The changing patterns of asbestos-related diseases mean clinicians must be vigilant about taking exposure histories from their patients, experts advise.

Writing in an editorial published in this week’s MJA Professor Bill Musk a respiratory physician from Sir Charles Gairdner Hospital in Perth and colleagues said rates of malignant mesothelioma (MM) have levelled off in Australia, at around 50 per million per annum in men and tenfold less in women.

However the pattern of exposure of patients with MM was changing and increasingly, people were presenting with MM arising solely from domestic exposure.

“Asbestosis also remains a problem because it cannot be distinguished on clinical or pathological grounds from diffuse interstitial pulmonary fibrosis of other or unknown cause, other than on the basis of evidence (historical, radiological or pathological) of asbestos exposure.

“As exposure to asbestos in the community declines, it will be increasingly unlikely that clinicians will be mindful of the condition and diligent in taking an asbestos exposure history.”