Pulmonary and pleural lesions related to asbestos exposure appear to be at present, among the most frequent and, consequently, most important occupational diseases. They are collectively named "asbestosis" but the term, in use for nearly 60 years, usually denotes the pulmonary lesion, ie, fibrosis within the lungs (pneumoconiosis). It was coined long before anybody had any idea of the kind, extent, and significance of pleural involvement in this form of pneumoconiosis. In the past two decades however, it has become evident that the pleural lesion, often presumably a consequence of a mild exposure, has been far more frequent and, therefore, even more important, particularly because it may appear earlier, thus giving some (if any) chance for the prevention of malignant complications. It could also be expected that the incidence of pleural lesions would continue to increase in the future, because of still-present, although less heavy, asbestos exposure in modern industry and also because of more accurate modern techniques for its visualization (oblique views, computerized tomography).
Nevertheless, in spite of their unequivocal importance, asbestos-induced pleural changes have not as yet been properly named. This is by no means a mere terminological failure of more-or-less academic interest; it may pose some very practical difficulties in the legal certification of an obvious and typical occupational disease.
During our recent endeavours to establish diagnostic and legal criteria for the asbestosis certification in Yugoslavia, we have proposed [BeritiC et al, 19841 that the term "asbestosis" should be used to denote only the kind, not the site, of the pathological process (such as eg , "tuberculosis," "atherosclerosis, " "collagenosis ," "amyloidosis," etc). We have noted that pleural changes caused by asbestos are apparently an independent pleural disease, not a mere "sign of exposure," or even less so, a complication of pulmonary asbestosis. If asbestosis were regarded as a process, then there would be no valid reason why the term "pleural asbestosis" or asbestosis pleurae would not be accepted and applied to asbestos-induced pleural changes.