Asbestos Related Illness and Disease

Some useful information about the diseases caused by asbestos inhalation.

There are four main diseases associated with inhalation of asbestos fibres. These are asbestosis (a scarring of the lung tissue caused by asbestos), two kinds of cancer (mesothelioma and asbestos related lung cancer), and diffuse pleural thickening (a non-malignant disease affecting the lung lining).

Asbestosis
Asbestosis is defined as lung fibrosis caused by the inhalation of asbestos fibres. Diagnosis is made on the basis of clinical features, X-ray appearances and a history of heavy asbestos exposure. It is generally recognised that heavy asbestos exposures are required in order to produce clinically significant asbestosis within the lifetime of an individual. Current trends therefore still largely reflect the results of heavy exposures in the past.

• Based on Death certificates, where asbestosis is described as being the underlying cause, there were 117 deaths due to the disease in 2008 (the latest year with published data).
• There were 429 deaths in total in 2008 where the death certificate mentioned the term "asbestosis", and 69 of these are also included on the mesothelioma register because the death certificate also mentioned the term "mesothelioma".
• Disablement benefit cases for asbestosis have risen erratically since the early 1980s, with the trend increasing strongly from the late 1990s through to the middle of the new millennium. The number of cases for 2009 is 825.

Mesothelioma
Mesothelioma is a formerly rare form of cancer which affects the pleura (the lining of the lungs) and the peritoneum (the lining surrounding the lower digestive tract). In the majority of cases mesothelioma is rapidly fatal following diagnosis so mesothelioma death statistics give a clear indication of the disease incidence. Mesothelioma is closely related to asbestos and many cases, particularly among men, are a result of exposures in occupational settings.

However, mesothelioma has been reported in some individuals without any known exposure to asbestos. The long delay between initial exposure to asbestos and death from mesothelioma is typically between 30 and 40 years. This means that deaths occurring now and most of those expected to occur in the future reflect industrial conditions of the past rather than current work practices.

• The total number of mesothelioma deaths has increased from 153 in 1968 to 2249 in 2008.
• The most frequently recorded occupations on death certificates of men now dying from mesothelioma includes carpenters and joiners; plumbers, heating and ventilating engineers; and electricians and electrical fitters.
• The expected number of deaths amongst males is predicted to increase to a peak of 2038 (90% prediction interval: 1929 to 2156) around the year 2016.

Asbestos-related lung cancer
Asbestos has been recognised as an important risk factor for lung cancer for many years. However, there are a number of other agents that can cause the disease - most importantly, tobacco smoke - and lung cancers resulting from asbestos exposure are clinically indistinguishable from those caused by these other agents. This means that the total number of asbestos related lung cancers has to be derived from statistical estimates based on evidence from epidemiological studies rather than direct counting of individual cases.

It is likely that there are around as many asbestos related lung cancer deaths in Great Britain annually as there are mesothelioma deaths. There were 2249 mesothelioma deaths in 2008.

There were 335 recorded new cases of disablement in 2009 due to asbestos-related lung cancer and 86 reports of lung cancer in the THOR scheme, not all of which were asbestos-related. These numbers are substantially lower than the likely annual total number of deaths inferred from the number of mesotheliomas.

Diffuse Pleural Thickening
The pleura is a two-layered membrane which surrounds the lungs and lines the inside of the rib cage. Some asbestos fibres inhaled into lungs work their way out to the pleura and may cause fibrosis or scarring to develop there. This causes the pleura to thicken and this may show up on a chest X-ray or CT scan. Pleural thickening occurs in two forms:

• Diffuse pleural thickening extends over a large area and may restrict expansion of the lungs, leading to breathlessness; and
• Pleural plaques are localised areas of pleural thickening, that don’t usually interfere with breathing.

Diffuse pleural thickening is another disease associated with exposure to asbestos. There were 400 new cases of disablement in the year 2008 due to this disease, although this figure is likely to be a substantial underestimate. The annual number increased during the 1990s but has remained fairly stable over recent years. The increase may be partly or wholly explained by the acceptance of claims under the Industrial Injuries Disablement Benefit (IIDB) scheme for unilateral (affecting only one lung) cases and other changes in data collection methods.

An estimated 856 cases of benign (non-cancerous) pleural disease - mostly attributable to asbestos - were seen for the first time by occupational and chest physicians in 2009.

More About Asbestos

About Asbestos - An Introduction
Asbestos Testing
Asbestos Register
Asbestos Regulations
Asbestos Related Illness / Disease
Asbestos Removal
Working With Asbestos

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