Inhalation of asbestos fibers is one cause of interstitial lung disease, a group of conditions involving scarring of the tissue around the air sacs in the lungs. Asbestosis is an interstitial lung disease caused by asbestos exposure. ILD can only be cured by a lung transplant, but for most patients, treatments focus on slowing the progression of the disease and relieving symptoms.
What Is Interstitial Lung Disease?
Interstitial lung disease is not one specific illness or condition; instead, it is a category of more than 100 lung diseases with various possible causes, though sometimes the cause is never determined.
Because there are so many ILDs, they are generally categorized by association with a certain disease or environmental contaminant.[1] For example, ILD caused by asbestos exposure is called asbestosis. Asbestosis belongs to the exposure category of ILDs.[2]
These are some of the other hundreds of types of ILDs with various causes:
- Silicosis is caused by exposure to silica dust.
- Black lung disease, or pneumoconiosis, results from exposure to coal dust and is common in miners.
- Desquamative interstitial pneumonitis is an inflammatory disease that most often occurs in smokers.
- Sarcoidosis occurs when inflammatory cells clump together in the lungs.
- Idiopathic pulmonary fibrosis is when scar tissue develops in the lungs with no known cause.
All ILDs cause lung tissue scarring that worsens over time. ILDs are specifically characterized by scarring around the alveoli or air sacs of the lungs, also known as the interstitium or interstitial space.
The interstitium is important for the exchange of oxygen and other gases between the lungs and capillaries. As scarring worsens, this exchange becomes increasingly difficult.
What Causes Interstitial Lung Disease?
There are many types of ILD and many causes. Sometimes, the cause of the illnesses is unknown. There are three main causes of ILD:
- Exposure to toxins. Asbestos, silica, animal waste, and dust from grains are just some of the airborne substances that can trigger respiratory damage and scarring.
- Medical conditions. Certain conditions can cause significant lung damage, including rheumatoid arthritis, scleroderma, connective tissue disease, and Sjogren’s syndrome.
- Medications. Some chemotherapy drugs, antibiotics, heart medications, and anti-inflammatory drugs can trigger an ILD.
ILD Caused by Asbestos
Interstitial lung disease caused by exposure may occur when someone inhales airborne contaminants. Possible contaminants include silica, coal dust, farm dust, fumes from welding, and much more.
For someone who has worked around asbestos, inhalation of the fibers may lead to lung scarring that causes asbestosis.[1]
When asbestos fibers enter the lungs, they can become embedded in tissue. Sometimes, this occurs in the pleura and may lead to mesothelioma. These tiny fibers can also travel further into the lungs, causing damage to tissue in the interstitium.
In response to this damage, the body attempts to make repairs, thickening tissue and causing scarring. The scarring is more extensive with greater exposure to asbestos. Unfortunately, even when the contaminant is removed, scarring continues to worsen.
What Are the Symptoms of Interstitial Lung Disease?
While various contaminants may cause an ILD through exposure, they all cause similar symptoms. These symptoms are also similar to other lung conditions, like chronic obstructive pulmonary disease (COPD) and asthma.
Symptoms of ILD include:[3]
- Shortness of breath
- Chest pain
- Coughing
- Fatigue that worsens with exercise or exertion
- Unexplained weight loss
Once symptoms are obvious, the disease has likely progressed so far that it is irreversible.[2]
How Is Interstitial Lung Disease Diagnosed?
Diagnosing an ILD can be tricky because symptoms are similar to other more common conditions, like COPD. If you have been exposed to asbestos, dust, or environmental contaminants, it is important to inform your doctor to receive the most complete diagnosis.
These are the typical steps in a diagnosis:[4]
- A doctor begins with a physical exam and a review of health history.
- Diagnosis generally begins with chest X-rays and lung function tests.
- Lung function tests determine if your lung capacity is diminished.
- Other imaging tests, such as CT scans or MRIs, may also provide a more detailed picture of the tissues in your chest cavity and lungs.
- A doctor may use a bronchoscope to insert a camera and image the insides of the airways.
