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Is there a link between Idiopathic Pulmonary Fibrosis and Asbestos?
Asbestos-related disease deaths
The Health and Safety Executive predicts that the number of deaths from mesothelioma will peak in or around 2020. This is based upon the amount of asbestos imported into the UK and the widespread, industrial use of asbestos, particularly between 1950 to 1980.
The expectation is that as asbestos use declined, exposure to asbestos dust would also have declined and therefore the number of deaths is expected to drop accordingly.
Most diseases caused by exposure to asbestos have long latency periods of typically between 20 and 50 years, which is why there is such a long time between the reduction in the use of asbestos and the predicted peak in asbestos-related mortality.
What is IPF?
Idiopathic pulmonary fibrosis (IPF) is an irreversible lung disease which results in breathlessness which will worsen over time. ‘Pulmonary fibrosis’ is used to describe the scarring of the lung tissue which causes the shortness of breath. The designation ‘idiopathic’ is given when the cause of the lung fibrosis is unknown.
Who does IPF affect?
Mortality due to IPF in the UK continues to rise and accounts for approximately 5000 deaths per year. In 2012 about 32,500 people were diagnosed with IPF in the UK, with a high incidence in Northern Ireland, North West Scotland, Scotland and Wales. The risk and incidence of IPF increases significantly with age, so IPF is diagnosed more frequently in those over 40.
How is it distinct from asbestosis?
Whilst IPF shares many of the same characteristics as asbestosis, one of the most important distinctions is that a claim for compensation cannot be made for IPF, but a claim can be made for asbestosis.
Why is IPF on the increase?
There appears to be no reason for the rising incidence of IPF in the UK. IPF has been linked with occupations such as metal and woodworkers, textile or stone exposure or from cattle or farming exposure. Infection from particular viruses might be another cause.
Can IPF be linked with asbestos exposure?
A recent study compared the number of deaths of mesothelioma, asbestosis and IPF with the level of asbestos imported for the relevant latency period. The number of male deaths due to IPF and mesothelioma for each year was very similar.
The number of female deaths due to IPF and mesothelioma also increased. The number of female deaths due to IPF was consistently higher than those due to mesothelioma.
However, the number of asbestosis deaths was lower for males and did not increase for females.
What does this all mean?
The results of the study showed that the rising number of asbestos deaths and historic asbestos importation was connected. The number of deaths due to IPF was also significantly related to previous asbestos imports.
Although the study cannot conclude that IPF is caused by exposure to asbestos, it does raise interesting questions as to whether IPF is in fact due to unrecognised asbestos exposure.
Until clinical evidence is identified which links IPF with asbestos exposure, clinicians will be reliant upon patients providing clear evidence of their asbestos exposure when assessing whether or not pulmonary fibrosis could be asbestosis. If the patient cannot provide detailed evidence of exposure to asbestos dust, then it is highly likely that they will be diagnosed with IPF.
When is it asbestosis?
In order to prove a claim for asbestosis, the history of asbestos exposure needs to be moderate to heavy for many years, together with clinical evidence of asbestosis.
An asbestosis claim can be proven where there is an occupational history of one year with heavy exposure to asbestos or five to 10 years of moderate exposure to asbestos. As a general rule the greater the level of exposure, the greater the extent of the asbestosis.
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