7. Pleural plaques and other conditions of the pleura
Several other conditions may affect the pleural lining of the lung as a result of asbestos exposure. They are all relatively benign conditions, though they may be frightening for the patient if he thinks he has or may develop cancer or mesothelioma. Pleural plaques are one of these conditions. These are harmless scars in the pleura that can be found in almost anyone who has been exposed to asbestos at work. They often show up on X-ray. More rarely, the pleura scars more extensively (so-called 'pleural fibrosis') and this may cause some difficulty with breathing, If, as is only very rarely the case, it needs treatment, it can be removed by an operation. Very occasionally asbestos exposure causes fluid to accumulate around the lung (pleural effusion). This usually goes away by itself, or it can be removed easily with a needle.
Figure 7 Pleural plaques on the surface of the lung
The Scottish Parliament have passed the Damages (Asbestos-related Conditions)(Scotland) Bill, which allows people in Scotland with certain asbestos related conditions including pleural plaques who were negligently exposed to asbestos to sue for compensation. The purpose of this bill is 'to ensure that the House of Lords Judgment, which ruled that 'asymptomatic pleural plaques...do not give rise to a cause of action under the law of damages' does not have effect in Scotland. People with pleural plaques, asymptomatic pleural thickening and asymptomatic asbestosis 'caused by negligent exposure' to asbestos will now be able to raise an action for damages.
The provisions of the Bill take effect from the date of the House of Lords Judgment in Johnston v NEI International Combustion Ltd (i.e. 17th October 2007). People whose cases have not been settled or determined by a court before the date when the Bill comes into force will be covered by its provisions.
A scientific paper has recently been published in the 'Environmental Health' journal describing the relationship between plaques and asbestos exposure5. This research suggests that average exposure level and time since first exposure (but not exposure duration) are the key variables that predict the prevalence of plaques. This study also shows that fifty years after first exposure to asbestos the predicted prevalence of plaques for a population with moderate exposure (1 fibre/ml) is about 60%.
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