{"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":"2024-12-10T17:17:41","modified_gmt":"2024-12-10T17:17:41","slug":"asbestosrelateddiseases","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/respiratory\/asbestosrelateddiseases\/","title":{"rendered":"Asbestos Related Diseases"},"content":{"rendered":"\nAsbestos Related Diseases<\/title>\n\n\n\n<p class=\"wp-block-paragraph\">\u200b\u200bAll clinicians should have a low threshold for ordering a chest x-rays \nif there is a history of asbestos exposure.  Refer for CT scan even if \nthe chest x-ray is normal if there is a strong suspicion of an \nunderlying respiratory problem. <\/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<h3 class=\"wp-block-heading\">Pleural plaques<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">These are benign collagenous deposits that develop on the parietal pleura.  They are most often highlighted on a chest X-ray report and seldom require further investigation. <\/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. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">However, they are important as they corroborate prior asbestos exposure whether suspected or not.  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\">If you feel comfortable with the facts, 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 progressive breathlessness, chest pain, and haemoptysis 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\">Refer patients with pleural plaques who report:<\/p>\n\n\n\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\n\n\n<li>Haemoptysis .<\/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 <a href=\"http:\/\/www.clydesideactiononasbestos.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">www.clydesideactiononasbestos.org.uk\/<\/a><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Diffuse pleural thickening<\/h3>\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 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\">Referral for detailed imaging (CT) and lung function are often helpful.  <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Refer cases of suspected diffuse pleural thickening to Dr Reid at the WGH.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Asbestosis<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Asbestosis is a fibrosing lung disease which presents in a similar manner to other fibrosing lung conditions eg progressive breathlessness and cough.  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\">Cases of suspected asbestosis may be referred to the Interstitial Lung Disease clinic at the RIE or to Dr Reid at the Western General Hospital.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Mesothelioma<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Mesothelioma is an aggressive malignancy arising from mesothelial cells.  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.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If mesothelioma is suspected an urgent cancer referral should be made to any the lung cancer service or the on-call respiratory SpR should be contacted and admission arranged to facilitate further investigation.<\/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<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.clydesideactiononasbestos.org.uk\/\" data-type=\"link\" data-id=\"https:\/\/www.clydesideactiononasbestos.org.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Respiratory ORD Clydeside Action on Asbestos (www.clydesideactiononasbestos.org.uk)<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.hse.gov.uk\/\" data-type=\"link\" data-id=\"https:\/\/www.hse.gov.uk\/\" target=\"_blank\" rel=\"noreferrer noopener\">Respiratory ORD Health and Safety Executive (www.hse.gov.uk)<\/a><\/li>\n<\/ul>\n\n\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Asbestos Related Diseases ​​All clinicians should have a low threshold for ordering a chest x-rays if there is a history of asbestos exposure.  Refer for CT scan even if the chest x-ray is normal if there is a strong suspicion of an underlying respiratory problem.<\/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 ​​All clinicians should have a low threshold for ordering a chest x-rays if there is a history of asbestos exposure.  Refer for CT scan even if the chest x-ray is normal if there is a strong suspicion of an underlying respiratory problem.","_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":5,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3713\/revisions"}],"predecessor-version":[{"id":21860,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3713\/revisions\/21860"}],"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}]}}