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Asbestos is a group of toxic but naturally occurring fibers used for a variety of purposes, in particular for the construction industry.
As a consequence, many were exposed to this dangerous substance through the course of their work. Whilst exposure to asbestos has now dramatically reduced, the consequences of exposure in previous decades are now at a peak due to a long latent period between exposure and disease onset.
These consequences are mainly centered on the lung and are rarely, if ever, treatable. As a result, many of the individuals who develop these conditions suffer from disabling symptoms.
The use of asbestos in new building work was prohibited in 1992 for blue and brown asbestos and in 1999 for white asbestos, so it is possible that any building constructed before 2000 could contain asbestos.
Many workers were at risk of exposure to asbestos, but in particular those working in construction – such as: plumbers, insulation workers, heating engineers and roofing contractors; those working in shipyards such as dockers; those working in asbestos manufacturing and those working with brake linings such as car mechanics. Non-occupational exposure often came through exposure to dusty clothes of an asbestos worker, living in the vicinity of an asbestos manufacturer or accidental exposure during building demolition.
Asbestos related lung disease is caused by a combination of the direct toxic effect of the asbestos fibers on the lung tissue and the toxic chemicals released by inflammatory cells within the lung tissue which are activated in an attempt to remove the asbestos fibers.
Asbestos related lung diseases can be malignant (mesothelioma or lung cancer) or non malignant (asbestosis, diffuse pleural thickening or pleural plaques). There is a typical long latency period between exposure to asbestos and development of lung disease (30-40 years), therefore as the peak exposure to asbestos in the UK occurred in the 1960s the current prevalence of asbestos related lung disease is probably now at a peak.
Whilst cigarette smoking remains the most important risk factor for lung cancer, tobacco and asbestos exposure work synergistically to increase the likelihood of lung cancer by approximately 60 fold in those exposed to both. In those patients who have asbestosis who develop lung cancer, the asbestos exposure has been shown to increase the risk of developing lung cancer by approximately 4-5 fold.