Exposure to asbestos commonly occurred in the workplace but some exposures occurred in family members of people who worked with asbestos and who may have brought asbestos fibres home on their work-clothes.

In the past, the occupations in which asbestos exposure occurred were heavy industry and shipbuilding, railway plant works and the power industries. Since the decline of these industries and the eventual total ban on asbestos imports into the UK in 1999 these ‘traditional’ exposures to asbestos have disappeared.

However it is now recognised that the risks of asbestos exposure have not disappeared – currently people who work in the building and construction trades may well encounter asbestos in the form of insulation materials in many public and domestic buildings in the UK. Sadly we are now seeing a rise in cases of asbestos-related diseases from these occupations.

Asbestos is recognised as the cause of several significant health conditions:

Mesothelioma

This is a cancer that affects the filmy membrane that surrounds the lungs and lines the chest cavity- the pleura – and also less commonly affects the membrane that surrounds the intestines and lines the abdominal cavity – the peritoneum; very rarely it can affect the membrane around the testicles called the tunica vaginalis.

Mesothelioma takes a very long time to develop following exposure to asbestos, usually 30-40 years. It can be difficult to diagnose mesothelioma and there may be delay in reaching a definite diagnosis. Unfortunately it is usually not very responsive to treatments and the results of treatment are often disappointing.

Pleural mesothelioma usually presents with breathlessness, a nagging chest pain, or both. The breathlessness may be due to an accumulation of fluid around the lung – called a pleural effusion. This fluid can be drained off and this relieves the breathlessness but it may recur and require other types of intervention. Pain in mesothelioma is often complex, due to several causes, and if it is not readily controlled by the common painkillers may require specialist management from either a pain clinic or palliative care team.

Peritoneal mesothelioma may present with abdominal swelling due to accumulation of fluid in the abdomen. Peritoneal mesothelioma may progress less rapidly than pleural mesothelioma.

There are around 2500 cases of mesothelioma in the UK each year.

Asbestosis

This is a progressive scarring of lung tissue caused by irritation from asbestos fibres that causes the lungs to become less flexible over time, often over many years.

Breathlessness is the main symptom and a variety of self-help techniques may reduce the impact of the condition, often accessed via a pulmonary rehabilitation service. Unfortunately there is no curative treatment for asbestosis and so it is important to keep as fit and active as possible to reduce the burden of the illness. It is also very important to stop smoking because the combination of smoking with asbestos greatly increases the risk of lung cancer – see below.

Pleural thickening
In this non-mailgnant condition the pleural membrane, normally thin and slippery, becomes thick and rigid, forming a sort of hard rind around the lung.

Diffuse pleural thickening is diagnosed when a significant portion of the pleura on one lung is affected. When the thickening is extensive it may restrict the movement of that lung and cause breathlessness. Asbestos exposure is not the only cause of pleural thickening.

Pleural plaques
Pleural plaques are the comonest sign of asbestos exposure and are simply ‘scar tissue’ that develops on the pleural membrane. Plaques are seen on xrays or scans and often create a lot of anxiety in people when they are discovered.

Pleural plaques do not change into mesothelioma but they do indicate that asbestos exposure has occurred.

Lung Cancer

Asbestos also interacts with smoking to greatly increase the risk of lung cancer – in this situatiuon the diagnosis may be asbestos-related lung cancer.

The link between smoking and lung cancer is well-known but in some cases exposure to asbestos in combination with smoking may have increased the risk of lung cancer and contributed to the process by which the cancer developed.

If you have a history of exposure to asbestos at work or lived with someone who worked with asbestos it is possible that asbestos may have contributed to your lung cancer. If so, this would not alter the treatment of your condition but it could mean that you might be eligible for financial compensation and/or industrial disease benefit. This is not straightforward and you should take expert advice.