Asbestos-Related Pleural Disease

ByCarrie A. Redlich, MD, MPH, Yale Occupational and Environmental Medicine Program Yale School of Medicine;
Efia S. James, MD, MPH, Bergen New Bridge Medical Center;Brian Linde, MD, MPH, Yale Occ and Env Medicine Program
Reviewed/Revised Nov 2023
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Asbestos-related pleural disease includes thickening (plaques) and calcification of the pleura, adhesions, pleural effusion, partial lung collapse, and mesothelioma.

  • People with asbestos-related pleural disease may have difficulty breathing.

  • Diagnosis is based on history and chest imaging findings.

  • Treatment focuses on relief of symptoms.

(See also Overview of Asbestos-Related Disorders and Overview of Environmental and Occupational Lung Disease.)

Asbestos is a family of naturally occurring silicates (minerals) whose heat-resistant and structural properties are useful in construction and shipbuilding materials, automobile brakes, and some textiles. Asbestos can be found in low levels in the air, water, and soil, but this low level of environmental exposure is not a significant contributor to human disease. When inhaled, asbestos fibers settle deep in the lungs, causing scars.

Asbestos inhalation can cause the membranes covering the lungs (the pleura) to thicken and become scarred. These thickenings are called pleural plaques and do not usually cause symptoms. If pleural plaques become more extensive they can cause breathing difficulty and mild breathing abnormalities on lung function testing. Pleural plaques do not become cancerous.

Inhaling asbestos fibers can occasionally cause fluid to accumulate in the space between the two pleural layers of the lungs (pleural space). This fluid accumulation is called a noncancerous (benign) asbestos effusion. People with a noncancerous asbestos effusion may have difficulty breathing.

Although asbestos-related pleural plaques and fluid accumulation are not cancerous, they are indicative of past asbestos exposure and therefore an increased risk for developing lung cancer and mesothelioma.

Diagnosis of Asbestos-Related Pleural Disease

  • A history of asbestos exposure

  • Chest imaging

Pleural plaques that develop in many people with exposure to asbestos often contain calcium, which makes them easy to see on chest x-rays and computed tomography (CT).

Treatment of Asbestos-Related Pleural Disease

  • Treatment to relieve symptoms

Symptoms are treated as necessary. Occasionally, doctors need to drain fluid by inserting a tube into the chest.

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