Which diseases are recognized?

Asbestosis is a lung disease caused by inhaling asbestos fibers. It leads to diffuse fibrosis of the lungs, meaning that lung tissue is gradually damaged. Symptoms, such as shortness of breath, usually appear first during physical activity and can later occur even at rest. Clinically, the disease progresses slowly, and its signs are often nonspecific compared to other types of lung fibrosis.

This disease occurs only in people with heavy asbestos exposure, mainly in occupational settings. In Belgium, such exposure has been greatly reduced since the mid-1980s, thanks to strict regulations protecting workers’ health.

Although the use of asbestos has been completely banned in Belgium since 1998, it was widely used across many sectors before the ban. As a result, the consequences of past exposure continue to appear today.

While cases of asbestosis are now rare, diagnoses are still made, especially in people who were heavily exposed to asbestos before the bans came into effect.

The fact that the effects of past exposure persist explains why this disease is still recognized by the Asbestos Fund today. It also highlights the ongoing need for responsible asbestos management and continued awareness of the health risks associated with asbestos exposure.

Diffuse pleural thickening is a form of fibrosis of the visceral pleura, the membrane that surrounds the lungs. It is not specific to asbestos, especially when it occurs on only one side. Other factors, such as infections or hemothorax, can also cause it.

These thickenings are visible on a chest CT scan and are often associated with changes in the nearby lung tissue, such as rounded atelectasis (partially collapsed areas of the lung). In the most extensive cases, they can lead to moderate reductions in lung function, which may qualify for compensation.

In addition, pleural plaques are thickened areas of the parietal pleura, which are sometimes calcified. They are common in people exposed to asbestos but are generally asymptomatic and usually do not lead to other asbestos-related diseases. They are often discovered incidentally during imaging conducted for other reasons.

These plaques do not qualify for compensation, either through the Asbestos Fund or via Fedris under the occupational disease system, because they do not cause functional impairment.

Mesothelioma is a rare and highly aggressive malignant tumor that can affect the following tissues:

• the pleura (the lining around the lungs),
• the peritoneum (the lining of the abdominal cavity),
• or, in rarer cases, the pericardium (the lining around the heart).

In industrialized countries, 80% of cases are linked to asbestos exposure, usually in the workplace. Non-occupational exposures are also possible, for example through inhaling fibers brought home on workers’ clothing or by living near factories that produce or use asbestos.

The main symptoms include:

• chest pain,
• shortness of breath,
• abdominal pain,
• weight loss, or a general decline in health,
• sometimes a pleural effusion (fluid buildup around the lungs).

The latency period between exposure and disease onset can be up to 40 years, which makes early detection difficult. Unfortunately, mesothelioma often leads to death shortly after diagnosis. Even after the asbestos ban, new cases continue to occur.

Lung cancer includes all primary malignant tumors of the lungs. Smoking remains the main cause of this type of cancer. However, when someone smokes and is also exposed to asbestos, the risk increases dramatically.

For example,

• if asbestos doubles the risk (×2)
• and smoking multiplies it by 20,
• the combined risk becomes 40 times higher.

Inhaled asbestos fibers can accumulate in the lungs, irritate tissue for years, and alter cell division, which can promote tumor development.

The link between asbestos exposure and laryngeal cancer is less clear than for lung cancer. Smoking and alcohol consumption remain more significant risk factors.

However, compensation is possible if the individual can demonstrate substantial asbestos exposure, equivalent to at least 25 fiber-years, regardless of other risk factors.

A fiber-year is a standardized unit, primarily used in epidemiological studies and medical assessments to quantify occupational asbestos exposure.

Asbestos-related ovarian cancer is rare, with approximately 700 cases per year in Belgium, and the average age at diagnosis is 65 years. Over the past twenty years, the incidence of this cancer has gradually declined.

Most ovarian cancers are epithelial tumors (adenocarcinomas). They are often asymptomatic in the early stages and later present with nonspecific signs, such as weight loss or loss of appetite.

Treatment usually involves surgery combined with chemotherapy.

The causal link between asbestos exposure and this cancer is well documented. In Belgium, it primarily concerns women who worked in the 1970s in factories producing asbestos ropes or fireproof textile products.

The risk applies only in cases of significant exposure, defined as approximately 10 years of full-time work. A list of high-risk occupations and situations is included in the criteria established by Fedris.

The presence of asbestos fibers in tumor tissue is not a criterion for recognizing this cancer as an occupational disease.