Currently, there is no specific treatment option for asbestosis. Till now, not a single prospective study involving asbestosis patients has been conducted to evaluate immunosuppressive or anti-inflammatory agents, for example, glucocorticoids or cytotoxic therapy. Whole lung lavage has been evaluated as a means to remove deposited dust in certain pneumoconioses, but it has not been used to treat asbestosis patients.

Hence, management of asbestosis patients should focus more on preventive measures such as:

  • Giving up smoking
  • Early detection of radiographic and physiologic abnormalities
  • Prevention of further exposure to airborne asbestos particles
  • Providing supplemental oxygen to patients with exercise-induced oxygen desaturation or resting hypoxemia
  • Timely treatment of respiratory infections
  • Pneumococcal and influenza vaccination

Complications – There are two major complications that can occur due to exposure to asbestos – respiratory failure and malignancy.

Respiratory failure – A slowly progressive process, asbestosis eventually leads to respiratory failure in a small percentage of patients. Given below are risk factors for onset of lung function abnormalities in individuals exposed to asbestos:

  • The overall duration of exposure
  • Cumulative asbestos exposure
  • Type of fiber (exposure to crocidolite fibers which are linked with the most perpetual progression)
  • Symptoms of dyspnea
  • Diffuse pleural thickening
  • Cigarette smoking
  • Honeycombing on HRCT
  • Higher numbers of inflammatory cells (eosinophils and neutrophils) and fibronectin in BAL fluid

Cigarette smoke may speed up the progression of pulmonary fibrosis following exposure to asbestos. While the working of this synergistic interaction is not known, it is assumed that reactive oxygen species play a significant role.

Malignancy – While some investigators have expressed doubts over the causal association between asbestosis and bronchogenic carcinoma, majority of studies have established a definitive relationship between the two entities. For instance, in a Dutch cohort study involving 58,279 men, in which 524 study subjects developed lung cancer, it was noticed that exposure to asbestos was linked with a relative risk of lung cancer of 3.5 (95% CI 1.7 to 7.2). These statistics were derived after adjusting for smoking habits, age, and intake of retinol, vitamin C, and beta-carotene.

The increased risk of lung cancer as linked with exposure to asbestos is magnified significantly in case of coexisting exposure to tobacco smoke. For instance, in one report, the risk of death from lung cancer among asbestos workers increased 16 times in case they smoked in excess of 20 cigarettes every day and 9 times in case they smoked less than 20 cigarettes every day as compared to asbestos workers without a history of regular cigarette smoking.

It appears that combined exposure to asbestos and cigarette smoke multiplies the risk of developing lung cancer.

  • Asbestos exposure without a history of cigarette smoking had 6-fold relative risk.
  • Cigarette smoking without a history of exposure to asbestos had 11-fold relative risk.
  • The relative risk for regular cigarette smokers with a known history of exposure to asbestos was 59.


The relative risk for any individual depends upon the overall quantum of exposure to both asbestos and cigarette smoke. Also, the type of asbestos fiber determines the overall risk of lung cancer. It appears that the risk is more for workers who are exposed to amphibole fibers as compared to workers exposed to chrysotile fibers.

Exposure to asbestos also increases the occurrence of other neoplasms. Other forms of malignancies that have been associated with asbestos exposure include cancers of the oropharynx, larynx, esophagus, kidney and biliary system.