Shall we talk about asbestosis, which silently damages your lungs?

Today we are going to talk about something a little serious, but one that we all need to be aware of. Sometimes, due to the jobs we do, or the environment we live in, harmful substances can enter our bodies. Even if it doesn't cause an immediate illness, it can lead to serious health problems after years. Asbestosis is one such disease that silently damages our lungs.

What is asbestosis?

Simply put, asbestosis is a lung disease caused by prolonged exposure to asbestos dust and fibers. Asbestos is a type of fine, long-lasting, airborne material. In the past, especially before the 1970s, people who worked in construction, manufacturing, mining, mills, as technicians, and electricians were at higher risk. People who removed asbestos-containing products and worked on ships in the Navy (which used asbestos on ships at the time) were also at higher risk.

When these asbestos fibers get into your lungs, they can cause a condition called ``fibrosis``, which is a thickening and scarring of the lungs . Sometimes the membrane around the lungs, ``pleura``, can also thicken. When this lung tissue becomes scarred and thickened, it becomes difficult to breathe. In severe cases, this can be life-threatening and even fatal. Not only that, exposure to asbestos also increases the risk of developing lung cancer.

What is asbestos?

Okay, now let's see what asbestos is. It is a collection of six naturally occurring mineral fibers. These fibers are very strong, fire resistant, and resistant to chemicals. Because of these properties, they are used in the building materials industry and in manufacturing industries.

• Strengthen things like cement and plastic.
• As a thermal insulator.
• Protect buildings, textiles, and military vehicles from fire.
• Absorb the sound.

These asbestos fibers can be white, blue, brown, gray, or green. White asbestos fibers (called ``chrysotile'') are the most widely used throughout the world.

How common is asbestos exposure? How does asbestosis develop?

In fact, we are all exposed to asbestos at some point in our lives. Asbestos is found almost everywhere in small amounts. But most people do not develop any disease from it. These diseases only develop in people who are exposed to asbestos for a long time and continuously.

The risk of asbestos exposure in the workplace was highest before the 1970s. However, the risk is still present today. Because it takes a long time for symptoms to appear, doctors are still diagnosing new cases of asbestosis. Although there are laws to control asbestos exposure in the workplace, sometimes workers can be exposed through mistakes.

According to the World Health Organization (WHO), millions of people are exposed to asbestos, especially in the workplace. It is difficult to say exactly how many people suffer from asbestosis and related diseases. This is because symptoms can take 30 to 40 years to appear. Some studies show that about 20% of workers who breathe asbestos develop some form of disease. However, not everyone develops asbestosis. There are other diseases that can be caused by asbestos. For example:

• Interstitial lung disease (ILD)
• Pleural effusion (this is when something like water fills around the lungs)
• Some types of lung cancer, especially pleural mesothelioma

What are the first signs of asbestosis? (These can take years to appear!)

Asbestosis symptoms vary depending on the severity of the disease. Sometimes symptoms appear 20-30 years or more after exposure to asbestos. The scarring in the lungs usually develops slowly. Therefore, you may not notice the symptoms right away.

The first symptom of asbestosis is difficulty breathing , especially during exertion or exercise. Other symptoms may include:

• Chest pain and tightness.
• Rounding of the nail tips (this is called `(Clubbing of your nails)`).
• Cough (perhaps a persistent dry cough).
• A crackling sound is heard in the chest when breathing.
• Extreme fatigue and difficulty exercising.
• Weight loss for no reason.

What causes asbestosis?

The main cause of asbestosis is the inhalation of small asbestos fibers or dust. These asbestos fibers are not harmful until they are released into the air. However, once they are released into the air, they break into small particles. These particles get into the air and enter the lungs when we breathe in. They then accumulate in the lungs, causing scarring and inflammation. The scarred lung tissue becomes very tight and cannot expand properly. That is why it becomes difficult to breathe.

The risk of developing asbestosis increases depending on how long you were exposed to asbestos and how intense the exposure was. In the past, asbestos was widely used in the building and manufacturing industries. People who work in these industries and are constantly inhaling asbestos particles are at the highest risk.

The important thing is that asbestos, which is simply present in insulation or tiles, for example, does not cause this disease. The risk only exists if it is released into the air.

What products may still contain asbestos?

Here are some materials and products that may still contain asbestos:

• Clutch pads and brake linings in cars.
• Cement, putties, and plaster for construction.
• Thermal insulation.
• For pipe wrapping.
• Some types of sheets that are used for roofs, and siding that is used for walls (you can see these in old houses in Sri Lanka too).
• Vinyl floor tiles.
• Electrical wiring harness.
• Millboard.
• Patching and jointing compound.
• Flow tiles and the types of glues that stick them.
• Sound absorbing materials.

