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What are pleural plaques?

Pleural plaques are benign localised patches of scar tissue that grow on the pleural lining in the chest. The pleura is a thin membrane that lines both the ribcage and the lungs. Plaques usually develop on the ribcage lining, rather than the lungs. Pleural plaques sometimes develop on the diaphragm too.  They can sometimes calcify, but they don’t generally have much effect on lung function.

 

What causes pleural plaques?

Pleural plaques are caused by inhaling asbestos fibres into the lungs, where they are embed in the lung lining and cause fibrous scar tissue to form and harden. It’s not known exactly how this embedding of asbestos fibres cause the formation of pleural plaques.

 

How do I know if I have pleural plaques?

You may not know! They usually have no symptoms and may only be discovered during a routine x-ray or CT scan that you may be having for different reasons. They do not generally have any effect on quality of life. However, if you know that you have been exposed in the past to asbestos, then it’s best to tell your doctor about your exposure and have regular tests for reduced lung function, while keeping an eye on any lung-related symptoms.

 

What are the symptoms of pleural plaques?

There aren’t really any, and the condition doesn’t worsen. If you do experience symptoms such as a grating feeling or breathlessness, then see your doctor as these are probably not caused by the plaques, and could be an indicator of another condition that needs treating. Patients are advised to visit their doctor with respiratory symptoms like this, regardless of their history of asbestos exposure.

 

How are pleural plaques diagnosed?

As there are rarely symptoms, pleural plaques can go undetected for decades, only to be found by chance during routine medical tests. They’ll show up in a chest x-ray as a holly leaf shape, usually with thickened edges. They’re easier to spot on an x-ray if they’re in a certain position and they’re calcified. A CT scan is more popularly used to detect them, since it can find plaques regardless of their location in the chest, and before they have calcified.

 

Is there a national compensation payment scheme open for pleural plaques?

Not for pleural plaques alone, since they are benign and don’t cause the severe health problems associated with more complex asbestos-related conditions such as diffuse pleural thickening, lung cancer, asbestosis or mesothelioma.

However, if you have been exposed to asbestos, and you develop certain conditions such as diffuse mesothelioma, you may be able to make a claim for these under the Diffuse Mesothelioma Payment Scheme (DMPS), the 2008 Diffuse Mesothelioma Scheme, or the Pneumoconiosis etc (Workers’ Compensation) Act 1979.  The eligible conditions in the Pneumoconiosis etc (Workers’ Compensation) Act include asbestosis, silicosis and kaolinosis.

 

Can I get benefits payments for pleural plaques under the Industrial Injuries Disablement Benefit?

No, not for pleural plaques. You can view the complete list of prescribed diseases covered by the Industrial Injuries Disablement Benefit here. However, if you do suffer symptoms brought on by pleural plaques, you may be able to make a personal injury compensation claim.

 

How do I make a compensation claim for pleural plaques in England and Wales?

Read our guides to industrial disease compensation claims here:

In England and Wales, you can only make a compensation claim for pleural plaques if you actually experience symptoms, which is very rare, or you also have other asbestos-related conditions. This is because the House of Lords ruled in 2007 that asymptomatic pleural plaques alone did not give rise to damages that are actionable or compensable, nor can a compensation claim be brought for the anxiety of being diagnosed with pleural plaques.

Pleural plaques are mostly without symptoms (asymptomatic) so making a claim for symptomatic pleural plaques, without other conditions, is quite a rare occurrence in England and Wales.  It’s very important to take legal advice if you have pleural plaques and you experience symptoms, as they may actually be indicators of more serious asbestos-related conditions.

Northern Ireland and Scotland have different legal situations. In Northern Ireland, the House of Lords’ 2007 decision was overturned by the Damages (Asbestos-related Conditions) Act (Northern Ireland) 2011, which provides that asbestos-related asymptomatic pleural plaques constitute a personal injury, for which compensation can be claimed for.

In Scotland, the Lords’ decision was not binding, but the Damages (Asbestos-related Conditions) Act was passed in 2009 by the Scottish Parliament to ensure it did not affect cases in Scotland. This means that since that date, people in Scotland can bring compensation claims for asbestos-related pleural plaques, even if they have no symptoms.

If you were exposed to asbestos in Scotland, whether working for an English or Scottish employer, you may also still be able to make a claim for personal injury.

 

What about time limits?

Typically, compensation claims must also be started within three years of diagnosis, or the date of your ‘knowledge’ that something may be amiss.  This is why it’s so important that, if you know you have been exposed to asbestos in the past, to report any lung or breathing symptoms to your doctor as soon as you start experiencing them. Otherwise, the clock for the three-year limit may start running. You can read more about time limits for occupational disease claims here.

 

What is the difference between pleural plaques and diffuse pleural thickening?

 

Pleural plaques Diffuse pleural thickening
What are they? Firm lesions of scar tissue, which are sometimes calcified. Extensive scarring that thickens the lining of the lungs, restricting lung function.
Where do they occur? In discrete patches on the lining of the rib cage: the parietal pleura. Sometimes on the diaphragm, and they can also develop on the visceral pleura lining the lungs. Usually in the lining of the lungs: the visceral layer of the pleura.
When do they occur? After exposure to asbestos and tend to appear between 5-30 years post exposure. After exposure to asbestos – symptoms take between 5-30 years to show. Often after experiencing an excessive fluid build up in the pleural cavity – called diffuse pleural effusion.
Do they cause lung impairment? Not usually, and it will be minimal. Some patients may experience minor breathlessness or slightly reduced lung function. Yes: the scarring is more extensive. As scar tissue grows, it can begin to close off the space between the lung and the rib cage, causing chest pain and breathlessness.

 

How are pleural plaques treated?

They don’t require any treatment, as they don’t usually cause any symptoms. However, with any lung-related condition, quitting smoking can help to prevent further lung damage.

 

Will I develop mesothelioma or lung cancer if I have pleural plaques?

Not as a direct result of having pleural plaques. Pleural plaques are benign and non-cancerous, and they can’t turn cancerous. However, pleural plaques develop because of asbestos exposure – and that exposure could be a factor in whether or not you later develop lung cancer or mesothelioma.

 

Will I develop other asbestos-related conditions if I have pleural plaques?

Not necessarily – it does not mean you will automatically develop other asbestos-related conditions just because you have pleural plaques. They are different to asbestosis, and they are not a form of pre-malignant cancer.  However, as pleural plaques are caused by exposure to asbestos, it’s important to note that this exposure could pre-dispose you to developing asbestos-related conditions such as pleural thickening, mesothelioma, or lung cancer.

 

What next?

If you’ve been exposed to asbestos, or have pleural plaques with symptoms, then give us a call on 0114 267 8780 or 0800 163 622, or email us and we’ll help you to get started.

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