Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2015 Mar;21(2):193-200.
doi: 10.1097/MCP.0000000000000144.

Asbestosis and environmental causes of usual interstitial pneumonia

Mridu Gulati  1 , Carrie A Redlich
Affiliations
Review

Asbestosis and environmental causes of usual interstitial pneumonia

Mridu Gulati et al. Curr Opin Pulm Med. 2015 Mar.

Abstract

Purpose of review: Recent epidemiologic investigations suggest that occupational and environmental exposures contribute to the overall burden of idiopathic pulmonary fibrosis (IPF). This article explores the epidemiologic and clinical challenges to establishing exposure associations, the current literature regarding exposure disease relationships and the diagnostic work-up of IPF and asbestosis patients.

Recent findings: IPF patients demonstrate a histopathologic pattern of usual interstitial pneumonia. In the absence of a known cause or association, a usual interstitial pneumonia pattern leads to an IPF diagnosis, which is a progressive and often terminal fibrotic lung disease. It has long been recognized that asbestos exposure can cause pathologic and radiographic changes indistinguishable from IPF. Several epidemiologic studies, primarily case control in design, have found that a number of other exposures that can increase risk of developing IPF include cigarette smoke, wood dust, metal dust, sand/silica and agricultural exposures. Lung mineralogic analyses have provided additional support to causal associations. Genetic variation may explain differences in disease susceptibility among the population.

Summary: An accumulating body of literature suggests that occupational and environmental exposure can contribute to the development of IPF. The impact of exposure on the pathogenesis and clinical course of disease requires further study.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest

C.A.R. has no conflicts.

Figures

FIGURE 1
FIGURE 1. Asbestosis high-resolution chest CT scan
(a) HRCT lung windows demonstrate lower lobe predominant disease with evidence of reticular markings and honeycombing. (b) Mediastinal windows reveal evidence of pleural thickening and calcfiications (Courtesy of Jonathan Killam, MD and Ami Rubinowitz, MD). CT, computed tomography.
FIGURE 2
FIGURE 2. Histopathology of usual interstitial pneumonia
(a) Reveals a low-power UIP view showing temporal heterogeneity with areas of abnormal lung alternating with normal lung. (b) Reveals a fibroblast focus representing an area of active fibroblast proliferation typically seen in UIP patients (Courtesy of Robert Homer, MD, PhD). UIP, usual interstitial pneumonia.
FIGURE 3
FIGURE 3. Asbestos body
Asbestos bodies seen on iron stained section represent asbestos fibers surrounded by a coating of iron and protein. Definitive identification of the enclosed fibers requires scanning electron microscopy and energy dispersive X-ray analysis (Courtesy Robert Homer, MD, PhD).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Baumgartner KB, Samet JM, Coultas DB, et al. Occupational and environmental risk factors for idiopathic pulmonary fibrosis: a multicenter case-control study. Collaborating Centers. Am J Epidemiol. 2000;152:307–315. - PubMed
    1. Baumgartner KB, Samet JM, Stidley CA, et al. Cigarette smoking: a risk factor for idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 1997;155:242–248. - PubMed
    1. Glazer CS, Newman LS. Occupational interstitial lung disease. Clin Chest Med. 2004;25:467–478. vi. - PubMed
    1. Gustafson T, Dahlman-Hoglund A, Nilsson K, et al. Occupational exposure and severe pulmonary fibrosis. Respir Med. 2007;101:2207–2212. - PubMed
    1. Hubbard R, Cooper M, Antoniak M, et al. Risk of cryptogenic fibrosing alveolitis in metal workers. Lancet. 2000;355:466–467. - PubMed

MeSH terms