Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through

Our plain-English summary of Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through, by R. Bu, L. Puttagunta, K. Halloran, et al (Respirology Case Reports, 2025).

The study

• Authors: R. Bu, L. Puttagunta, K. Halloran, J.G. Weinkauf, D.C. Lien, B. Laing, E. Leung, D. Helmersen, M.V. Thakrar, A. Hirji
• Journal: Respirology Case Reports
• Published: 2025;13(7):e70283
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Asbestosis is a form of fibrotic interstitial lung disease caused by the inhalation of excessive asbestos fibres. We describe a patient who developed asbestosis due to occupational exposures while working as a hairdresser in the 1970s and 1980s. Not appreciating this profession as a risk factor for developing asbestosis led to several treatment strategies that were ineffective and eventually led to the need for lung transplantation. More recent changes to governmental policy have effectively reduced the incidence of such an exposure risk; however, given the long latency of the disease, we emphasise that a broad occupational history including potential historic exposures remains an important component of the assessment of interstitial lung disease. We also outline many reasons for a second wave of asbestosis-related lung disease that is only now emerging and encourage clinicians to continue to maintain asbestosis on the differential for working up undifferentiated fibrotic lung disease.

© 2025 The Author(s). Respirology Case Reports published by John Wiley & Sons Australia, Ltd on behalf of The Asian Pacific Society of Respirology.

In plain English

This case report described one patient, a man who had worked as a hairdresser in Canada and the United States for 30 years from the early 1980s. In 2018, at age 60, he was referred to a respirology clinic with worsening breathlessness on exertion. A chest X-ray showed widespread lung disease, although one taken a decade earlier had been normal. CT scanning showed a usual interstitial pneumonia pattern and calcified pleural plaques. At first no reliable asbestos exposure history was found, and his job was not linked to asbestos. Steroid treatment was followed by worsening symptoms. He was diagnosed with idiopathic pulmonary fibrosis and then had a double lung transplant. Examination of the removed lungs showed end stage asbestosis with asbestos bodies. After the transplant, questioning revealed frequent use of hair dryers made in the 1970s and 1980s, which the authors, citing earlier reports, said often contained asbestos. He had also used talcum powder with possible asbestos contamination. He later received Workers' Compensation Board funding. The authors concluded that hairdressers should be recognised as a group at higher risk of asbestos exposure in historic periods.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One previously healthy 60-year-old male hairdresser who worked in Canada and the United States for 30 years from the early 1980s, referred to a respirology clinic in 2018
• Exposure: Frequent use of handheld and hooded hair dryers manufactured in the 1970s and 1980s, during the first decade of his career, and talcum powder with possible asbestos contamination. The authors described these as likely contributors. No fiber type is named.
• Main results:
  • A chest radiograph from a decade before referral was normal.
  • High-resolution CT showed a usual interstitial pneumonia pattern and bilateral calcified pleural plaques.
  • Pulmonary function testing showed moderate restriction and decreased diffusion capacity.
  • The patient was treated with glucocorticoids, and his symptoms worsened over the next 6 months.
  • He was diagnosed with idiopathic pulmonary fibrosis (IPF) and later underwent double lung transplantation.
  • Examination of the explanted lungs showed end stage asbestosis, with chronic interstitial fibrosis and asbestos bodies.
  • After transplantation, the patient obtained retroactive funding through the Workers' Compensation Board for disease acquired from occupational exposure.
• The authors' conclusion: The authors described this as, to their knowledge, the first documented case of asbestosis acquired with exposures as a hairdresser. They said that without a detailed exposure history, asbestosis may be misdiagnosed as IPF. They concluded that the case underscores the importance of recognising hairdressers as an occupational group at higher risk of asbestos exposure during historic periods.

Topics

Medical terms in this study, explained in our Lexicon: Lung Transplant, Occupational Exposure, Interstitial Lung Disease, Latency, Occupational History.

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• Reply to 'Letter to the Editor: "Asbestosis Requiring Lung Transplantation in a Retired Hairdresser: An Occupational Exposure to Comb Through"' — R. Bu, L. Puttagunta, et al. (2025)
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