Canadian Association of University Teachers

 
Home > Issues & Campaigns > Asbestos > Sample Letter

Issues & Campaigns

Sample Letter

Date_______________


Dear Doctor _______________________,


Re: Possible exposure to Asbestos

I have worked in an environment where asbestos products were used. I may have been exposed to asbestos, and may be exhibiting symptoms of an asbestos-related disease.

It is vital that I be properly assessed and tested to establish whether I may have one of the following asbestos-related diseases, so that I can be medically treated, and have the proper documentation for any potential Workers' Compensation Claim:

 

  • Asbestosis – a diffuse pulmonary fibrosis which develops over long periods of exposure. It is irreversible and progressive, with a latency period of over 10 years. Linked to heavy occupational exposure, it is also found among those not known to have been occupationally exposed.
  • Mesothelioma – a formerly rare, but increasingly common cancer of the lung or abdominal cavity, which begins in the pleural cells. The only known cause is exposure to asbestos. The latency period can be between 15 - 50 years. There is no known cure.
  • Pleural Plaques – not all workers exposed to asbestos get pleural plaques, but pleural plaques are always associated with asbestos exposure, and are an early warning sign to the development of asbestos-related diseases. They are detectable by x-ray, but must achieve a certain density to be visible.

    For your convenience, "Recommendations for Examination of Asbestos-Related Disease" is attached. This was produced by physicians for physicians through the Occupational Health Clinics for Ontario Workers (OHCOW).

    For further information, please contact a physician at OHCOW at info@ohcow.on.ca or call (416) 443-6323/1-877-817-0336 (Ontario only).

    Yours truly,

     

    (name)
    (address)



    Recommendations for Examination of Asbestos-Related Disease

    Asbestos has been used extensively in insulation, as a fire-retardant, noise barrier, and a component of brakes, and the manufacturing of cement pipes and thermal wrap for pipes.

    Asbestos inhalation can cause pulmonary fibrosis (asbestosis), pleural thickening including pleural effusion. Asbestos dust exposure can also cause lung cancer and malignant mesothelioma of the pleura and peritoneum. Exposures of high concentrations have also been related to cancers of gastro intestinal tract, kidney, pancreas and larynx.

    1. Occupational History

    The past work history of a person from the earlier state to the current date should be noted together with the possibility of asbestos exposure. If there is asbestos exposure, inquire if there was an asbestos program and whether asbestos dust levels were measured. Also inquire about personal protective equipment used by the worker at the time of exposure. The worker may also provide information regarding the types of ventilation available at the workplace.

    2. Medical History

    Symptoms of asbestosis consist of gradual onset of shortness of breath on exertion and it progresses over time. There may be a dry cough or one where there is production of a small amount of clear sputum. There may be an aching chest pain.

    3. Family History

    There should be inquiries regarding lung cancer and lung fibrosis. There may also be the possibility of exposure from asbestos dust brought home from the workplace by a member of the household.

    4. Smoking History

    The person's number of pack years should be estimated, together with the time that the person quit smoking. The possibility of passive smoking should also be noted. Pipe and cigar smoking, together with use of smokeless tobacco, should also be noted.

    5. Physical Examination

    Attention should be paid to the respiratory, cardiovascular and the gastrointestinal system. The presence of tachypnea and respiratory distress at rest should be noted. Check the neck for cervical adenopathy. Inspiratory basilar rales that persist after cough is typical in asbestosis. Clubbing of the fingers, indicating chronic respiratory problem, should be noted.

    6. Investigations

    Chest x-ray – PA and lateral views should be obtained. Right and left anterior oblique views may define the costal pleural abnormalities. High resolution CT scan can detect the presence of pleural thickening as well as fibrosis. Pulmonary function testing should include forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and FEV/FVC and the forced expiratory rate at mid-expiration (FEF 25-75) should be done. A low diffusion, as indicated by a low DLCO may indicate fibrosis in the lungs. For patients with severe dyspnea, exercise testing may provide further evaluation of their hypoxemia. Biopsy may be needed for evaluation of mesothelioma and lung cancers.

    References

    Levin SM, Cann PE, Lax MB, Medical Examination for Asbestos Related Disease. American Journal of Industrial Medicine, 2000, vol. 37; pgs 6-22.