Asbestosis
Asbestosis is a chronic inflammatory medical condition affecting the parenchymal tissue of the lungs. It is caused by the chronic inhalation of asbestos fibers. People with occupational exposure to the mining, manufacturing, handling or removal of asbestos are at risk of developing asbestosis.
There is an increased risk of lung cancer and mesothelioma associated with asbestosis. The risk is related to the total dose of asbestos received and the duration of asbestos exposure. Exposure to the crocidolite form of asbestos is the form most associated with mesothelioma among the four forms of asbestos. Mesothelioma usually occurs between 20-40 years after exposure to asbestos and has a very poor prognosis, with most patients dying within 2-4 years of diagnosis.
Inhalation of fibers of asbestos lead to development of alveolar and interstitial fibrosis of lung tissue. This leads to reduced lung capacity and compliance, leading to reduced gas transfer.
The primary symptom of asbestosis would be a slow, insidious onset of shortness of breath on exertion. In severe, advanced cases, this may lead to respiratory failure. Cough is not usually a typical symptom unless the patient has concomitant other respiratory tract diseases.
Diagnosis of asbestosis is largely dependent on a good and accurate clinical history taking. Occupational exposure to asbestosis is critical to the diagnosis. Histopathological diagnosis is usually not necessary for patient management but can be used to confirm the diagnosis in post-mortem.
History of Asbestosis (particular reference to Witternoom, Western Australia)
By 1930 it was recognised that asbestosis was a horrific disease frequently resulting from exposure to asbestos. The 1930 Merryweather and Price report to the United Kingdom Parliament is recognised as an important medical report. It included a report on the effects of asbestos dust on the lungs, on dust suppression in industry and it established that asbestosis was a serious disease from which asbestos workers suffered.
In 1935 a Western Australian Factories and Shops Inspector reported on the effect of asbestos dust on the lungs of workers in the James Hardie factory in Perth.
A Health Bulletin distributed to doctors in Victoria in 1942 referred to asbestosis and advised that persons likely to get asbestosis were asbestos miners and workers, and that it resulted from the inhalation of asbestos fibres.
In 1943 the link between asbestos and cancer was confirmed by a report from a laboratory in New York. Johns Manville (later the principal buyer of asbestos from Wittenoom) suppressed the report (Govt. Select Committee Report). A report on an asbestos mill at Zeehan in Tasmania (owned and operated by a CSR subsidiary) identified asbestos dust was a health hazard and discussed ways of eliminating the dust.
In 1944 Mines Inspector Adams reported on the dust menace at Wittenoom and discussed the need to reduce dust levels, and the Western Australian Assistant State Mining Engineer reported on the dangers of the dust being generated at Wittenoom.
In 1946 the known asbestos toll reached 235 in Britain, 16 in France, 30 in Italy and in Western Australia the first known asbestosis case at Wittenoom was reported.
In 1948 Dr Eric Saint, a Western Australian Government Medical Officer, wrote to the head of the Health Department. He warned of the dust levels in the Witternoom mine and mill, the lack of extractors and the dangers of asbestos and risk of asbestosis, and advised the mine would produce the greatest crop of asbestosis the world has ever seen. He also advised the Wittenoom Mine Management that asbestos is extremely dangerous and that men exposed would contact chest disease inside six months.
In 1959 Dr McNulty reported the dirty, dusty conditions throughout the mine and mill to the Health Department of Western Australia.
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