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Asbestosis

Asbestosis is a chronic inflammatory medical condition affecting the parenchymal tissue of the lungs. It occurs after long-term, heavy exposure to asbestos, e.g. in mining. Sufferers have severe dyspnea (shortness of breath) and are at an increased risk regarding several different types of lung cancer. more...

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As clear explanations are not always stressed in non-technical literature, care should be taken to distinguish between several forms of relevant diseases. According to the World Health Organisation (WHO), these may defined as; asbestosis (the subject of this article), lung cancer, and mesothelioma (generally a very rare form of cancer, when more widespread it is almost always associated with prolonged exposure to asbestos).

Signs and symptoms

The primary symptom of asbestosis is generally the slow, insidious onset of shortness of breath on exertion. In severe, advanced cases, this may lead to respiratory failure. Coughing is not usually a typical symptom, unless the patient has other, concomitant respiratory tract diseases.

People with extensive occupational exposure to the mining, manufacturing, handling or removal of asbestos are at risk of developing asbestosis. There is also an increased risk of lung cancer and mesothelioma. This risk is related to the total dose of asbestos received and the duration of asbestos exposure.

Diagnosis

The definitive diagnosis of asbestosis is largely dependent on a detailed and accurate clinical history. Reliable data on the level and duration of occupational exposure to asbestos is critical to the diagnosis (though, until recently, rarely available in practice). Histopathological diagnosis is usually not necessary for patient management but can be used to confirm the diagnosis, especially if the simultaneous presence of other diseases is suspected.

Pathogenesis

Asbestosis is the scarring of lung tissue resulting from the inhalation of asbestos fibers. When such fibers reach the alveoli (air sacs) in the lung, where oxygen is transferred into the blood, the foreign bodies (asbestos fibers) activate the lung's local immune system and provoke an inflammatory reaction. Macrophages phagocytose (ingest) the fibers and stimulate fibroblasts to deposit connective tissue. The result is fibrosis. The fibrotic scar tissue is much less efficient in gas exchange, reducing oxygen transfer to the blood, as well as the removal of carbon dioxide. The total lung capacity (TLC) may be reduced. In the more severe cases, the drastic reduction in lung function may induce heart failure (cor pulmonale).

Treatment

There is no curative treatment. Close monitoring (routine X-rays or even pleural biopsy) for mesothelioma is mandated. Oxygen therapy at home is often necessary to relieve the shortness of breath. Supportive treatment of symptoms includes respiratory treatments to remove secretions from the lungs by postural drainage, chest percussion, and vibration. Aerosol medications to thin secretions may be prescribed.

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Employees contract asbestos-related diseases: Failure to warn, provide respiratory equipment: Wrongful deaths: Asbestosis: Verdict
From Law Reporter, 8/1/01

Adams v. Consolidated Rail Corp., W Va., Brooke County Cir. Ct., No. 98-C-46 RI, Oct. 13, 2000.

DeMatteis, 63; Knight, 74; Robinson, 64; Shaffer, 55; Clyde Terry, 71; and Monty Terry, 51, were railroad employees who contracted diseases connected to asbestos exposure. Knight suffered from mesothelioma, from which he eventually died. Shaffer eventually died from lung cancer. Both men are survived by their wives.

DeMatteis, Robinson, Clyde Terry, and Monty Terry each contracted asbestosis. DeMatteis and Shaffer had been trainmen, Knight had been a machinist, Robinson had been a trackman, and Clyde Terry and Monty Terry had been carmen.

Robinson incurred lost income of $375,000. No other claims for lost earnings were made.

The men sued four railroads, alleging defendants knew or should have known of the hazards of asbestos and that it was being used where plaintiffs worked.

Plaintiffs claimed defendants were negligent because they failed to (1) provide reasonable warnings to their employees about the dangers of asbestos, (2) provide respiratory protection to plaintiffs, (3) issue proper safety rules, (4) medically monitor their employees, (5) monitor air levels for asbestos in the workplace, and (6) implement a reasonable industrial hygiene program. Defendants also failed to report asbestos-related illnesses to the appropriate federal agency, plaintiffs alleged.

A jury awarded plaintiffs $4.5 million. Robinson and Shaffer each received $1.25 million, Knight received $1 million, Monty Terry received $400,000, and DeMatteis and Clyde Terry each received $300,000. Defendants are jointly and severally liable.

Plaintiffs' experts included Michael Ellenbecker, industrial hygiene, Lowell, Mass.; Raymond A. Harron, radiology, Bridgeport, W Va.; David Laman, pulmonology, Pittsburgh, Pa.; Michael Blatt, pulmonology, Wheeling, W Va.; and James L. Kenkel, economics, Pittsburgh, Pa.

Defendants' expert witnesses in this case included Gregory J. Fino, pulmonology, Pittsburgh, Pa.; Jerome Wiot, radiology, Cincinnati, Ohio; and Larry Liukonen, industrial hygiene, Philadelphia, Pa.

Plaintiffs' Counsel

*Mark T. Coulter, Pittsburgh, Pa.

Documents in this case are available through the Litigation Resources section in the back of this issue, courtesy of Mr. Coulter.

Copyright Association of Trial Lawyers of America Aug 2001
Provided by ProQuest Information and Learning Company. All rights Reserved

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