Also, some items used in the home may contain asbestos:

• Artificial ashes and sparks in gas-fired fireplaces.
• Vehicle brake pads, linings, clutch facings, gaskets.
• Fire-resistant gloves, stove pads, table pads, and fire-resistant fabrics (like blankets and curtains).
• Some plastics, paints, coatings, gums.
• Vermiculite is used for attic insulation and some things to buy for gardening.

How long does it take to develop asbestosis?

Sometimes doctors diagnose asbestosis in people who have not worked with asbestos for decades. It can take up to 30 years for symptoms to appear. Imagine that, if you were exposed in your youth and are middle-aged, you may not be able to recognize the disease.

Who is at higher risk of developing asbestosis? What are the risk factors?

Nowadays, there are laws and regulations to reduce exposure to asbestos in the workplace. However, some jobs still expose you to asbestos. This is especially true when demolishing or renovating buildings built before the 1970s. Even homes built before 1977 may contain asbestos in things like pipes, ceilings, and floor tiles. However, if you live in a home built before 1977, it is not a risk. The risk only arises if asbestos is in the air as dust and can be inhaled. There is no risk when it is in a solid state.

You are at higher risk of developing asbestosis if you have been exposed to asbestos for a long time, especially if your job involves working with materials that contain asbestos.

Job-related risk

People who do jobs like these are at higher risk:

• People who work in asbestos mines, people who install and remove asbestos.
• Automotive and aircraft technicians (old vehicles had asbestos in things like brakes and clutches).
• Construction workers (especially those who demolish and renovate old buildings).
• Electricians (old insulation materials contained asbestos).
• People who work on railways and shipyards (building and repairing ships).

Similarly, studies have found that those involved in rescue and cleanup work during the attacks on the World Trade Center (WTC) in New York City are also at risk of developing asbestos-related diseases such as asbestosis.

Other influencing factors

These factors also affect your risk:

• Duration of exposure: How long you were exposed to asbestos. Generally, the longer the exposure, the greater the risk.
• Exposure Intensity: How much asbestos you were exposed to.
• Industry type: If asbestos is contained within a product (such as walls, tiles), the risk is low. However, if asbestos is released into the air, such as when being cut or broken with a saw, the risk is higher.
• Personal risk factors: The risk is much higher if you are a smoker or if you have pre-existing lung disease.
• Genetic causes: If there is a mutation in the gene called `(BAP1 gene)`.

People with this disease are usually exposed to asbestos over many years through their work. For example, if you were exposed to asbestos while doing renovations at home, you are less likely to develop asbestosis.

What are the possible complications of asbestosis?

Many people with asbestosis have difficulty breathing and a persistent cough. In severe cases, complications can be life-threatening.

Complications that can occur due to asbestosis are:

• Lung cancer: People with asbestosis and smokers are at an increased risk of developing lung cancer.
• Mesothelioma: A type of cancer that develops in the lining of the abdomen, chest, or lungs. It is strongly linked to exposure to asbestos.
• Respiratory failure: Your lungs are unable to get enough oxygen into your blood, and carbon dioxide builds up in your tissues.
• Right-sided heart failure: The right side of your heart stops working properly.

How is asbestosis diagnosed? (Diagnosis)

Your doctor will examine you and ask about your medical history. Be sure to tell your doctor if you have been exposed to harmful substances, such as asbestos. It is very important to tell them about your jobs and where you worked.

In addition, the doctor may order other tests to complete the diagnosis. These include:

• Chest X-ray.
• CT scan (Computed Tomography - CT scan) (this allows you to see the condition of the lungs more clearly).
• Lung function tests (to check how well your lungs are working) such as spirometry.
• Bronchoscopy (rarely, a camera is inserted into the lungs to look inside and, if necessary, a small tissue sample (biopsy) can be taken).

What are the treatments for asbestosis?

The main goal of treating asbestosis is to control symptoms and preserve lung function.

Unfortunately, the damage caused to the lungs by asbestos cannot be reversed.

Treatment for asbestos-related diseases aims to relieve symptoms, treat complications associated with the disease, and slow the spread of the disease.

The treatment you receive will depend on the severity of your condition. You may have treatments such as:

• Oxygen therapy: Giving you extra oxygen through a tube placed in your nose or a mask can help you breathe easier.
• Pulmonary rehabilitation: This involves teaching you special exercises and breathing techniques that can improve your quality of life.
• Lung transplant surgery: Very rarely, for people with severe disease, a lung transplant can relieve symptoms and extend life by providing a new, healthy lung.
• Medications: Medications called ``Anti-fibrotics'' can slow down the rate of scarring in the lungs. However, they cannot cure existing scarring. Your doctor will discuss the risks and benefits of these medications with you and help you decide what is best for your health.

