Asbestos and Asthma

[jenrose150]

Any advice would be greatly appreciated.

My CT scans show right middle lobe collapse, bronchial wall thickening, pericardial effusion, sinus narrowing and atrophy, and collapsed septum.  Had asthma as a kid, but now I cannot breath and it feels different than asthma.  I don't wheeze -- it feels like something is squeezing my chest and bad pain in forehead.  Doctors just gave me Advair and other cortisteroids.

I recently received two independent reports showing asbestos all over my apartment (airborne and dust), including HVAC system.  One 'testing' company said it was a safe level of asbestos since the hi-concentrations are located in 'inaccessible areas' such as on top of my furniture or behind my bed (serious).  Is this true?  Is there any 'safe' level of asbestos in a home environment?  And could chronic asbestos exposure be causing the above lung disease?

Finally, is there a way to test the lungs or body for asbestos exposure?  I understand that Mesothelioma often takes 15-30 years to diagnose and often they catch it too late.  So is there a way to identify potential for lung cancer early on and pro-actively treat the exposure/cancer potential?  If so, which hospital?

[National Jewish Health]

The first question that must be addressed is why do you have a pericardial effusion?  What has caused it, how large it is and what impact, if any, is it having on your heart and its ability to pump blood?  Unless this effusion is described as “tiny” or “very slight”, your doctors need to pursue this pericardial effusion, the causes of which are too numerous to describe here.  Such effusions are due to inflammation of the pericardium, which is the membrane that envelopes the heart.  In some instances, it may become constrictive pericarditis.  That can interfere with blood return to the heart and result in impaired circulation, associated with shortness of breath.  Much information on the effect of an effusion can be derived from an echocardiogram.

Middle lobe collapse or syndrome is no longer believed to be the result of bronchial collapse due tuberculosis infected lymph nodes.  In general, in the absence of recurrent infection, simple collapse is not deemed to be a serious disease.  In this circumstance, attempts to re-expand the right middle lobe (RML) or surgically remove it are not indicated.

As for asbestos, there is no “safe level” of asbestos exposure.  In years past the disease was caused by exposure in the home, to fibers brought home on the clothing of people working with asbestos.  You should contact the Environmental Protection Agency (EPA) to report the findings of asbestos in your apartment and seek their advice both for dealing with your apartment exposure and their advice on accepted monitoring techniques.  You may want to visit their website, as well.  If it is in your apartment, it is highly likely to be in the apartments of your neighbors, placing all of you at risk for pulmonary fibrosis, lung cancer and mesothelioma.

The diagnosis can be made by chest x-ray, better yet by CT scan and by the demonstration of asbestos fibers in bronchial washings obtained at the time of bronchoscopy.  Bronchoscopy should also be considered for evaluation of the RML collapse, if the CT scan suggests the presence of disease in the RML, as opposed to simple collapse.

Good luck.