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Last reviewed: 21 Apr 2025
Last updated: 02 Jan 2025

Summary

Definition

History and exam

Key diagnostic factors

  • occupational exposure
  • longer duration of exposure
  • smoking history

Other diagnostic factors

  • dyspnoea on exertion
  • cough
  • crackles
  • indirect exposure
  • chest pain
  • clubbing

Risk factors

  • cumulative dose of inhaled asbestos
  • cigarette smoking

Diagnostic investigations

1st investigations to order

  • chest x-ray: posterior-anterior (PA) and lateral
  • pulmonary function tests

Investigations to consider

  • high-resolution CT chest
  • lung biopsy
  • bronchial lavage

Treatment algorithm

ONGOING

Contributors

Authors

Kenneth D. Rosenman, MD

Professor of Medicine

Division of Occupational and Environmental Medicine

Michigan State University

East Lansing

MI

Disclosures

KDR declares that he has no competing interests. KDR is the author of an article cited in this topic.

Peer reviewers

Henry A. Anderson, MD

Chief Medical Officer

Wisconsin Division of Public Health

Madison

WI

Disclosures

HAA declares that he has no competing interests.

Keir Lewis, MD

Senior Clinical Lecturer

Institute of Life Sciences

Swansea University

Swansea

UK

Disclosures

KL declares that he has no competing interests.

Thomasz J. Kuzniar, MD, PhD

Assistant Professor

Division of Pulmonary and Critical Care Medicine

Evanston Northwestern Healthcare

Evanston

IL

Disclosures

TJK declares that he has no competing interests.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American Thoracic Society. Diagnosis and initial management of nonmalignant diseases related to asbestos. Am J Respir Crit Care Med. 2004 Sep 15;170(6):691-715.Full text  Abstract

Wolff H, Vehmas T, Oksa P, et al. Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations. Scand J Work Environ Health. 2015 Jan;41(1):5-15.Full text  Abstract

Rom WN. Asbestosis, pleural fibrosis and lung cancer. In: Rom WN, Markowitz SB, eds. Environmental and occupational medicine 4th ed. Philadelphia: Lippincott Williams and Wilkins; 2007:298-316.

Markowitz SB, Levin SM, Miller A, et al. Asbestos, asbestosis, smoking, and lung cancer. New findings from the North American insulator cohort. Am J Respir Crit Care Med. 2013 Jul 1;188(1):90-6. Abstract

Banks DE, Shi R, McLarty J, et al. American College of Chest Physicians consensus statement on the respiratory health effects of asbestos. Results of a Delphi study. Chest. 2017 Sep 18;4(1):e000223.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available here.

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