It’s been decades since the U.S. government started banning asbestos products and uses, yet doctors are still treating patients with asbestos-related lung disease.

Asbestos is a material that was frequently used in insulation, flooring, fireproofing and other building applications. Shipyard, power plant and industrial workers likely were exposed to asbestos. It’s still used with more safety regulations in some products today, like brake pads and fire-resistant clothing. Older homes may have been built with asbestos-based pipes, insulation, flooring and ceiling tiles.

Amount of exposure matters. People who worked around asbestos every day are at greater risk for health problems, but people who have asbestos in their homes should watch for signs it’s breaking down and flaking.

Asbestos is made of rod-shaped fibers small enough to breathe in. The fibers get deep into the small airways and penetrate the alveoli (tiny sacs that exchange oxygen and carbon dioxide between the lungs and the blood stream) and lining of the lungs.

“Fibers sit in the lungs for 20 to 30 years before you start to notice the effects,” said Dr. Edward Ebert, a Marshfield Clinic pulmonologist.

Asbestos fibers cause inflammation

Inflammation caused by asbestos fibers leads to scarring in the lungs, called asbestosis. It’s a progressive disease that continues to develop over decades, even after asbestos exposure has ended.

The first and often the only sign is shortness of breath with activity that never caused problems before,” Ebert said.

Asbestosis can’t be cured and the scarring process can’t be stopped. Treatment focuses on making breathing easier.

Pleural effusions, or fluid in the space around the lungs, can form when asbestos fibers penetrate the lining of the lungs. The lining also can thicken, forming pleural plaques. Pleural effusions can be treated, but plaques don’t go away.

Cancer is the most serious consequence

Mesothelioma is a type of cancer only associated with asbestos exposure. It’s difficult to treat because it doesn’t involve a contained mass. Instead, it spreads along the lining of the lungs, heart and abdomen and can eventually encase the lungs like a rind.

Asbestos exposure also can cause small cell and non-small cell lung cancers.

The first signs of lung cancer may include shortness of breath and coughing up blood. Lung cancer often doesn’t cause symptoms until it’s advanced.

“There are lung cancer screening recommendations in place based on tobacco use but none based solely on asbestos exposure,” Ebert said. “Your doctor may want you to get a chest X-ray if you have a prominent history of asbestos exposure.”

Smoking makes matters worse

“Complications from asbestos exposure can be more pronounced in smokers,” Ebert said.

Smoking decreases the lungs’ natural ability to clear asbestos fibers, so people who smoke are more likely to have fibers in their lungs causing problems decades after exposure. Smoking also increases risk of small cell and non-small cell lung cancers.

If you’ve been exposed to asbestos in your job or your home, talk to your primary care provider and get regular checkups.