Interstitial Lung Diseases

Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and scarring make it hard to get enough oxygen. The scarring is called pulmonary fibrosis.

Breathing in dust or other particles in the air is responsible for some types of interstitial lung diseases. Specific types include:

• Black lung disease among coal miners, from inhaling coal dust
• Farmer's lung, from inhaling farm dust
• Asbestosis, from inhaling asbestos fibers
• Siderosis, from inhaling iron from mines or welding fumes
• Silicosis, from inhaling silica dust

Other causes include autoimmune diseases or occupational exposures to molds, gases, or fumes. Some types of interstitial lung disease have no known cause.

Treatment depends on the type of exposure and the stage of the disease. It may involve medicines, oxygen therapy, or a lung transplant in severe cases.

Occupational Health

Occupational health problems occur at work or because of the kind of work you do. These problems can include:

• Cuts, fractures (broken bones), and sprains and strains
• Loss of limbs
• Repetitive motion disorders
• Hearing problems caused by exposure to noise
• Vision problems
• Illness caused by breathing, touching, or swallowing unsafe substances
• Illness caused by exposure to radiation
• Exposure to germs in health care settings

Good job safety and prevention practices can reduce your risk of these problems. Try to stay fit, reduce stress, set up your work area properly, and use the right equipment and gear.

Ozone

Ozone is a gas. It can be good or bad, depending on where it is. "Good" ozone occurs naturally about 10 to 30 miles above the Earth's surface. It shields us from the sun's ultraviolet rays. Part of the good ozone layer is gone. Man-made chemicals have destroyed it. Without enough good ozone, people may get too much ultraviolet radiation. This may increase the risk of skin cancer, cataracts, and immune system problems.

"Bad" ozone is at ground level. It forms when pollutants from cars, factories, and other sources react chemically with sunlight. It is the main ingredient in smog. It is usually worst in the summer. Breathing bad ozone can be harmful. It can cause coughing, throat irritation, worsening of asthma, bronchitis, and emphysema. It can lead to permanent lung damage, if you are regularly exposed to it.

Environmental Protection Agency

Pneumonia

What is pneumonia?

Pneumonia is an infection in one or both of the lungs. It causes the air sacs of the lungs to fill up with fluid or pus. It can range from mild to severe, depending on the type of germ causing the infection, your age, and your overall health.

What causes pneumonia?

Bacterial, viral, and fungal infections can cause pneumonia.

Bacteria are the most common cause. Bacterial pneumonia can occur on its own. It can also develop after you've had certain viral infections such as a cold or the flu. Several different types of bacteria can cause pneumonia, including:

• Streptococcus pneumoniae
• Legionella pneumophila; this pneumonia is often called Legionnaires' disease
• Mycoplasma pneumoniae
• Chlamydia pneumoniae
• Haemophilus influenzae

Viruses that infect the respiratory tract may cause pneumonia. Viral pneumonia is often mild and goes away on its own within a few weeks. But sometimes it is serious enough that you need to get treatment in a hospital. If you have viral pneumonia, you are at risk of also getting bacterial pneumonia. The different viruses that can cause pneumonia include:

• Respiratory syncytial virus (RSV)
• Some common cold and flu viruses
• SARS-CoV-2, the virus that causes COVID-19

Fungal pneumonia is more common in people who have chronic health problems or weakened immune systems. Some of the types include:

• Pneumocystis pneumonia (PCP)
• Coccidioidomycosis, which causes valley fever
• Histoplasmosis
• Cryptococcus

Who is at risk for pneumonia?

Anyone can get pneumonia, but certain factors can increase your risk:

• Age; the risk is higher for children who are age 2 and under and adults age 65 and older
• Exposure to certain chemicals, pollutants, or toxic fumes
• Lifestyle habits, such as smoking, heavy alcohol use, and malnourishment
• Being in a hospital, especially if you are in the ICU. Being sedated and/or on a ventilator raises the risk even more.
• Having a lung disease
• Having a weakened immune system
• Have trouble coughing or swallowing, from a stroke or other condition
• Recently being sick with a cold or the flu

What are the symptoms of pneumonia?

The symptoms of pneumonia can range from mild to severe and include:

• Fever
• Chills
• Cough, usually with phlegm (a slimy substance from deep in your lungs)
• Shortness of breath
• Chest pain when you breathe or cough
• Nausea and/or vomiting
• Diarrhea

The symptoms can vary for different groups. Newborns and infants may not show any signs of the infection. Others may vomit and have a fever and cough. They might seem sick, with no energy, or be restless.

Older adults and people who have serious illnesses or weak immune systems may have fewer and milder symptoms. They may even have a lower than normal temperature. Older adults who have pneumonia sometimes have sudden changes in mental awareness.

What other problems can pneumonia cause?

Sometimes pneumonia can cause serious complications such as:

• Bacteremia, which happens when the bacteria move into the bloodstream. It is serious and can lead to septic shock.
• Lung abscesses, which are collections of pus in cavities of the lungs
• Pleural disorders, which are conditions that affect the pleura. The pleura is the tissue that covers the outside of the lungs and lines the inside of your chest cavity.
• Kidney failure
• Respiratory failure

How is pneumonia diagnosed?

