A woman with a fatal lung disease is believed to have contracted a lung disease “secondhand” from her father decades earlier.
The 80-year-old woman with chronic obstructive pulmonary disease (COPD) was experiencing an exacerbation of the condition and was having difficulty breathing. She was admitted to the hospital, where doctors found accumulations of plaque scattered throughout her lungs, making it difficult to breathe in air.
Because of her family history, doctors suspected something unusual had happened and checked immediately after learning more about the woman’s childhood.
The woman told her doctors that when she was a child, she and her sisters played with their father, who worked installing thermal insulation.
When he returned home from work, his clothes were covered in “snow-like” particles, which turned out to be asbestos.
Doctors believe that her passive exposure as a child to asbestos, which weakens lung tissue, led her to develop pleural plaques: thickened areas of tissue in the lining of the lungs.
The medical team also found lung damage in the woman’s two sisters, which they say corroborated their theory.
While pleural plaques cannot be transmitted from person to person, exposure to asbestos, even decades ago, could increase the risk of developing them. However, it is unclear how common this is.
The scans above show the patient’s lungs 20 years ago (left) and today (right). On current examination, pleural plaques can be seen in the lungs.
COPD affects just over one in 15 American adults, which is more than 14 million people, according to the CDC.
Smoking is the number one cause, as the chemicals in tobacco smoke damage the lining of the airways.
The woman in the case report, from West Virginia, smoked up to 40 cigarettes a day for 20 years.
However, asbestos fibers can also increase the risk, as these fibers lodge in the lungs and cause inflammation and scarring.
These toxic chemicals are also one of the main causes of pleural plaques.
These plaques are thickened areas of tissue that develop in the lining of the lungs and can cause difficulty breathing and chest pain.
Although asbestos was used in roofing and home insulation for decades, the Environmental Protection Agency (EPA) banned it in most products in 1989 because of its links to lung diseases and cancer.
But even now, the EPA links asbestos to 40,000 deaths per year from lung, ovarian and throat cancer, mostly in older Americans who were previously exposed to the chemical for long periods of time.
And it wasn’t until earlier this year that chrysotile asbestos, the last form of the chemical used in the United States, was finally banned.
writing in the New England Journal of MedicineDoctors at West Virginia University Health Sciences Center compared X-ray images of the woman’s lungs from 20 years ago to the present.
The researchers also compared the scans of the woman’s two sisters, which also showed pleural plaques that had worsened from 20 years earlier to the present day.
The images above are scans of the patient’s two sisters. Both developed pleural plaques, which could be due to exposure to asbestos as children.
COPD causes progressive damage to the airways, resulting in constant coughing and difficulty breathing (file image)
The team noted that the women had developed calcified pleural plaques, which form when calcium salts build up in lung tissue due to inflammation.
It is not clear whether the woman’s sisters smoked or had COPD, but exposure to asbestos is the most common cause of this type of lung plaques.
A 2020 study stated that up to eight percent of the US population may have pleural plaques, but up to 60 percent of workers exposed to asbestos may develop plaques.
And it often takes decades for pleural plaques to form after exposure to asbestos.
Signs of these plaques include difficulty breathing, chronic cough, chest pain, and coughing up blood, but often there are no symptoms.
A CT scan is used to diagnose the condition, and doctors generally do not recommend treating the plaques because removing them can damage the lungs and do not usually cause serious complications.
In rare cases, pleural plaques can increase the risk of other diseases, such as lung cancer and mesothelioma.
In the case of the 80-year-old woman, she was able to be discharged after receiving treatment for her COPD exacerbation, which typically includes oxygen to help breathing, antibiotics for any infections, and steroids to reduce lung inflammation.