Tuesday 27 August 2013

Asbestos-Related Lung Cancers Among Smokers

This guest post is from Melissa Hathaway of Claris Law. 

While an increasing number of people are aware of the link between occupational exposure to asbestos and mesothelioma – an incurable form of cancer that affects the lining of the lungs – it is not so widely appreciated among the public that deadly asbestos fibers can also contribute to lung cancer. Indeed, in recent months the Lung Cancer Asbestos Victims Center has been advising anyone with a diagnosis of mesothelioma or a lung cancer related to occupational asbestos exposure to take steps toward seeking compensation.

Failure to make a connection

It is easy to understand why some individuals may not make the connection between the onset of their lung cancer and previous asbestos exposure. In part this may relate to the time lag between their contact with asbestos and the development of symptoms; most commonly these will be a cough, breathlessness, chest pain, swallowing difficulties, weight loss, and reduced appetite, which can take up to 40 years to become apparent. However, this is only one of the reasons.

While high-risk occupations are generally considered to be those related to asbestos mining or manufacturing items containing the material, along with those in construction industries, the presence of asbestos in so many buildings means that some jobs are surprisingly risky. For instance, due to the fact that around half of the schools in America contain this hazardous material, teachers working in these buildings on a daily basis are at high risk of exposure and figures published by the National Center for Health Statistics show 2.1% of elementary school teachers die from mesothelioma. Third, smokers may assume that their lung cancer is purely a consequence of their tobacco habit. We’re frequently told that the majority of cases of lung cancer are the result of tobacco use, so it is only natural as a smoker to assume this is the sole cause. However, smoking and asbestos exposure are a lethal combination.

Smoking and asbestos exposure together

The American Cancer Society reports that for non-smokers exposed to asbestos fibers in the workplace, their risk of lung cancer is five times that of those who did not receive this exposure. However, if someone additionally smokes, the risk of lung cancer may be beyond 50 times greater than a non-smoker with no asbestos exposure. Therefore, if it is likely that you have been exposed to asbestos through your current or a previous occupation, it has never been more important to quit tobacco use. Although it is no easy task to give up smoking, the availability of smoking cessation support can help greatly, whether that is through counseling, nicotine replacement therapy or targeted medication. While such treatments might be beyond their financial means for some people at present, the Affordable Care Act will bring with it the requirement that stop-smoking treatments be covered through health insurance policies, increasing their availability.

The good news is that if you are successfully able to quit smoking, there is evidence that this will have a positive impact on your risk of lung cancer following asbestos exposure. A study published this April in the American Journal of Respiratory and Critical Care Medicine provides weight to this. This piece of research investigated the relationship between exposure to asbestos, smoking and lung cancer risk among more than 2000 insulator workers, and found as expected that the impact of both factors was additive when it came to mortality from lung cancer. However, it also demonstrated that if smokers who have been exposed to asbestos are able to kick their habit, their risk of dying from lung cancer halved within the 10 years following quitting; after a 30-year period free from tobacco, their risk was similar to that of a non-smoker.

Identifying asbestos related lung cancer

Simply having worked in an environment where asbestos exposure has occurred is not sufficient evidence to attribute the development of lung cancer to this, and if you are also a smoker, this can complicate matters further. You will likely be required to give a detailed account of your employment to estimate the asbestos dose you would have received. Beyond a chest x-ray to identify pleural plaques, expect to undergo a lung biopsy or bronchoscopy to detect the presence of asbestos fibers; this will indicate whether they are present in sufficient quantities to trigger cancerous changes. The presence of asbestosis – inflammation and scarring of the lung tissue – increases the likelihood that a lung cancer is asbestos-related, as the former is believed to be a consistent marker of this type of cancer, particularly when there is a background of tobacco use. While it is not to say that in the absence of asbestosis a lung cancer could not be asbestos-related, at present this is the criterion used by pathologists when making their diagnosis.

Source: http://www.pissd.com/2013/07/asbestos-related-lung-cancers-among-smokers/

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