A Case Report of Occupational Asbestos-Related Benign Pleural Disease in Tile Factory in Thailand

Abstract

Asbestos exposure is a significant risk factor for both benign and malignant asbestos-related lung diseases. Among these, asbestos-related benign pleural disease can result in permanent impairment of pulmonary function. Workers involved in handling asbestos-containing materials are at particular risk for such diseases. Despite this, Thailand continues to import and use asbestos in various industries, posing an ongoing public health challenge. This case report describes an 81-year-old male who presented with progressively worsening shortness of breath over one month. Chest x-ray demonstrated right pleural effusion. Thoracocentesis was performed and revealed lymphocytic predominant exudative pleural effusion. Cytologic study did not demonstrate evidence of malignancy. CT scan of the chest revealed right pleural effusion with pleural thickening along parietal pleural. Calcified pleural plaque at diaphragmatic pleura was also identified. The patient underwent pleuroscopy and pleural biopsy revealed no evidence of malignancy, including malignant mesothelioma. He had a history of a 35-year career as a factory worker producing asbestos-containing tiles, during which the patient was frequently exposed to high levels of asbestos without personal protective equipment. The patient reported no history of non-occupational or environmental exposure to asbestos. Based on these findings, the diagnosis of asbestos-related benign pleural disease was confirmed. This case may underscore underreporting of asbestos-related lung diseases, particularly due to inadequate occupational history taking. There may be many patients with similar backgrounds from asbestos tile factories who have developed asbestos-related lung diseases, both benign and malignant. Therefore, it is essential to implement disease prevention measures and medical surveillance programs for workers with occupational asbestos exposure.