- A bronchoalveolar lavage is an injection of salt water into the lungs to collect cells for analysis.
- In some cases, a surgical biopsy will be performed. For a biopsy, a small sample of tissue is removed and examined by a pathologist.
- Pathologists use the tissue sample to determine if the tissue is scarred by ILD.
Treatment for ILDs
Finding the underlying cause is essential to treating ILD. If your ILD is caused by asbestos, the first step in treatment is to avoid any further exposure. Treatment plans for ILDs also include procedures to treat scarring, limit further damage, and help your lungs get more oxygen.[4]
Slowing Disease Progression
The damage of ILD cannot be reversed, but treatments can slow the progression of scarring for some patients. If you have asbestosis, ceasing exposure to asbestos will help slow the disease.
Medications may help slow the formation of scar tissue. However, depending on the underlying cause of the ILD, they are not always effective.
For example, corticosteroids suppress the immune system, which can slow the progression of ILD if the cause is an autoimmune disorder. However, this will not help someone with asbestosis.
Managing Symptoms
Because there is no cure for ILD, a major focus of treatment is managing symptoms. This helps patients breathe more easily and enjoy a higher quality of life:
- Oxygen therapy. Supplemental oxygen can help you breathe more easily, increase your oxygen intake, and help you sleep better.
- Pulmonary rehabilitation. This is a program of breathing techniques, exercises, relaxation strategies, nutrition counseling, and emotional support to improve overall function and well-being.
- Medications. Certain medications can make breathing easier, often by thinning the fluid in the lungs.
- Lifestyle changes. Lifestyle changes can also help manage the disease and, in some cases, slow disease progression. Stopping smoking is the most important change to make. Also important is eating well, sleeping adequately, and getting vaccinated to prevent respiratory infections.
Lung Transplant
In rare cases, a lung transplant may be an option when damage to lung tissue is severe and the patient is otherwise healthy.
Lung transplants are not common for treating asbestosis; however, if a lung is available and a patient is a good candidate, doctors may consider this procedure. For some patients, a transplant is the best option, though it is risky and may result in organ rejection.[4]
Complications of Asbestosis and other ILDs
In addition to difficulty breathing and inadequate oxygen, ILDs can cause other serious complications. High blood pressure in the lungs, or pulmonary hypertension, can be triggered by an ILD.
Other complications of ILDs include heart failure on the right side of the heart and respiratory failure.
These conditions can be life-threatening. If you have asbestosis and you smoke, you may also be at risk for lung cancer. ILDs may also cause pleural plaques and pleural effusions, the thickening of lung tissue, and fluid buildup around the lungs.
What Is the Prognosis for Interstitial Lung Disease?
If you are diagnosed with asbestosis or another ILD, your prognosis will depend on the extent of your disease. If caught early, asbestosis may not cause serious symptoms or complications.
Early treatment can mitigate symptoms and slow progression. When not diagnosed until extensive damage has been done, or if you also smoke, the prognosis will likely be worse.
The estimated average life expectancy for asbestosis is around 10 years.[5]
Preventing ILD
Preventing interstitial lung disease involves reducing risk factors when possible. Eliminating exposure to asbestos and other toxins, for instance, will reduce the risk of developing a related ILD.
Most people do not come into contact with asbestos anymore. If you work at a job with asbestos on the premises, be sure to get safety training and request and use safety and protective gear. Employers are obligated to provide these.
Make sure your home is free of pollutants, like mold and dust with animal waste. If you live in an older home, have it checked for asbestos. This is especially important before doing any renovations or repairs that could disturb asbestos materials.
Can I Get Compensation for Interstitial Lung Disease?
ILDs caused by exposure are preventable. If you worked around harmful substances, like asbestos, you might be able to seek compensation. Contact a mesothelioma or asbestos lawyer who can review your case for free to provide initial advice.
If a lawyer thinks you have a case, they will review your work history to determine which companies exposed you to asbestos. They can then help you file a claim with an asbestos trust fund if you qualify or start a lawsuit to seek a settlement.
