[Asbestosis].

Abstract

Asbestosis is a rare pneumoconiosis secondary to inhalation of asbestos fibers. It follows sufficient professional exposures (more than 25 fibers x years/ml). The mean latency is 20 years. Clinical symptoms include exertion dyspnea, crackles and clubbing. Chest radiography the performances of which have been enhanced by the use of the ILO score shows fine reticular or reticulonodular opacities which predominate in pulmonary bases often in association with benign pleural abnormalities. An ILO score equal or higher than 1/1 is suggestive of asbestosis in the context of a compatible professional history. Pulmonary function is typical of diffuse interstitial lung disease. High resolution CT is the most performance investigation in particular in presence of asbestosis either minimal or of recent origin. The diagnosis of asbestosis is based on the professional exposure, a compatible interstitial lung and pleural disease and the exclusion of alternative hypothesis. The diagnosis can be comforted by bronchoalveolar lavage (cytology and biometeorology). Various evolutions are possible: stability, progression to respiratory insufficiency, increased incidence of bronchial carcinoma. Life expectancy is reduced in severe cases. There is no efficient medical treatment. Asbestosis is recognized as a professional disease. A better recognition of asbestosis necessitates a performance policy of depistage in populations with significant present or past exposure and an appropriate diagnostic strategy including high-resolution-CT.