Update der AWMF-S2k-Leitlinie Diagnostik und Begutachtung asbestbedingter Erkrankungen

Update of the AWMF S2k guideline “Diagnostics and Assessment of Occupational Asbestos-related Diseases” – What’s new? The S2k guideline “Diagnostics and Assessment of Occupational Asbestos-related Diseases” was updated in November 2020. This article summarises the most important changes. There is a new reference to the risk of potentially high exposures to asbestos fibres when renovating plaster, fillers and adhesives containing asbestos. Biomarkers such as mesothelin and calretinin should currently only be used in the context of research. “Asbestos airways disease”, which can only be diagnosed histologically, is included in the guideline as an early form of asbestosis. Since the UIP („usual interstitial pneumonia“) pattern is not characteristic of asbestosis, computed tomography cases with UIP patterns alone cannot be assigned reliably to asbestosis without the simultaneous detection of pleural plaques. With regard to the evaluation of functional damage, attention is drawn to the importance of flow volume curve, wholebody plethysmography, diffusion capacity and exercise testing. If available, the reference values according to the Global Lung Initiative (GLI) are the basis of assessment. The guideline contains specific recommendations on prevention, medical treatment and, for the first time, the importance of outpatient rehabilitation and training therapy. There are also references to the assessment of the new occupational disease ovarian cancer after occupational exposure to asbestos. Keywords: occupational asbestos-related diseases – guideline – asbestos airways disease – asbestosis