Pleural Asbestosis

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Pleural asbestosis, more properly termed "asbestos-related pleural abnormalities," is the most common finding in asbestos-induced pulmonary disease and, as described previously, involves pleural thickening, often manifested as discrete pleural plaques. Pleural disease, sometimes called pleural asbestosis is a scarring of the outside lining and occurs in the same area that pleural mesothelioma may be found. The term pleural asbestosis is not often used anymore, but rather the term asbestos-related disease including such findings as pleural plaquing, diffuse pleural thickening, pleural effusions, rounded atelectasis and cicatricial scarring are more frequently used.

Inhalation of asbestos fibers can cause parenchymal (lung) asbestosis, pleural asbestosis (now termed "asbestos-related pleural abnormalities") as previously mentioned, pleural mesothelioma, and lung carcinoma. Patients with pleural asbestosis are also more likely to have or develop parenchymal asbestosis and should be appropriately monitored. Consequences of asbestos includes lung cancer (also known as bronchogenic carcinoma), pulmonary asbestosis, pleural asbestosis, cancer of the esophagus, larynx, stomach, colon and rectum.

Pleural Plaques:

Pleural plaques represent circumscribed areas of fibrous thickening, typically of the parietal pleura, due to the deposition of paucicellular collagenous tissue with a laminar or basket-weave pattern; they may or may not calcify. People with pleural asbestosis sometimes do not experience severe symptoms. Examples are the detection of pleural abnormalities in suspected cases of asbestosis and the detection of parenchymal disease obscured on the chest film and also use as an aid to differential diagnosis. There is evidence that peritoneal mesotheliomas are associated with higher levels of asbestos exposure than pleural mesotheliomas are. Because pleural plaques may be associated with low levels of asbestos exposure, the attribution of lung cancer to asbestos exposure must be supported by an occupational history of substantial asbestos exposure or measures of asbestos fiber burden.

Pulmonary asbestosis was confirmed in 38 (35%), pulmonary and pleural asbestosis in 49 (45%), and pleural asbestosis in 22 (20%) group 1 patients (exposed to chrysotile). Treatment records obtained in conjunction with the veteran's claim demonstrate that that a chest x-ray taken in October 1997 revealed that the lung fields were bilaterally well expanded and free of any pleural effusions or definitive pulmonary infiltrates. It further observes the August 1998 chest x-ray which revealed that the veteran had minimal apical pleural thickening.

Risk of Disease:

Often, secondary diseases, such as pneumonia will be an immediate cause of death in as much as the mesothelioma lowers the resistance of the body to such diseases. That means that wherever people have received asbestos exposure, regardless of their trade, age, sex or race, they are at risk of cancer and other diseases. Certain occupations, however, are known to be those where risk of exposure to asbestos is great, and the numbers of people in such occupations contracting asbestos disease are high. It is recommended that in radiologic diagnosis, high-resolution computed tomography should always be used in addition to ILO classification, particularly in the initial stages of the lung and pleural disease.

Under the 1948 amendment, claims are required to be filed within two years after the employee ceased to be exposed to the occupational disease in the course of employment, or within oney ear after the employee knows or should know the nature of hisdisability and its relation to his employment, whichever islater. Similarly, the amended noticeprovision required notice to the employer within five monthsafter the employee ceased to be exposed to the disease or "within ninety days after the employee knew or ought to have known the nature of his disability and its relation to his employment,"whichever is later. Asbestos-associated respiratory diseases have long latency periods: 10 to 40 years or more, depending on the disease and exposure factors.

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