Asbestos, lead, and the family: household risks

Although the intrafamilial transmission of infectious diseases has long been recognized, the induction of environmental disease in household contacts is being increasingly documented and requires a higher index of suspicion. An incidental radiographic finding, such as pleural thickening or calcification, or even interstitial pulmonary fibrosis in a young person without obvious occupational exposure to asbestos, should prompt the physician to clarify the parental occupational history. Likewise, unexpected evidence of lead induced abnormalities, such as elevated blood lead and/or erythrocyte protoporphyrin levels, should focus the examiner's attention on possible intrafamilial transmission, treatment, and prevention.