Monday, 25 November 2013

Pleural plaques – Diseases associated to Asbestos exposure

The pleura is a thin tissue covered by a layer of cells (mesothelial cells) that surrounds the lungs and lines the inside of the chest wall.
C. Pleural plaques
Pleural plaques is a medical condition as a result of exposure to asbestos that lead to accumulated plagues within the pleural cavity(a). Many diseases such as pneumonia, breast cancer, and heart failure can affect the pleural space.,therefore, it is often a secondary effect of another disease process.
C.2. Diseases associated to Asbestos exposure
In the study on the relationships between fiber characteristics and asbestos-related diseases among compensated workers, from data collected between 1988 and 2007 by the Institut national de santé publique du Québec (INSPQ), indicated that most workers (85%) presented chrysotile fibers in their lungs, and respectively 76%, 64%, and 43% had tremolite, amosite, and crocidolite. Half of the total fibers were short, 30% were thin fibers and 20% corresponded to the World Health Organization definition of fibers (length ≥ 5 µm, diameter ≥ 0.2 and <3 µm). Chrysotile fibers were still observed in the lungs of workers 30 years or more after last exposure(17).
According to British Thoracic Society, Other conditions caused by exposure to asbestos, include
1. Asbestosis
Asbestosis is a form of pulmonary fibrosis that is usually progressive. It results in severe respiratory disability and often premature death. It is linked to the cumulative exposure to asbestos and type of asbestos.
2. Bronchial carcinoma
Bronchial carcinoma is also linked with the cumulative exposure to asbestos but it is not clear whether a diagnosis of asbestosis is required before bronchial carcinoma can be attributed to asbestos exposure. The risk of bronchial carcinoma is increased in a multiplicative fashion by tobacco smoking.
3. Mesothelioma
Mesothelioma is a malignancy of the pleura or peritoneum with a poor prognosis and with limited therapeutic possibilities. It is strongly associated with length of latency period but also with cumulative exposure.
4. Diffuse pleural thickening
Diffuse pleural thickening is a progressive condition that affects larger confluent areas of pleura than pleuralplaques. This condition sometimes causes respiratory disability.
5. Pleural effusion
Pleural effusion may occur in asbestos-exposed individuals. This can cause dyspnoea and usually requires investigation to look for mesothelioma, bronchial carcinoma or other causes(18).

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