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Interstitial lung disease causes inflammation and scarring. Some diseases, medications and environmental factors, such as inhaling asbestos fibers or certain dusts, can contribute to it. There is a clear link between asbestos exposure and asbestosis or interstitial pneumonitis, a form of ILD.
Written by Karen Selby, RN | Medically Reviewed By Dr. Rupesh Kotecha | Edited By Walter Pacheco | Last Update: November 6, 2024
Interstitial lung disease is an umbrella term for approximately 200 different relatively rare lung diseases that cause lung inflammation or scarring. Some ILD types only cause scarring (fibrosis), some only cause inflammation and others can cause both.
In instances where a patient has inflammation without scarring, early treatment may prevent scarring. The inflammation and scarring affect the interstitial lining that supports the lung’s alveoli. This decreases lung function as thickened tissue can’t supply oxygen to the blood as effectively as healthy lung tissue.
Environmental factors, some health conditions, medications and genetic predisposition can contribute to the development of this disease. Asbestosis, for example, is an ILD linked to asbestos exposure. As the body tries to expel inhaled asbestos fibers, inflammation and scarring can occur. It’s a progressive disease that continues to worsen over time.
ILDs are typically grouped into broad categories related to their cause. These include exposure to irritants, some types of medical treatment, autoimmune disorders and smoking.
The causes of some ILD cases can’t easily be identified. These are often classified as idiopathic pulmonary fibrosis. Idiopathic means the disease was spontaneous or the cause is unknown.
Types of ILDs
Autoimmune disorders contributing to ILD include lupus, polymyositis or dermatomyositis, rheumatoid arthritis and scleroderma. Potential exposure risks include asbestos, silica dust and cotton dust. Medical treatments that may cause lung inflammation and scarring include chemotherapy, radiation and certain medicines.
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Many of the different forms of ILD display similar symptoms associated with decreased lung function. They typically appear after scarring develops, meaning that irreversible damage has already occurred.
Symptoms of asbestosis can easily be mistaken for signs of other lung conditions, such as COPD or asthma. Many ILD symptoms worsen with exertion.
Interstitial Lung Disease Symptoms
Latency periods vary among different forms of interstitial lung disease. The onset of symptoms can take from months to years depending on the disease progression. Some ILDs have a long latency period, so symptoms may not appear right away, while others advance more rapidly.
It can take 20 to 30 years for asbestosis symptoms to develop, and some patients don’t exhibit symptoms at all. Many patients don’t know they have the condition until lung damage becomes significant many years after exposure.
Patients with ILD can experience several potentially serious complications. Many of them are the result of decreased lung function and how that affects the body. They include accumulations of fluids and calcium deposits in the lining of the lungs, high blood pressure within the lungs and increased risk of infection and certain types of cancer.
Lung cancer is a particular concern among patients with asbestosis who are also smokers. Quitting smoking can reduce your chances of developing cancer and improve overall lung function.
Additionally, acute exacerbation is a serious concern. This sudden worsening of respiratory symptoms affects a large number of patients with ILD and can occur at any time. For many patients, it can be what ultimately leads to a diagnosis.
Navy veteran Jerry Cochran was diagnosed 50 years ago with sarcoidosis. The more he read about it, the more concerned he was that his symptoms just didn’t match up. In 1991, he was given a new diagnosis – silicosis – from inhaling silica dust while scraping paint on the USS Independence. He was also later diagnosed with asbestosis, an asbestos-related interstitial lung disease.
Doctors use chest X-rays, CT scans and pulmonary function tests to diagnose interstitial lung diseases. The similarity of symptoms between ILDs and other lung conditions can make getting a diagnosis difficult. Comprehensive testing can help rule out other conditions, so doctors can make a proper diagnosis.
In some cases, a lung biopsy may be necessary. Tissue collected can show the condition of lung tissue and may detect the presence of other lung conditions, such as cancer. Doctors collect samples using a bronchoscopy, bronchoalveolar lavage or surgical biopsy.
ILD and asbestosis treatment focuses on relieving symptoms, reducing complications and slowing further scarring of the lungs. Oxygen can help address shortness of breath from existing damage. Other medications, including corticosteroids, anti-fibrotics and tyrosine kinase inhibitors, may help relieve some symptoms and slow disease progression.
Asbestosis is a type of pulmonary fibrosis. A large amount of scarring in the lungs characterizes the condition. It’s treated symptomatically, which means there are options to reduce the amount of symptoms a patient has such as breathing treatments, oxygen or pain management.
More intensive interventions include draining fluid from the lungs and respiratory therapy. In the latter, a trained therapist teaches patients breathing exercises to improve lung function. In rare cases, a lung transplant may be necessary, but this isn’t a common treatment for asbestosis.
The prognosis after an ILD diagnosis varies tremendously according to disease type. General physical condition and certain lifestyle factors, such as smoking, can impact disease progression. Smokers exposed to asbestos have a high likelihood of developing ILD.
With asbestosis, patient prognosis often depends on the length and severity of asbestos exposure. Individuals may live full lives for many years after a diagnosis.
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Asbestos.com. (2024, November 6). Interstitial Lung Disease & Asbestos. Retrieved November 22, 2024, from https://www.asbestos.com/mesothelioma/interstitial-lung-disease/
"Interstitial Lung Disease & Asbestos." Asbestos.com, 6 Nov 2024, https://www.asbestos.com/mesothelioma/interstitial-lung-disease/.
Asbestos.com. "Interstitial Lung Disease & Asbestos." Last modified November 6, 2024. https://www.asbestos.com/mesothelioma/interstitial-lung-disease/.
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Dr. Rupesh Kotecha is a renowned radiation oncologist in leadership roles at Miami Cancer Institute. He is an associate professor at Florida International University's college of medicine and an adjunct faculty member at Memorial Sloan Kettering.
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