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New research confirms that sleep disturbances are linked to pain and depression, but not disability, among patients with osteoarthritis (OA).  Results from a new study found that poor sleep increases depression and disability, but does not worsen pain over time.

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Older women with disordered breathing during sleep were found to be at greater risk of decline in the ability to perform daily activities, such as grocery shopping and meal preparation, according to a new study led by researchers at the Johns Hopkins Bloomberg School of Public Health and the University of California, San Francisco.

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People with moderate to severe obstructive sleep apnoea may have an intrinsic inability to burn high amounts of oxygen during strenuous aerobic exercise, according to a new study led by researchers at University of California, San Diego School of Medicine.

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This webinar will be a clinical presentation in assessing a child who presents with snoring. Snoring is a very common presentation in childhood with some studies suggesting that up to 30% of children will snore at some point in their life. Within those that snore, there will be some who have obstructive sleep apnoea.

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Sleep apnoea may make it hard for you to remember simple things, such as where you parked your car or left your house keys, a small study suggests.

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Researchers believe that disrupted circadian clocks are the reason that shift workers experience higher incidences of type 2 diabetes, obesity and cancer. The body's primary circadian clock, which regulates sleep and eating, is in the brain. But other body tissues also have circadian clocks, including the liver, which regulates blood glucose levels.

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The Wesley Asbestos Research Group

In conjunction with The Wesley Research Institute, the Wesley Asbestos Research Group was officially launched on June 11, 2008. The group was launched with Karen Banton,widow of mesothelioma victim and campaigner Bernie Banton.

Unique in Queensland, the Group seeks to facilitate research and raise awareness of asbestosis and asbestos-related diseases both to the medical fraternity and the general community, with the aims of improving treatment and enhancing the quality of life of those affected.

Currently new research programmes are being developed. If you are affected we would welcome your potential participation in future projects. Referrals will also be accepted by treating medical practitioners.

Wesley Asbestos Research Groupclick here for more information

The History of Asbestos

Asbestos is a mineral which has been known and used for 4,500 years. Centuries before Christ, Finnish peasants mixed it in pottery and sealed cracks in their log huts with it. The ancient Romans wove asbestos fibres into fabrics to make towels, nets and even head coverings for women. In medieval times, Emperor Charlemagne reportedly used an asbestos tablecloth to convince some Barbarian guests that he had supernatural powers - by throwing it into a fire and pulling it out unsinged!

With the advent of the Industrial Age in the 1800's when industry realised its potential uses. Before long, asbestos supported a flourishing global industry.

In the early 1900's, doctors in Europe knew that asbestos workers were dying from respiratory ailments. In 1924, Dr W E Cooke reported in the British Medical Journal cases of pulmonary fibrosis (asbestosis) in workers employed in the asbestos industry. Unfortunately it took many years for this information to be acted on.

Why was Asbestos so useful?

closeup of asbestos fibre

Asbestos is a term applied to some mineral silicates present in a fibre form. There are many members of the family: common among these are blue asbestos (crocidolite), white (chrysolite) and brown or grey asbestos (amosite). Other forms of asbestos include anthophyllite, used mainly in Finland, and tremolite, present in some commercial talcs.

Because of its unique properties - flexibility, tensile strength, insulation (from heat and electricity) and chemical inertness - asbestos is one of the most useful and versatile minerals known to mankind. It is the only natural mineral that can be spun and woven like cotton or wool into useful fibres and fabrics.

How does Asbestos enter the lungs?

Any particle gaining entry to the air passages must by-pass a number of protective mechanisms in order to reach the tiny air sacs or alveoli. These protective systems remove all but a very small number of the very finest inhaled particles, usually less than 10 microns in diameter. Blue asbestos fibres are relatively long and thin and are more likely to reach the alveoli rather than the curlier fibres of white asbestos.

What happens to asbestos within the lungs?

Asbestos fibres reaching the alveoli are handled in different ways by the body. Scavenger cells may entirely engulf a very small fibre and carry it away out of the lung in the sputum or through the draining lymphatic system. Some fibres may also get covered with a yellowish-brown coating composed of iron and protein. These coated fibres are known as 'asbestos bodies'. Other fibres may, however, remain untouched by these mechanisms and can remain in the body over a lifetime with no apparent ill effect. Other fibres can lead to progressive lung damage, which has been highlighted by much media attention in Australia in recent years.

