{"id":3713,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/asbestosrelateddiseases\/"},"modified":"2026-08-20T11:57:55","modified_gmt":"2026-08-20T10:57:55","slug":"asbestosrelateddiseases","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/asbestosrelateddiseases\/","title":{"rendered":"Asbestos Related Diseases"},"content":{"rendered":"\n<title>Asbestos Related Diseases<\/title>\n\n\n\n<h4 class=\"wp-block-heading\">Information<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Asbestos-related lung diseases are serious health conditions caused by the inhalation of asbestos fibres, leading to various respiratory disorders, including pleural plaques (thickened areas on the pleura), diffuse pleural thickening, asbestosis, lung cancer and mesothelioma.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Workers in industries such as construction, shipbuilding and manufacturing are at the highest risk due to direct exposure to asbestos-containing materials. Asbestos fibres can also be released into the air from deteriorating buildings or during home renovations, posing risks to non-occupational individuals. There can be a long latency period and symptoms of asbestos-related diseases may not appear for 20 to 40 years after initial exposure, making early diagnosis challenging. Asbestos-related diseases are diagnosed through a combination of medical history, exposure history, imaging tests (like chest X-rays or CT scans), and pulmonary function tests. While there is no cure for asbestosis or mesothelioma, treatments focus on managing symptoms and may include medications, pulmonary rehabilitation, and in some cases, surgery for lung cancer.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Types of Asbestos-Related Lung Diseases<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Pleural plaques<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">These are benign collagenous deposits that develop on the parietal pleura.&nbsp; They are most often highlighted on a chest X-ray report and seldom require further investigation.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pleural plaques do not usually cause impairment of lung function or any respiratory disability and are not pre-malignant.&nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, they are important as they corroborate prior asbestos exposure whether suspected or not.&nbsp; It is important to be clear about the difference between pleural plaques and other asbestos-related conditions when discussing the problems with colleagues or patients.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Advise patients with pleural plaques of<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Risks of other asbestos-related lung disease<\/li>\n\n\n\n<li>The importance of warning symptoms such as progressive breathlessness, chest pain, haemoptysis or weight loss which require urgent assessment<\/li>\n\n\n\n<li>When appropriate, smoking cessation is of paramount importance owing to increased risks of lung cancer.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Up-to-date medico-legal advice can be provided by charities such as Action on Asbestos <a href=\"http:\/\/www.clydesideactiononasbestos.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.clydesideactiononasbestos.org.uk\/<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Diffuse pleural thickening<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Diffuse pleural thickening refers to thickening of the visceral pleural and may be suggested if the chest x-ray is reported as showing blunting of the costophrenic angle.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Diffuse pleural thickening is a different condition from pleural plaques (which affect the parietal pleura) and may cause shortness of breath and\/or chest pain.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Refer cases of suspected diffuse pleural thickening to the Interstitial Lung Disease clinic at RIE, WGH or SJH.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Asbestosis<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Asbestosis is a chronic lung disease characterised by scarring (fibrosis) of lung tissue due to prolonged exposure to asbestos fibres. Symptoms include shortness of breath, cough and chest pain. The disease can progress even after exposure has ceased.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Its presence may be suggested by clinical features (crackles on auscultation) or reported on the chest X-ray as an interstitial lung disease.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Refer cases of suspected asbestosis to the Interstitial Lung Disease clinic at RIE, WGH or SJH.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Mesothelioma<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Mesothelioma is an aggressive malignancy arising from mesothelial cells.&nbsp; Common sites include the pleura or peritoneum. Pleural mesothelioma usually presents with breathlessness and\/or persistent chest wall pain. Other symptoms may include night sweats and weight loss. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If mesothelioma is suspected an urgent suspicion of cancer referral should be made to the lung cancer service or the on-call respiratory SpR should be contacted and admission arranged to facilitate further investigation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>L.N &amp; D.M &#8211; 14-8-26<\/strong><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<ul class=\"wp-block-list\">\n<li>Please see <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/lungcancer\/\" target=\"_blank\" rel=\"noreferrer noopener\">Lung Cancer \u2013 RefHelp<\/a> for details on Urgent Suspicion of Cancer CXR and Respiratory clinic referral criteria.<\/li>\n\n\n\n<li>All clinicians should have a low threshold for ordering a chest x-ray if there is a history of asbestos exposure.&nbsp;<\/li>\n\n\n\n<li>A CXR should always be performed prior to referral. A normal CXR does not always exclude asbestos-related lung disease.<\/li>\n\n\n\n<li>Refer to the ILD service at RIE, WGH or SJH for consideration of a CT scan even if the chest x-ray is normal if there is a strong suspicion of an underlying respiratory disorder.\n<ul class=\"wp-block-list\">\n<li>Sci-Gateway \u2013 RIE or WGH or SJH &gt; Respiratory medicine &gt; LI Basic Sign Referral<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who can refer:<\/h4>\n\n\n\n<p class=\"wp-block-paragraph\">Any primary or secondary care clinician can refer&nbsp;.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer via the Urgent Suspicion of Cancer (USOC) pathway:\n<ul class=\"wp-block-list\">\n<li>All suspected cases of mesothelioma<\/li>\n\n\n\n<li>All suspected cases of lung cancer<\/li>\n\n\n\n<li>See <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/lungcancer\/\">Lung Cancer \u2013 RefHelp<\/a> for more details on referral criteria for CXR and USOC Respiratory Clinic referral<\/li>\n\n\n\n<li>Of note patients who present with haemoptysis should always have an USOC referral made for updated CXR and Respiratory Clinic review simultaneously.