This review shows that long-term exposure to asbestos-containing dust leads not only to a reduction of lung volume as well as to limitations of forced expiratory flows, such as FEF (50) and FEF (75), but also to increased frequencies of FEV (1)/FVC, and elevated airway resistance. There is evidence for significant dose-response relationships and an increase in functional changes in parallel to an increase due to the latency period. Remarkably, even asbestos workers without radiologically detectable pleural or parenchymal changes already show these functional impairments. In non-smokers, asbestos-induced lung function impairment is usually small on average, although some of these subjects show functional impairment of clinical relevance in the pathological range. In asbestos workers who also smoke, due to synergistic effects, lung function, especially of the peripheral airways, is highly significantly reduced. The use of inappropriate reference values, healthy worker effects, and airway trapping lead to an underestimation of asbestos-induced lung function impairments. There are no differences among the various occupations associated with asbestos exposure.
