Dr. Muhammad Majid Hanif
Cardiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
I had some concerns regarding asbestosis. Approximately 10-11 years ago, I worked on a building site. I was asked to remove some insulation off a water pipe in an attic. At that time, I asked the site manager if the insulation was asbestos and he said it was not. I also took a sample of it back to the office and asked the health and safety manager and he also said it was not. As time has gone on I have always wondered if it was asbestos that I removed from the pipe. This was not a task I carried out frequently in my work so cannot think of any other times I may have come into contact with the asbestos. I worked as a plumber for approximately 2 years but I did not really get involved with older buildings. My main problem is that I am a hypochondriac and I recently saw a show on television where it said if you think you may have come across asbestos, speak to your general practitioner. So, I went to my GP and he advised that it would be considered a low risk encounter and people who suffer from mesothelioma are people who work with it day in and day out over many years. He said there was not any concern and that asbestos is in the air in small doses. I said I did not want to end up with mesothelioma and he advised that it was very rare and in his 30 years as a GP only one patient he knew had mesothelioma who worked in a ship building industry day in and day out. He said that even in a worst case situation it would not show up until I was in my 70s (I am just 30 years old now). The average latency period is around 40 years for mesothelioma. My visit did put my mind at rest but I still went for a second opinion and the private doctor advised me the same. As I had paid for a 25 minutes consultation she did give me a physical examination and said everything was normal. After checking my peak flow test in which I scored 660 and my blood oxygen saturation which was 98%, she said it was really good. She said everything was normal and not to worry. But again I find myself still worrying. Please advice.
Hi
Welcome to icliniq.com. I want to assure you not to worry as everything is looking normal to me. I have thoroughly gone through your case and can well understand your genuine concerns regarding asbestosis, mesothelioma and other risks you may be having being exposed to insulation a decade ago. You are 30 years old and there is no latent period for mesothelioma to come up like this. A person at a very high and continuous exposure of asbestos, may develop asbestosis after more than 20 years. Every asbestosis patient never gets malignant mesothelioma or lung carcinoma (it is same as not every hepatitis B patient gets hepatocellular carcinoma). Mesothelioma never comes as a first sign of disease. It first appears as many lung issues that go on for many years and with chronic asbestosis it may sometimes affect the patient. You are all safe and negative for any kind of lung issues. In my view, you are never a candidate of asbestosis or mesothelioma as the pipe insulations you had removed has been confirmed having no asbestos by your safety manager. Right now your lungs are all very fine and you did really great with the peak flow testing. Your blood oxygen saturation is very good being 98%. You were at a risk of less than 1% of developing asbestosis. If you were working in an industry like ship making or painting and you inhaled years and years of large amounts of asbestos on a continuous basis, you may develop asbestosis. Same is the case with other pneumoconiosis (occupational lung diseases) categories. If there had been any risks or damages done to the delicate parts of your lungs, you would have most probably been presented as rales (abnormal breath sounds) in the posterior sides of lungs bases, abnormal PFT (Pulmonary Function Test), but as you know your score of peak flow of 660 is pretty good. Some other signs and symptoms would have been fingernail clubbing (drumstick fingers), cyanosis (bluish discoloration of the skin due to reduced oxygen supply), difficulty in breathing and shortness of breath when you exert a little bit, like climbing stairs, edema (swelling) of feet, and cough. All investigations have been sufficiently done. Please relax and no need to worry for that anymore. You look safe. Just for your own satisfaction, you may go for serial chest x-ray, PFT and cardiac examination, all from your GP every 6-8 months. So, my final suggestion for you is to sit, relax and enjoy your healthy life. All the available evidences of medical science makes you free of any risk of asbestosis or mesothelioma from that insufficient/no exposure incident.
Patient's Query
Thank you doctor for your response.
I did have a CT scan of my abdomen recently for a health checkup and it covered the lung bases. The report said that the lung bases are clear. I know it did not cover the whole lungs but the doctor did say that if there was a heavy exposure to asbestos then my lung bases can show signs of this on a CT. I was just thinking that the safety manager might not be that qualified to advise as I did read that sometimes asbestos is not easily identifiable. Anyway I am really pleased that you are also not concerned. So, I think when I have my annual checkup with the doctor I will ask for him to listen to my lungs, to do a oxygen saturation and peak flow each time. Thank you so much for putting my mind at rest.
Hi,
Welcome back to icliniq.com. I am glad that your lung bases are clear (according to your CT scan report). Well, I agree with you that your safety manager may not be that competent. That is why we have devised CT scanners/digital x-ray machine and other hi-tech radiological diagnostic gadgets to get assistance in diagnosis of the disease at earlier stages. Asbestosis is very easy to diagnose and nobody at risk may ever get skipped through the serial process of diagnosis. The major diagnostic tool in pneumoconiosis and especially asbestosis is the history of the patient and the profession he does. You never fit into the diagnosis based straight on the history (and you got the green signal right at your first visit to a physician). CT scan is the best way to see the morphological structures of human bodily organs. Asbestos whenever comes in (it is somewhat fibrous) it always goes to the bottom and affects the bases of the lungs. On CT scan, bases of the lungs came out clear meaning that there was no harm/damage done by anything.
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