When should you suspect asbestos-related pulmonary disease?

Abstract: A number of factors complicate the diagnosis of asbestos-related pulmonary diseases. Most persons who have had heavy exposure to asbestos are now aged at least 65 years and, therefore, are more likely to have other respiratory problems, such as chronic obstructive pulmonary disease, that may be difficult to differentiate from asbestosis. An accurate assessment of exposure history is particularly challenging because of poor recall of events by patients and because critical variables, such as fiber type, size, and length, can be difficult to evaluate. High-resolution CT (HRCT) has better sensitivity and specificity for asbestos-related pleural disease and neoplasms than does chest radiography. However, HRCT findings in patients with asbestosis are relatively nonspecific. Bronchoalveolar lavage and lung biopsy can provide definitive information about the extent of asbestos exposure. (J Respir Dis. 2005;26(11):499-510)