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An epidemic of asbestos related lung (ARLD) disease stares the developed countries in the face. However, these countries have lately banned the use of asbestos. Nevertheless, Western countries have no qualms of selling asbestos to poor countries that have no credible health safety regulations in the work place. Epidemiologic studies predicted a decline in incidence of ARLD in the US after the year 2000, with a peak incidence in the UK in 2020. Lung cancer (LC) develops in up to 25% of asbestos workers. In exposed nonsmokers, there is 5-fold increase. In exposed individuals, smoking further increases the risk of bronchogenic carcinoma by 80-90-fold. However the silent killer, asbestos is still active in developing countries and is likely to remains so in decades to come. In the Middle East, immigrant workers still work in asbestos environment. Saudi Arabia is the only major country in the Middle East that has banned asbestos, but workers continue to be at risk due to maintenance work on buildings built before the ban. As asbestos related lung disease remains silent in many and has a long latent period, the only way of detecting these diseases early is by diligence being aware of the patient’s occupational history and affective imaging. Presently there is no credible screening for ARLD. Here we review imaging studies in ARLD to increase awareness of this potentially lethal disease. Whereas diagnosis of ARLD is a matter for compensation in the developed countries it is a matter of survival in the developing world where industrialization has just begun and may take decades to remove the threat of asbestos. In this review we will discuss the clinical, radiologic, and pathologic features of ARLD.
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