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Refer as routine via Sci-Gateway:\n<ul class=\"wp-block-list\">\n<li>Patients with pleural plaques who report the following symptoms in the absence of red flags such as weight loss, appetite loss or thrombocytosis:\n<ul class=\"wp-block-list\">\n<li>Shortness of breath<\/li>\n\n\n\n<li>Chest pain<\/li>\n\n\n\n<li>Persistent cough<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Patients with suspected asbestos related lung disease and a normal chest x-ray, if there are persistent respiratory symptoms or when the cause of respiratory symptoms or abnormal lung function is unclear.<\/li>\n\n\n\n<li>All suspected cases of diffuse pleural thickening and asbestosis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Those with pleural plaques alone without respiratory symptoms.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Pleural plaques are not usually associated with significant respiratory symptoms or lung function impairment. If these are present an alternative diagnosis should be considered such as COPD. In these patients spirometry is useful as if COPD is confirmed, treatment with appropriate inhaled therapies may relieve symptoms and therefore referral to secondary care may not be required. &nbsp;<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Advise patients with pleural plaques of<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Risks of other asbestos-related lung disease<\/li>\n\n\n\n<li>The importance of warning symptoms such as progressive breathlessness, chest pain, haemoptysis or weight loss which require urgent assessment<\/li>\n\n\n\n<li>When appropriate, smoking cessation is of paramount importance owing to increased risks of lung cancer.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<ul class=\"wp-block-list\">\n<li>For patients with suspected Lung Cancer or Mesothelioma:\n<ul class=\"wp-block-list\">\n<li>Sci-Gateway &#8211; SJH or WGH or RIE &gt; Respiratory Medicine &gt; LI Suspected Lung Cancer<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>For patients with suspected asbestos related lung disease or diffuse pleural thickening:\n<ul class=\"wp-block-list\">\n<li>Sci-Gateway \u2013 SJH or WGH or RIE &gt; Respiratory Medicine &gt; LI Basic Sign referral (Put reason for referral in presenting complaint and this will be triaged appropriately)<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>Spirometry is not essential prior to referral but it can be useful as often these patients will have co-existing COPD and will benefit from inhaled bronchodilator therapy.<\/li>\n<\/ul>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\">Please consider arranging spirometry as often these patients have co-existing COPD which will require treatment with inhaled bronchodilator therapy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Please discuss the relevant environmental exposures and advise regarding the importance of wearing appropriate personal protective equipment (PPE) whilst at work to ensure there is no further exposure to asbestos fibres.&nbsp; See <a href=\"https:\/\/www.hse.gov.uk\/ppe\/index.htm\" target=\"_blank\" rel=\"noreferrer noopener\">Personal protective equipment (PPE) at work<\/a><\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/lungcancer\/\" target=\"_blank\" rel=\"noreferrer noopener\">Lung Cancer \u2013 RefHelp<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.gov.scot\/binaries\/content\/documents\/govscot\/publications\/advice-and-guidance\/2025\/08\/scottish-referral-guidelines-suspected-cancer-2025\/documents\/scottish-referral-guidelines-suspected-cancer-2025\/scottish-referral-guidelines-suspected-cancer-2025\/govscot%3Adocument\/scottish-referral-guidelines-suspected-cancer-2025.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Scottish Referral Guidelines for Suspected Cancer 2025<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/\" target=\"_blank\" rel=\"noreferrer noopener\">Respiratory \u2013 RefHelp<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"http:\/\/www.clydesideactiononasbestos.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Action on Asbestos<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/actionpf.org\/information-and-support\/what-is-asbestosis\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/actionpf.org\/information-and-support\/what-is-asbestosis<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.pulmonaryfibrosis.org\/docs\/default-source\/programs\/educational-materials\/fact-sheets-english\/pf-fact-sheet---asbestosis.pdf?sfvrsn=257e539b_11\" target=\"_blank\" rel=\"noreferrer noopener\">https:\/\/www.pulmonaryfibrosis.org\/docs\/default-source\/programs\/educational-materials\/fact-sheets-english\/pf-fact-sheet&#8212;asbestosis.pdf?sfvrsn=257e539b_11<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/chronicobstructivepulmonarydisease\/\" target=\"_blank\" rel=\"noreferrer noopener\">Chronic Obstructive Pulmonary Disease \u2013 RefHelp<\/a><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><a href=\"https:\/\/www.hse.gov.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">HSE: Information about health and safety at work<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Asbestos Related Diseases Information Asbestos-related lung diseases are serious health conditions caused by the inhalation of asbestos fibres, leading to various respiratory disorders, including pleural plaques (thickened areas on the pleura), diffuse pleural thickening, asbestosis, lung cancer and mesothelioma. Workers in industries such as construction, shipbuilding and manufacturing are at the highest risk due to<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":4381,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_searchwp_excluded":"","footnotes":""},"categories":[589],"class_list":["post-3713","page","type-page","status-publish","hentry","category-asbestosrelateddiseases"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/respiratory\/asbestosrelateddiseases\/\" rel=\"tag\">Asbestos Related Diseases<\/a>","rttpg_excerpt":"Asbestos Related Diseases Information Asbestos-related lung diseases are serious health conditions caused by the inhalation of asbestos fibres, leading to various respiratory disorders, including pleural plaques (thickened areas on the pleura), diffuse pleural thickening, asbestosis, lung cancer and mesothelioma. Workers in industries such as construction, shipbuilding and manufacturing are at the highest risk due to","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3713","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=3713"}],"version-history":[{"count":7,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3713\/revisions"}],"predecessor-version":[{"id":29606,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3713\/revisions\/29606"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4381"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=3713"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=3713"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}