Sometimes pneumonia can be hard to diagnose. This is because it can cause some of the same symptoms as a cold or the flu. It may take time for you to realize that you have a more serious condition.

Your health care provider may use many tools to make a diagnosis:

• A medical history, which includes asking about your symptoms
• A physical exam, including listening to your lungs with a stethoscope
• Various tests, such as
  • A chest x-ray
  • Blood tests such as a complete blood count (CBC) to see if your immune system is actively fighting an infection
  • A Blood culture to find out whether you have a bacterial infection that has spread to your bloodstream

If you are in the hospital, have serious symptoms, are older, or have other health problems, you may also have more tests, such as:

• Sputum test, which checks for bacteria in a sample of your sputum (spit) or phlegm (slimy substance from deep in your lungs).
• Chest CT scan to see how much of your lungs is affected. It may also show if you have complications such as lung abscesses or pleural effusions.
• Pleural fluid culture, which checks for bacteria in a fluid sample that was taken from the pleural space
• Pulse oximetry or blood oxygen level test, to check how much oxygen is in your blood
• Bronchoscopy, a procedure used to look inside your lungs' airways

What are the treatments for pneumonia?

Treatment for pneumonia depends on the type of pneumonia, which germ is causing it, and how severe it is:

• Antibiotics treat bacterial pneumonia and some types of fungal pneumonia. They do not work for viral pneumonia.
• In some cases, your provider may prescribe antiviral medicines for viral pneumonia
• Antifungal medicines treat other types of fungal pneumonia

You may need to be treated in a hospital if your symptoms are severe or if you are at risk for complications. While there, you may get additional treatments. For example, if your blood oxygen level is low, you may receive oxygen therapy.

It may take time to recover from pneumonia. Some people feel better within a week. For other people, it can take a month or more.

Can pneumonia be prevented?

Vaccines can help prevent pneumonia caused by pneumococcal bacteria or the flu virus. Having good hygiene, not smoking, and having a healthy lifestyle may also help prevent pneumonia.

NIH: National Heart, Lung, and Blood Institute

Pulmonary Rehabilitation

What is pulmonary rehabilitation?

Pulmonary rehabilitation, also known as pulmonary rehab or PR, is a program for people who have chronic (ongoing) breathing problems. It can help improve your ability to function and quality of life. PR does not replace your medical treatment. Instead, you use them together.

PR is often an outpatient program that you do in a hospital or clinic. Some people have PR in their homes. You work with a team of health care providers to find ways to lessen your symptoms, increase your ability to exercise, and make it easier to do your daily activities.

Who needs pulmonary rehabilitation?

Your health care provider may recommend pulmonary rehabilitation (PR) if you have a chronic lung disease or another condition that makes it hard for you to breathe and limits your activities. For example, PR may help you if you:

• Have COPD (chronic obstructive pulmonary disease). The two main types are emphysema and chronic bronchitis. In COPD, your airways (tubes that carry air in and out of your lungs) are partially blocked. This makes it hard to get air in and out.
• Have an interstitial lung disease such as sarcoidosis and pulmonary fibrosis. These diseases cause scarring of the lungs over time. This makes it hard to get enough oxygen.
• Have cystic fibrosis (CF). CF is an inherited disease that causes thick, sticky mucus to collect in the lungs and block the airways.
• Need lung surgery. You may have PR before and after lung surgery to help you prepare for and recover from the surgery.
• Have a muscle-wasting disorder that affects the muscles used for breathing. An example is muscular dystrophy.

PR works best if you start it before your disease is severe. However, even people who have advanced lung disease can benefit from PR.

What does pulmonary rehabilitation include?

When you first start pulmonary rehabilitation (PR), your team of health care providers will want to learn more about your health. You will have lung function, exercise, and possibly blood tests. Your team will go over your medical history and current treatments. They may check on your mental health and ask about your diet. Then they will work together to create a plan that is right for you. It may include:

• Exercise training. Your team will come up with an exercise plan to improve your endurance and muscle strength. You will likely have exercises for both your arms and legs. You might use a treadmill, stationary bike, or weights. You may need to start slowly and increase your exercise as you get stronger.
• Nutritional counseling. Being either overweight or underweight can affect your breathing. A nutritious eating plan can help you work towards a healthy weight.
• Education about your disease and how to manage it. This includes learning how to avoid situations that make your symptoms worse, how to avoid infections, and how/when to take your medicines.
• Techniques you can use to save your energy. Your team may teach you easier ways to do daily tasks. For example, you may learn ways to avoid reaching, lifting, or bending. Those movements make it harder to breathe, since they use up energy and make you tighten your abdominal muscles. You may also learn how to better deal with stress, since stress can also take up energy and affect your breathing.
• Breathing strategies. You will learn techniques to improve your breathing. These techniques may increase your oxygen levels, decrease how often you take breaths, and keep your airways open longer.
• Psychological counseling and/or group support. It can feel scary to have trouble breathing. If you have a chronic lung disease, you are more likely to have depression, anxiety, or other emotional problems. Many PR programs include counseling and/or support groups. If not, your PR team may be able to refer you to an organization that offers them.

NIH: National Heart, Lung, and Blood Institute