothelioma.

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Asbestos has been used for more than 2,000 years. It was named by the Ancient Greeks, its name meaning “inextinguishable”. The Greeks also noted its harmful biological effects. Even though the Greek geographer Strabo and the Roman naturalist Pliny the Elder both observed the “sickness of the lungs” in the slaves that wove asbestos into cloth, they were in such awe of asbestos’ seemingly magical properties that they ignored the symptoms.

The Greeks used asbestos for the wicks of the eternal flames of the vestal virgins, as the funeral dress for the cremation of kings, and as napkins. It is rumored that Romans would clean asbestos napkins by throwing them in the fire. The asbestos cloth would come out of the fire whiter than it went in, so the Romans named asbestos “amiantus“, meaning “unpolluted”.

Use of asbestos declined during the Middle Ages, yet some say that Charlemagne had asbestos tablecloths. Marco Polo was also shown items made from asbestos cloth on his travels.

Asbestos use was brought back in the 1700s, but did not become popular until the Industrial Revolution during the late 1800s. It then began to be used as insulation for steam pipes, turbines, boilers, kilns, ovens, and other high-temperature products. Ancient observations of the health risks of asbestos were either forgotten or ignored.

At the turn of the twentieth century, researchers began to notice a large number of deaths and lung problems in asbestos mining towns. In 1917 and 1918, it was observed by several studies in the United States that asbestos workers were dying unnaturally young.

The first diagnosis of asbestosis was made in 1924. A woman had been working with asbestos since she was thirteen. She died when she was thirty-three years old, and an English doctor determined that the cause of death was what he called “asbestosis”. Because of this, a study was done on asbestos workers in England. Twenty-five percent of them showed evidence of asbestos-related lung disease. Laws were passed in 1931 to increase ventilation and to make asbestosis an excusable work-related disease. It would take the United States ten more years to make these steps.

In the 1930s major medical journals began to publish articles that linked asbestos to cancer. The re-discovery of asbestos-related diseases were put on the back burner for several years due to the emergence of silicosis (a lung disease caused by silica dust inhalation). The affected workers brought $300 million in lawsuits against their employers. This served as a warning to the asbestos companies, and afterwards they tried to cover up the health effects of asbestos. Asbestos companies continued to use asbestos in manufacturing and construction. Despite that many materials, such as fiberglass insulation, were created to replace asbestos, companies that used asbestos ignored the safer alternatives. They ignored the danger for the sake of profits, much like the tobacco industry. The conduct of the asbestos companies is especially egregious, however, because the victims were largely exploited workers who were unaware of the serious health risks they were exposed to on a daily basis.

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