According to the  (ATS), the general diagnostic criteria for asbestosis are:

• Evidence of structural pathology consistent with asbestosis, as documented by imaging or histology
• Evidence of causation by asbestos as documented by the occupational and environmental history, markers of exposure (usually pleural plaques), recovery of asbestos bodies, or other means
• Exclusion of alternative plausible causes for the findings

The abnormal chest x-ray and its interpretation remain the most important factors in establishing the presence of pulmonary fibrosis The findings usually appear as small, irregular parenchymal opacities, primarily in the lung bases. Using the ILO classification system, "s", "t", and/or "u" opacities predominate. CT or high-resolution CT (HRCT) are more sensitive than plain radiography at detecting pulmonary fibrosis (as well as any underlying pleural changes). More than 50% of people affected with asbestosis develop plaques in the parietal  the space between the chest wall and lungs. Once apparent, the radiographic findings in asbestosis may slowly progress or remain static, even in the absence of further asbestos exposure. Rapid progression suggests an alternative diagnosis.

Asbestosis resembles many other diffuse interstitial lung diseases, The differential diagnosis includes   (IPF), , sarcoidosis , and others. The presence of pleural plaquing may provide supportive evidence of causation by asbestos. Although lung biopsy is usually not necessary, the presence of asbestos bodies in association with pulmonary fibrosis establishes the diagnosis.Conversely, interstitial pulmonary fibrosis in the absence of asbestos bodies is most likely not asbestosis. Asbestos bodies in the absence of fibrosis indicate exposure, not disease.

Treatment

There is no curative treatment for asbestosis.oxygen therapy  at home is often necessary to relieve the shortness of breath and correct underlying hypoxia. Supportive treatment of symptoms includes respiratory physiotherapy  to remove secretions from the lungs by postural drainage, chest percussion, and vibration. nebulized  medications may be prescribed in order to loosen secretions or treat underlying chronic disease  Immunization against  and annual influenza vaccination should be administered. Patients should be advised that they are at increased risk for certain malignancies, and if they still smoke, cessation is highly recommended. They should undergopneumococcal pneumonia periodic PFTs, chest x-rays, and clinical evaluations, including cancer screening/evaluations, as appropriate. In many jurisdictions, the diagnosis of asbestosis is reportable to the State Health Department. Additionally, the individual may have legal or adjudication options for compensation. Removal from further asbestos exposures is recommended.

Asbestosis mesothelioma

Asbestosis is a chronic inflammatory and fibrotic medical condition affecting the parenchymal tissue of the lungs caused by the inhalation and retention of asbestos fibers. It usually occurs after high intensity and/or long-term exposure to asbestos (particularly in those individuals working on the production or end-use of products containing asbestos) and is therefore regarded as an occupational lung disease. People with extensive occupational exposure to the mining, manufacturing, handling or removal of asbestos are at risk of developing asbestosis. Sufferers may experience severe dyspnea (shortness of breath) and are at an increased risk for certain malignancies, including lung cancer and mesothelioma. Asbestosis specifically refers to interstitial (parenchymal) fibrosis from asbestos, and not pleural fibrosis or plaquing.

The signs and symptoms of asbestosis do not manifest until after an appreciable latency (time since first exposure), often several decades under current conditions in the US.The primary symptom of asbestosis is generally the slow onset of dyspnea, especially on exertion. Clinically advanced cases of asbestosis may lead to respiratory failure. On auscultation of the lungs, the physician may hear inspiratory rales.

The characteristic pulmonary function finding in asbestosis is a restrictive ventilatory defect. This manifests as a reduction in lung volumes, particularly the Vital Capacity (VC) and Total Lung Capacity (TLC). The TLC may be reduced through alveolar wall thickening; however this is not always the case. Large airway function, as reflected by FEV1/FVC, is generally well preserved. In the more severe cases, the drastic reduction in lung function due to the stiffening of the lungs and reduced TLC may induce right-sided heart failure (cor pulmonale). In addition to a restrictive defect, asbestosis may produce reduction in Diffusion Capacity and arterial hypoxemia.

