Pleural plaque disease is caused by chronic exposure to asbestos fibers, leading to the formation of plaque in the lungs that cannot be removed or repaired. Treatment focuses on managing symptoms, including difficulty breathing and pleural effusion, and avoiding further exposure to asbestos. Quitting smoking and promptly treating respiratory infections is also important. Asbestos lung disease remains a significant problem in many parts of the world.
Pleural plaque disease is a type of lung disease that can develop in the lungs of people who have been chronically exposed to airborne asbestos fibers. Asbestos is a naturally occurring mineral that has been used extensively in the twentieth century, particularly in construction, textile manufacturing and shipbuilding. Asbestos is potentially toxic when inhaled and can cause a type of lung cancer called mesothelioma and a chronic lung disease called asbestosis. Pleural plaques can develop as a symptom of asbestosis, but they can also form in the absence of any other type of lung disease.
While most uses of asbestos have been discontinued in many countries, asbestos is still mined in several locations, including Australia, Canada, Finland, North America and South Africa. Additionally, asbestos lung disease can remain undetected for two decades or more in an affected person. This means that pleural plaque disease and other asbestos diseases are still a significant problem in many parts of the world.
Asbestos fibers are long, thin and extremely strong. The most dangerous fibers are tiny and too small to be seen with the naked eye. When these fibers are inhaled into the lungs, they settle in the lung tissue. The body is unable to remove the fibers from the lungs or break them down into a less harmful form. Over a period of up to four decades, these fibers cause chronic irritation in lung tissue. This leads to the deposition of collagen fibers around the places where asbestos is located, forming plaque.
Eventually, plaque can calcify, which means that calcium salts have built up in the tissue, causing it to harden. The area where a pleural plaque sits therefore cannot function as normal lung tissue does, because it has hardened and can no longer expand when the lungs inflate during breathing. People with pleural plaques have difficulty breathing during exertion; in advanced cases of the disease, they may have difficulty breathing even at rest. Even breathing can be painful. Another common symptom is the presence of pleural effusion, which occurs because fluid builds up in the pleural cavity. This is the body cavity where the lungs are located.
A person with pleural plaques cannot be cured; once plaques are present in the lungs, they cannot be removed or repaired. Further damage can be avoided if he is no longer exposed to asbestos. Because the disease cannot be cured, treatment focuses on managing symptoms. One of the most common treatments is the use of an oxygen mask for people who have difficulty breathing.
Pleural effusion is treated with a procedure called aspiration, in which a long, thin needle is inserted into the pleural cavity. Excess fluid is removed through the needle. A procedure called pleurodesis may be done for people with severe, recurring pleural effusions. During this procedure, fluid is drained from the pleural cavity, and talcum powder or another inflammatory substance is placed into the cavity. The resulting inflammation causes swelling that closes the layers of the pleural membrane surrounding the lungs, preventing fluid from building up.
People with this condition are also advised to quit smoking as soon as possible, if applicable. In addition, it is important that respiratory infections, even mild ones such as a cold, are treated promptly and carefully monitored. Due to reduced lung function, these infections can become serious if left untreated.
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