Clinical Review

An overview of how asbestos exposure affects the lung

BMJ 2009; 339 doi: (Published 24 August 2009) Cite this as: BMJ 2009;339:b3209
  1. Graeme P Currie, consultant chest physician1,
  2. Stephen J Watt, consultant chest physician1,
  3. Nick A Maskell, consultant chest physician2
  1. 1Chest Clinic C, Aberdeen Royal Infirmary, Aberdeen AB25 2ZN
  2. 2North Bristol Lung Centre, Southmead Hospital, University of Bristol, Bristol BS10 5NB
  1. Correspondence to: G P Currie graeme.currie{at}

    Summary points

    • The risk of asbestos related lung disease is dose related and depends on fibre type

    • Joiners, plumbers, electricians, painters, shipyard workers, builders, engineers, and asbestos miners are at greatest risk

    • Asbestos exposure can cause benign disease (pleural plaques, pleural thickening, benign pleural effusions), malignant disease (mesothelioma, lung cancer), and interstitial lung disease (asbestosis)

    • Mesothelioma will peak in incidence between 2011 and 2015; it should be considered in all patients with a pleural effusion, chest pain, and history of asbestos exposure

    • Treatment options in asbestosis are limited

    • Some patients are entitled to compensation and should seek advice from the Department of Work and Pensions or dedicated charity organisations

    People exposed to asbestos often develop lung disease in later life; manifestations include benign, malignant, or diffuse interstitial lung disease. This evidence based review covers who is considered to be at risk, different ways that exposure to asbestos affect the lung, and matters relating to compensation. Because many doctors in primary and secondary care encounter patients who have been exposed to asbestos, they need to be aware of how different people can be affected.

    Sources and selection criteria

    We comprehensively searched articles published up to February 2009 using PubMed and Medline. Key words and phrases used were “asbestos”, “malignant mesothelioma”, “pleural plaques”, “pleural thickening”, “asbestosis”, “lung cancer”, “cigarette smoking”, “pleural effusions”, “compensation”, “occupation”, “chemotherapy”, “radiotherapy”, “surgery”, “treatment”, and “survival”

    Who is at risk of asbestos related lung disease?

    All people who have worked with asbestos are at potential risk of asbestos related lung disease through inhalation of fibres. Asbestos is a mineral silicate that occurs naturally in various forms. It is resistant to heat and other means of destruction, which explains its extensive use during the 19th and 20th centuries. The fibrous nature of asbestos allows it to be woven into cloth or incorporated into cement materials, ceiling tiles, brake and clutch linings, pipe and boiler …

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