How can you manage symptoms at home?

If you have asbestosis, you can do these things to make yourself more comfortable:

• Don't smoke. If you smoke, get help to quit today. Smoking can make the disease worse and spread more quickly.
• Avoid inhaling allergens, environmental pollution, and secondhand smoke.
• Stay away from people who are sick and practice good handwashing habits (wash your hands frequently, especially before eating and after using the bathroom).
• Drink plenty of water.
• Eat nutritious foods (like vegetables, fruits, clean fish, and meat).
• Talk to your doctor, create an exercise plan that suits you, and exercise regularly.

How to protect yourself from asbestosis?

You can reduce your risk of developing asbestosis by avoiding long-term exposure to asbestos. If your job involves exposure to this mineral, you should definitely wear a respirator (a special mask that filters particles in the air). This protective mask will prevent you from breathing in asbestos fibers or dust.

If you know you have been exposed to asbestos, you should have regular medical checkups and chest X-rays. These tests cannot prevent asbestosis, but they can help detect it early.

If you are a smoker and have been exposed to asbestos, the best thing you can do to reduce your risk of developing cancer is to quit smoking.

Should all asbestos products be avoided?

Asbestos fibers are only harmful if they become airborne. Today, many building materials and other products use bonded asbestos. This process prevents them from being released into the air. The risk of adverse health effects from such products is very low, if at all. However, you should avoid sanding, tearing, or otherwise damaging the material and breaking it into powder. Doing so can release the fibers into the air.

Do I need to remove asbestos from my home?

If you have asbestos-containing materials in good condition (for example, an old asbestos sheet roof) in your home, it is best to leave them alone. If you touch or damage these materials (break them, pull them apart), there is a risk of releasing fibers into the air. Check these materials periodically for damage or deterioration. If removal is necessary, seek the assistance of trained personnel.

What is the prognosis for someone with asbestosis? (Prognosis)

There is no cure for asbestosis, and the damage caused by the disease cannot be reversed. Once you inhale asbestos fibers, they stay in your body. Your future depends on how long and how much you were exposed to the particles.

Many people with mild asbestosis live fulfilling lives for years after being diagnosed with the disease. Some people's condition worsens and they need lifelong medical care.

Your doctor will probably do chest X-rays and lung function tests every few years to check for changes in the scarring in your lungs. As your condition progresses, the test results will change.

The average life expectancy after diagnosis is said to be around 10 years. However, this depends largely on the severity of the disease and how quickly it spreads.

When should I see a doctor?

If you have been exposed to asbestos and have difficulty breathing, chest discomfort, or a persistent cough, see your doctor right away. Be sure to tell your doctor about how you were exposed to asbestos (for example, through your job), even if it was secondhand exposure.

Is my family at risk from asbestos because of my job?

"Secondhand" asbestos exposure can occur. When a person works with materials containing asbestos, they can bring asbestos particles home on their shoes, clothes, skin, and hair.

To reduce this risk, many workplaces that use asbestos ensure that workers change their clothes when they come to work and when they leave. Many companies even have bathroom facilities where employees can wash these particles off their hair and skin. These precautions reduce the risk of illness for family members.

What is the difference between asbestosis and mesothelioma?

The main difference between asbestosis and mesothelioma is that mesothelioma is a cancer, while asbestosis is not. Asbestosis occurs in your lungs and the lining of your lungs (pleura). Mesothelioma starts in the tissues of your lungs and abdomen. It can spread throughout your body.

If you have been exposed to asbestos, even if you have no symptoms and feel well, talk to your doctor. There are things your doctor can do now to help manage the lung damage that asbestos can cause. You can also help yourself by not smoking or quitting smoking. Smoking can make asbestosis worse. If you have new trouble breathing, talk to your doctor right away.

The most important things we need to remember (Take-Home Message)

Okay, so let's review some of the most important facts about asbestosis that we've talked about.

• Asbestosis is a lung disease caused by prolonged exposure to asbestos fibers. It does not appear suddenly, but can take years to develop.
• This risk is higher for those in certain occupations, such as construction, shipbuilding, and mining, especially those who worked using old methods.
• Difficulty breathing, persistent cough, and chest pain are the main symptoms.
• There is no definitive cure for this yet. Treatment is aimed at controlling symptoms and improving quality of life.
• The most important thing is to be safe. If you work in areas where you may be exposed to asbestos, be sure to wear protective gear.
• If you think you have been exposed to asbestos, see a doctor for advice, even if you have no symptoms. If you are a smoker, be sure to quit.

Although this is a somewhat scary topic, being informed is the best defense. Take care of your health and seek medical advice if necessary.

` Asbestosis, asbestos, lung disease, breathing difficulties, occupational diseases, lung scarring, mesothelioma