The mesothelium consists of a single layer of flattened to cuboidal cells forming the epithelial lining of the serous cavities of the body including the peritoneal, pericardial and pleural cavities. Deposition of asbestos fibers in the parenchyma of the lung may result in the penetration of the visceral pleura from where the fiber can then be carried to the pleural surface, thus leading to the development of malignant mesothelial plaques. The processes leading to the development of peritoneal mesothelioma remain unresolved, although it has been proposed that asbestos fibers from the lung are transported to the abdomen and associated organs via the lymphatic system. Additionally, asbestos fibers may be deposited in the gut after ingestion of sputum contaminated with asbestos fibers.Pleural contamination with asbestos or other mineral fibers has been shown to cause cancer. Long thin asbestos fibers (blue asbestos, amphibole fibers) are more potent carcinogens than "feathery fibers" (chrysotile or white asbestos fibers).[6] However, there is now evidence that smaller particles may be more dangerous than the larger fibers. They remain suspended in the air where they can be inhaled, and may penetrate more easily and deeper into the lungs. "We probably will find out a lot more about the health aspects of asbestos from [the World Trade Center attack], unfortunately," said Dr. Alan Fein, chief of pulmonary and critical-care medicine at North Shore-Long Island Jewish Health System. Dr. Fein has treated several patients for "World Trade Center syndrome" or respiratory ailments from brief exposures of only a day or two near the collapsed buildings.Mesothelioma development in rats has been demonstrated following intra-pleural inoculation of phosphorylated chrysotile fibers. It has been suggested that in humans, transport of fibers to the pleura is critical to the pathogenesis of mesothelioma. This is supported by the observed recruitment of significant numbers of macrophages and other cells of the immune system to localized lesions of accumulated asbestos fibers in the pleural and peritoneal cavities of rats. These lesions continued to attract and accumulate macrophages as the disease progressed, and cellular changes within the lesion culminated in a morphologically malignant tumor.Experimental evidence suggests that asbestos acts as a complete carcinogen with the development of mesothelioma occurring in sequential stages of initiation and promotion. The molecular mechanisms underlying the malignant transformation of normal mesothelial cells by asbestos fibers remain unclear despite the demonstration of its oncogenic capabilities. However, complete in vitro transformation of normal human mesothelial cells to malignant phenotype following exposure to asbestos fibers has not yet been achieved. In general, asbestos fibers are thought to act through direct physical interactions with the cells of the mesothelium in conjunction with indirect effects following interaction with inflammatory cells such as macrophages.Analysis of the interactions between asbestos fibers and DNA has shown that phagocytosed fibers are able to make contact with chromosomes, often adhering to the chromatin fibers or becoming entangled within the chromosome. This contact between the asbestos fiber and the chromosomes or structural proteins of the spindle apparatus can induce complex abnormalities. The most common abnormality is monosomy of chromosome 22. Other frequent abnormalities include structural rearrangement of 1p, 3p, 9p and 6q chromosome arms.Common gene abnormalities in mesothelioma cell lines include deletion of the tumor suppressor genes:Neurofibromatosis type 2 at 22q12Asbestos has also been shown to mediate the entry of foreign DNA into target cells. Incorporation of this foreign DNA may lead to mutations and oncogenesis by several possible mechanisms Inactivation of tumor suppressor genes Activation of oncogenes

Activation of proto-oncogenes due to incorporation of foreign DNA containing a promoter region, Activation of DNA repair enzymes, which may be prone to error,Activation of telomerase,Prevention of apoptosisAsbestos fibers have been shown to alter the function and secretory properties of macrophages, ultimately creating conditions which favour the development of mesothelioma. Following asbestos phagocytosis, macrophages generate increased amounts of hydroxyl radicals, which are normal by-products of cellular anaerobic metabolism. However, these free radicals are also known clastogenic and membrane-active agents thought to promote asbestos carcinogenicity. These oxidants can participate in the oncogenic process by directly and indirectly interacting with DNA, modifying membrane-associated cellular events, including oncogene activation and perturbation of cellular antioxidant defences.Asbestos also may possess immunosuppressive properties. For example, chrysotile fibres have been shown to depress the in vitro proliferation of phytohemagglutinin-stimulated peripheral blood lymphocytes, suppress natural killer cell lysis and significantly reduce lymphokine-activated killer cell viability and recovery. Furthermore, genetic alterations in asbestos-activated macrophages may result in the release of potent mesothelial cell mitogens such as platelet-derived growth factor (PDGF) and transforming growth factor-β (TGF-β) which in turn, may induce the chronic stimulation and proliferation of mesothelial cells after injury by asbestos fibres

Signs and symptoms of mesothelioma

Most people are familiar with the pink cancer awareness ribbons that symbolize breast cancer, it seems that these pink beauties are everywhere. But, did you know that there are many other kinds them out there that represent different kinds of cancer that affect women all around the world? You might have seen one or two different colored pins and not even known what they meant. Here are some of the other colors of cancer awareness ribbons so you will know what they mean the next time that you see them:
Teal This color of cancer awareness ribbons are for ovarian cancer. While this cancer isn't as prevalent as breast cancer, its numbers are, unfortunately, on the rise. So, when you see a teal cancer awareness ribbon or pin, you will know what they stand for.
Peach This color of cancer awareness ribbons are for uterine cancer. This type of cancer is also not one that is mentioned much, but is a killer if not detected early enough and fought correctly.
Lavender This color of are for gynecological cancer. This encompasses several different kinds of cancers, from ovarian to cervical, basically anything that has to do with the female reproductive organs falls under this category.Teal and White This color are for cervical cancer. This cancer is hard to detect as well, unless it is screened for, but, when caught early, can be removed and treated.
All of these cancer awareness ribbons and pins are different colors to distinguish between the different types of cancer. It helps for survivors and loved ones to spread their message of hope and survival to those who may not have heard of this particular type of cancer and make sure that other women have their screenings to ensure that they catch these potentially fatal diseases early enough for treatments to be effective. So, the next time that you see different colored cancer awareness ribbon pins, be sure to ask the wearer about it and share their story with you. It might just be the motivation that you need to see your doctor and get screened or to push a friend or family member to get their screening. After all, women are more likely to push their friends and family to get in to see their doctors sooner than later. And, like the breast cancer pins and other types of cancer awareness merchandise, most of the proceeds go toward research and the search for a cure.