Types of Asbestos-Related Lung Damage

Pleural Plaques

Unrelated to the appearance of any scar tissue within the lung themselves, discrete patches of thickening may appear on the lining of the chest wall and over the diaphragms in the pleural membranes that surround the lungs. It usually takes over fifteen years before they can be seen on a chest x-ray and are better seen on a CT or CAT scan. They usually do not produce any symptoms and do not lead to lung cancer or mesothelioma (see below). They are a marker of previous asbestos exposure.

Benign Asbestos-Related Pleural Effusion

In this condition, fluid called an effusion appears between the lung and the chest wall. Many other diseases, such as cancer and tuberculosis, can also give rise to an effusion, so they all have to be excluded before this diagnosis can be made. Typically, a benign pleural effusion occurs a long time after asbestos exposure but is sometimes seen within ten years of exposure. It can begin with symptoms such as breathlessness and chest pain (called pleurisy) or more commonly without any symptoms at all. It is sometimes associated with pleural plaques, but not always. The amount of fluid is usually small compared with other causes, and it goes away without any treatment. However, in a number of cases, it may recur sometime later.

Diffuse Pleural Thickening

This is different from pleural plaques and affects a bigger area of lung surface. It may result from the presence of pleural effusion. The thickening can be seen on chest x-ray and CT. Although most people don't have any symptoms, a dull chest ache and breathlessness can occur if the thickening becomes extensive.

Asbestosis

With the passage of time, inhaled asbestos fibres if present in very large numbers, can sometimes cause inflammation to occur in the lung tissues leading to scar tissue or fibrosis. This is often called 'interstitial fibrosis'. It causes the lungs to stiffen and it cuts down on the passage of oxygen between the air and the blood. Such reduced size and oxygen movement in the lungs may be measured by pulmonary function testing. On chest x-rays, fibrosis is seen as fine spots and linear shadows, called reticulation.

Asbestosis is usually slowly progressive and does not reverse. It leads to respiratory disability and sometimes death from respiratory failure. Symptoms include shortness of breath, coughing, and bluish skin discoloration called cyanosis, which occurs when the body's oxygen is too low.

Lung Cancer

Lung cancers occur more frequently amongst workers who have been exposed to asbestos of any kind. However, heavily asbestos-exposed workers and those who smoke cigarettes are particularly prone to develop lung cancer. If diagnosed early, such cancers may be totally removed by surgery. Chemotherapy and radiotherapy are also often used in treating lung cancer. Current research is being done to see if there are any links between laryngeal and bowel cancer, and asbestos exposure.

Malignant Mesothelioma

Malignant Pleural Mesothelioma - people exposed to asbestos either within or outside the asbestos industry may, after many years, develop malignant mesothelioma. This cancer occurs in the cells of the pleura covering the surface of the lung and lining the inside of the chest wall and diaphragm. Crocidolite (blue asbestos) has the most potent effect in producing this cancer. This tumour may eventually totally envelope the lung, with a malignant growth sometimes several centimetres thick. The tumour is irreversible, poorly responsive to any current cancer treatments, and often fairly rapidly fatal. It may be accompanied by chest pain, fluid in the chest cavity (pleural effusion) and breathlessness. In rare cases combined surgery and chemotherapy may prolong life. Mesothelioma tumours have no relationship with tobacco smoking.

Peritoneal Mesothelioma

Around the outside of the coils of intestine and also lining the abdominal cavity is a membrane (the peritoneum) similar in character and thickness to the pleura. It is similar tissue to the pleura and, like it, can give rise to a malignant tumour called peritoneal mesothelioma, which is also related to previous asbestos exposure. This disease usually progresses slower then pleural mesothlioma..

What should I do if I have been exposed to Asbestos in the workplace?

Some exposure to asbestos can be quite trivial but with the recent media attention it has elevated the general community's concern. When an asbestos-related problem is first diagnosed, discuss all concerns with your doctor including whether you should seek further information from a thoracic physician.

It may be appropriate to seek advice from your doctor if you are unsure.

For more information on Asbestos exposure and specifically mesothelioma treatment please visit:

Mesothelioma and Asbestos Cancer Resource

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