Lupus, rheumatoid arthritis, and several other connective tissue and blood disorders and some environmental factors, including asbestos can cause Interstitial Lung Diseases.
However, the type of interstitial lung disease caused by asbestos exposure is called asbestosis. Asbestosis is also sometimes called pulmonary fibrosis or interstitial pneumonitis, although in most cases a doctor will call it asbestosis to avoid confusion.
Interstitial lung disease is a severe scarring of the lung caused by inflammation. As the scarring grows and becomes worse, the small supporting tissues of the alveoli, the interstitium themselves, become thicker. The alveoli are the tiny air sacs in the lungs, and as their interstitium become thicker and thicker they lose their ability to put oxygen into your blood and exhale carbon dioxide.
While the respiratory system is very efficient at expelling foreign bodies such as dust and other air pollutants, asbestos fibers are difficult for the respiratory system to expel from the body. What exactly causes the scarring to occur is not fully understood, although when the lungs and the body respond to an interstitial lung disease the response often causes the scarring to worsen.
Asbestosis usually will not develop until ten to thirty years after the exposure to asbestos. The lung damage from asbestosis and the asbestos exposure is non-reversible, however the symptoms can be treated. The scarring usually stops after the patient is no longer exposed to asbestos.
Unfortunately by the time a patient starts to experience symptoms of interstitial lung disease the diseases has caused too much damage and has gone past the point of being cured. At this stage, the only options are treatment, and the symptoms that will manifest at this stage could be:
Shortness of breath;
Easily becoming fatigued;
Clubbed fingers – only some patients will develop clubbed fingers.
An interstitial lung disease such as asbestosis has symptoms that are similar to other lung conditions, which usually makes it fairly challenging for doctors to accurately diagnose the disease. CT scans, X-rays, and pulmonary function / breathing tests are used for diagnosing interstitial lung diseases.
The first step most physicians will take in diagnosing a patient with an interstitial lung disease is to run lung capacity tests – either a pulmonary function test or having the patient exercise – such as using a treadmill. The doctor may also use a simple test using a spirometer to measure lung capacity. The patient will blow into the spirometer which can determine the level of the lungs' capacity.
The doctor will use a chest x-ray to rule out other lung conditions – emphysema, pneumonia or a collapsed lung, for example – however, an x-ray cannot diagnosis an interstitial lung disease. A diagnosis is more likely to be made with a high resolution CT scan (HRCT - High Resolution Computerized Tomography)
In some cases a tissue sample from the lung will need to be collected for a definite diagnosis of an interstitial lung disease to be determined. To obtain the tissue sample the doctor will use a transbronchial biopsy (bronchoscopy) or a bronchoalveolar lavage. A bronchoscopy uses a flexible fiber-optic tube that can be inserted down the mouth and throat into the lungs, which can then obtain tiny lung tissue samples.
A bronchoalveolar lavage is a procedure where the doctor uses the bronchoscope tube to insert saline (salt water) into the lung, which can then obtain a sample of lung tissue; the saline section, along with the lung tissues can be sucked up through the bronchoscope tube. Most times a bronchoalveolar lavage is used to monitor the progress of someone who has already been diagnosed with asbestosis or another interstitial lung disease.
In some rare cases, a lung tissue will have to be obtained by a surgical lung biopsy. A surgical lung biopsy involves the surgeon making a small cut between the ribs and then inserting a camera tube into the lungs to view the lungs; then the surgeon will make another incision to obtain the sample of lung tissue.
For a patient suffering an interstitial lung disease such as asbestosis, the goal of treatment is to prevent heart disease, other lung
diseases and high blood pressured – common complications of the interstitial disease. The other goal of treatment is to relieve symptoms, and ease discomfort of the patient.
A patient may receive corticosteroids anti-inflammatory medications to ease discomfort.
If the patient is suffering from breathing difficulties, they may be prescribed oxygen.
If the patient has excessive fluid build up in their lungs from their interstitial lung disease, the doctor can drain the excessive fluids from the lungs to help the patient breathe easier.
The doctor will also advise their patient to get vaccinated against pneumonia and the flu, as someone suffering from an interstitial lung disease is more prone to complications from any respiratory problem.
In some extreme cases the patient may have to receive a lung transplant.
Pulmonary hypertension is high blood pressure in the lungs and is a common complication from an interstitial lung conditions and can be life-threatening. The scarring caused by interstitial lung diseases in the alveoli in the lungs, seriously damages the alveoli which then cause the high blood pressure to occur. If the patient has developed a pulmonary hypertension the patient will receive blood thinners and medicine that relax and expand the blood vessels.
A person who has developed an interstitial lung disease and who also smokes has greatly increased their chance of developing lung cancer.
The development of an interstitial lung disease can lead to other damage in the lungs such as pleural effusions (fluid build up) or pleural plaques (calcium deposits on the lining of the chest wall and lungs, which are called the pleura)
Being exposed to the amount of asbestos necessary to develop asbestosis or other interstitial lung diseases can also lead to mesothelioma.
Asbestosis, if detected early and treated properly, does not necessarily lead to serious complications. However, if the patient smokes during their exposure to asbestos they are more likely to develop a serious interstitial disease. The severity of the interstitial lung disease will depend on the type of asbestos exposed too and the length of exposure.