What are pleural plaques?

Pleural plaques are a type of calcified fibrous tissue that develop on the pleura. They are caused by the inhalation of airborne asbestos fibres.

The pleura is a thin membrane with two layers, that lines the rib cage on one side and the lungs on the other. The pleural cavity (the tiny space between the two layers) is filled with pleural fluid. This allows the two layers of the pleura to slide effortlessly between each other, which they do whenever the lungs expand or contract during breathing.

Sometimes, asbestos fibres inhaled by the patient will penetrate the pleura. This will trigger the body’s natural defence mechanisms in the pleura, leading to swelling and the release of white blood cells. The asbestos fibres, being immensely durable, are able to resist this response. This leads to further swelling and the death of numerous white blood cells. Over time, the continual swelling process leads to scarring; this causes parts of the pleural membrane to calcify. This tissue eventually becomes visible in the form of thickened areas of white fibre on the surface of that membrane, known as pleural plaques. Not all patients exposed to asbestos will develop pleural plaques, for reasons that are not yet clear. It is thought that the immune system response just described occurs differently in certain individuals.

Symptoms and treatment of pleural plaques

Pleural plaques are symptomless in around 99% of cases. In less than 1% of cases, the patient may experience discomfort (in the form of a grating sensation) when they breathe, or a reduction in lung capacity (much lower than would be experienced by patients with asbestosis). This means that the condition is usually only discovered when a chest x-ray, scan or post-mortem examination is carried out for another reason, for example to identify the presence of mesothelioma. As the condition does not give rise to any particular symptoms, it does not give rise to the need for curative treatment.

There is evidence to suggest that people with pleural plaques are at a higher risk of going on to develop lung cancer, mesothelioma or asbestosis. This does not mean that the pleural plaques themselves will develop into a more serious condition as they are in fact benign and harmless and do not themselves develop into other asbestos-related conditions.

It is prudent to monitor the condition of a patient with pleural plaques to ensure that a further asbestos-related illness does not develop over time. Smokers who have been diagnosed with pleural plaques should see their GP for advice on giving up, because the risk of them developing asbestos-related lung cancer will be increased significantly if they continue to smoke.

Compensation for pleural plaques

As this is almost always a symptomless condition, it is not usually possible to get compensation for the occurrence of pleural plaques. The anxiety that is understandably caused to patients with this condition is regrettably not enough under the current law to obtain compensation (unless the anxiety is so severe that it could be described as a serious mental illness). In those rare cases where pleural plaques do lead to physical symptoms amounting to actual damage, it is possible to bring a claim for compensation. The present state of the law in England and Wales results from a House of Lords decision in 2007 (Rothwell v Chemical and Insulating Co Ltd).

The decision reversed the previous law under which compensation was routinely awarded to patients with pleural plaques, and for this reason it has been the subject of extensive campaigning.  In February 2010, the government announced that it would not be reversing the decision of the House of Lords, to much disappointment. It was also announced that a lump sum compensation payment of £5000 would be made to those patients with pleural plaques who had started an asbestos compensation claim prior to the House of Lords decision. This scheme closed on 1st August 2011, leaving pleural plaques sufferers with no route to compensation.

If you have a history of exposure to airborne asbestos and are concerned about your health, you are advised to get in touch with your GP. The asbestos compensation claims department at Humphreys & Co will continue to watch the situation regarding pleural plaques compensation and will announce any future developments on this website. If you would like to find out more about making an asbestos compensation claim, please click here to contact us.