In addition to exposures to asbestos that may occur during the production of asbestos products (from mining to manufacturing), common occupational asbestos exposures occur in shipbuilding and other construction trades (e.g., pipefitting, boilermaking) and in the manufacture of safety garments and friction materials (e.g., brake and clutch linings). Along with worker exposure in these areas, bystander exposure (e.g., spouses) can be responsible for some asbestos-related lung diseases.

A range of respiratory diseases has been associated with asbestos exposure. Pleural plaques indicate that asbestos exposure has occurred, but they are typically not symptomatic. Interstitial lung disease, often referred to as asbestosis, is pathologically and radiologically similar to idiopathic pulmonary fibrosis; it is typically accompanied by a restrictive ventilatory defect with reduced diffusing capacity of the lung for carbon monoxide (DLCO) on pulmonary function testing. Asbestosis usually develops at least 10 years after exposure, and no specific therapy is available.

Benign pleural effusions can also occur from asbestos exposure. Lung cancer is clearly associated with asbestos exposure, but does not typically present for at least 15 years after initial exposure. The lung cancer risk increases multiplicatively with cigarette smoking. In addition, mesotheliomas (both pleural and peritoneal) are strongly associated with asbestos exposure, but they are not related to smoking. Relatively brief asbestos exposures may lead to mesotheliomas, which typically do not develop for decades after the initial exposure. Biopsy of pleural tissue, typically by thoracoscopic surgery, is required for diagnosing mesothelioma.