This document summarizes interstitial lung disease (ILD) and occupational lung disease. ILD is characterized by diffuse involvement of the interstitium and includes idiopathic pulmonary fibrosis. Occupational lung disease results from inhalation of noxious substances at work and includes pneumoconiosis like coal worker's pneumoconiosis, silicosis, and asbestosis. Diagnosis involves clinical evaluation, imaging like chest X-ray and HRCT, and may include procedures like bronchoscopy and biopsy. Treatment depends on underlying cause but often includes avoiding further exposure and supplemental oxygen.

1. ILD & OLD
Interstitial & Occupational
lung diseases

2. Interstitial lung disease
 Heterogenous group of diseases,
characterized by diffuse involvement of
interstitium
 Insidious onset, chronic course
 Alveolitisinterstitial involvementfibrosis
 Causes- common
 Occupational/environmental exposure
 Collagen vascular diseases & vasculitides
 Drugs- amiodarone, NFT, bleomycin, busulphan, penicillamine
 Idiopathic

3. Manifestation
 Clinical-
 Dry cough, progressive dyspnea
 h/o exposure to dust/fumes or of CTD
 Clubbing
 End-inspiratory fine crepts, common at bases
 CxR- reticulonodular
changeshoneycombing
 HRCT- high-resolution CT
 PFT-
 Restrictive pattern, with decreased DLco
 ABG- hypoxemia

4. Radiological appearance

5. Diagnosis
Bronchoalveolar lavage
Transbronchial biopsy
Surgical lung biopsy- VATS/open

6. Idiopathic fibrosing interstitial pneumonia
 Formerly idiopathic pulmonary fibrosis
 R/O any underlying cause
 Patterns-
 UIP- usual interstitial pneumonia
 RB-ILD- respiratory bronchiolitis associated ILD
 AIP- acute interstitial pneumonitis
 NSIP- non-specific interstitial pneumonitis
 COP- cryptogenic organizing pneumonitis
 Rx- steroids, stop smoking, supplemental O2
 Finally, lung transplantation

7. Occupational lung disease
 Due to inhalation of noxious substances in
workplace
 Types-
 Pneumoconiosis- coal workers, silicosis, asbestosis, siderosis
 Hypersensitivity pneumonitis-
farmers, pigeon breeders, bagassosis
 Obstructive airway disease- grain/wood/cotton dust
 Toxic lung injury- nitrogen oxide
 Lung cancer- asbestos, radon gas, arsenic
 Pleural disease- asbestos, talc

8. Pneumoconiosis
 Chronic fibrotic lung diseases caused by
inhalation of coal or other inorganic
or silicate dusts
 Manifestation- as in ILD
 Dx- exposure + clinical + CxR/HRCT
 Rx-
 Supportive
 Avoid exposure
 No smoking

9. Coal-worker’s
pneumoconiosis
 Ingestion of inhaled coal dust by
macrophageschronic inflammation fibrosis
 Common in upper lobes
 Caplan syndrome- pulmonary nodules in coal worker
with rheumatoid arthritis

10. Silicosis
 Silicon dioxide particle inhalation
couses small rounded opacities in lung
 Associated with eggshell calcification-
calcification of periphery of hilar LN

11. Asbestosis
 Nodular interstitial fibrosis in persons
chronically exposed to asbestos fibres
 Associated with pleural calcification