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Pulmonary Fibrosis Foundation YouTube Channel

Pulmonary Fibrosis Foundation YouTube Channel

How Toxic Environmental Exposure Can Lead to Interstitial Lung Disease

How Toxic Environmental Exposure Can Lead to Interstitial Lung Disease

What are known environmental links to interstitial lung disease and how can you protect yourself? A lecture at the 2019 PFF Summit provides vital information.


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Occupational lung diseases are lung conditions caused by toxic materials an individual has been exposed to in the workplace. In addition to interstitial lung disease (ILD), they include a broad group of pulmonary diseases. 

In patients with ILD, the interstitium, or the tissue and space around the alveoli (air sacs of the lungs), is affected. The wall of tissue becomes scarred and thickened from breathing in harmful substances.

In a 30-minute video conference recorded at the Pulmonary Fibrosis Foundation’s 2019 Summit, Yale School of Medicine’s Mridu Gulati, M.D. presented an overview of environmental links to ILD, explaining how exposure to harmful substances may cause interstitial lung disease.*

Presentation highlights

  • ILD can be subdivided into two groups:
    • Group 1– The disease has a known cause. For instance, ILD may develop as a result of inorganic exposure, organic exposure, or smoking.
    • Group 2 – The cause of the disease is unknown (termed “idiopathic” lung diseases).
  • Diseases belonging to the first group may be caused by breathing inorganic (mineral) dust, such as asbestos, silica, or coal mining dust. Less common causes include inhalation of aluminum, antimony, barium, graphite, iron, etc. Other ILDs are associated with organic proteins in the environment, such as proteins related to farming, birds, molds, etc. Smoking has been identified as a cause of particular ILDs, as well. The focus of this talk was on occupational lung disease.
  • There is an alarming rise in coal worker’s lung diseases, which may result in progressive massive fibrosis, particularly in Central Appalachia. This increase may be explained by exposures of these workers to multiple harmful agents. Coal mining dust, in addition to carbon, contains silica methane, carbon monoxide, bioaerosols, and diesel exhaust.
  • A typical feature of these lung diseases is a long latency between exposure to a harmful substance and the first symptoms of the disease. The absence of acute symptoms also frequently occurs. Necessary preventive measures include continued surveillance and workplace protection.
  • One of the most widespread and well-known occupational lung diseases is asbestosis. While it is still used in some industries, commercial asbestos use has significantly declined in recent years. Due to its limitation and protective measures, deaths from asbestos declined from 39,784 in 1968 to 1,196 in 2015.
  • Another occupational lung disease is silicosis. Breathing in crystalline silica dust may cause silicosis, which is associated with inflammation and scarring, and the formation of silica-based nodular lesions in the upper lobes of the lungs.
  • A report by the US Centers for Disease Control and Prevention (CDC) in September of 2019 discussed the outbreak of silicosis among 18 stone fabrication workers in contact with silica-containing composite material. The CDC has also reported cases of silicosis in Virginia among dentists and dental technicians working with amalgams.
  • Several protective measures can reduce ILD frequency, including limiting time of exposure, using local exhaust ventilation or water spray, and wearing personal protective equipment.

*Gulati, M. (2020, January 17). Environmental links to ILD. Pulmonary Fibrosis Foundation (PFF) Summit 2019 [Video file]. Retrieved from https://www.youtube.com/watch?v=lN16G7fkV9M

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