Pleural plaques refer to the presence of scar tissue on the parietal pleura. They are the commonest manifestation of past exposure to asbestos and are often reported as an incidental finding on a chest X-ray which has been arranged for some other reason.
It is most unusual for pleural plaques to cause any symptoms or explain any clinical signs. They do not impair lung function. Pleural plaques are benign and have no malignant potential. Therefore, the reporting of incidental pleural plaques need not necessarily prompt referral, or further investigation, unless there are unexplained symptoms or signs. GP should explain to patients that they are benign scar tissue on the lining of the chest that are not in any way dangerous. They do not require follow up by repeated chest X-rays, CTs or referral.
Individuals with pleural plaques are at risk of other asbestos-related conditions by virtue of having been exposed to asbestos, but the risk is not increased because pleural plaques are present.
Calculating risks of other asbestos-related conditions including diffuse (visceral) pleural thickening, mesothelioma or lung cancer depends on the knowledge of cumulative asbestos exposure, fibre type and latency period.
The development of asbestosis requires substantial asbestos exposure and is very rare in individuals with low level exposure. Past asbestos exposure increases the risk of developing lung cancer; however, again the risks are largely confined to those with substantial exposures and are increased further still in individuals who smoke. Hence it is very important to emphasize the importance of smoking cessation.
Pleural plaques do not qualify an individual for industrial injuries benefit. It is still possible to pursue a civil claim in Scotland and the individual may be directed to charities such as Clydeside Action on Asbestos.
