Occupation-related ILD

Numerous interstitial lung diseases (ILDs) are caused by exposure to agents in the workplace, termed here ‘occupational ILDs’ (Occ-ILDs). Occ-ILDs have similar clinical, radiographic and pathologic presentations as non-occupational ILDs (Table 19.1) (1). Distinguishing Occ-ILDs from non-occupational ILDs is important for several reasons. First, the Occ-ILDs are common, as discussed below (2, 3). Additionally, the prognosis from Occ-ILD is different from that of the idiopathic interstitial pneumonias (IIPs). For example, both asbestosis and idiopathic pulmonary fibrosis (IPF) are characterized by a usual interstitial pneumonia (UIP) pattern on pathology, but the prognosis for asbestosis is far better (1). Finally, a diagnosis of Occ-ILD has implications for treatment and prevention. Minimizing or eliminating exposure is a cornerstone of treatment of Occ-ILDs (4, 5). Identification of an Occ-ILD also presents an opportunity for primary and secondary disease prevention among exposed co-workers and has implications for future employment of the patient as well as eligibility for compensation programmes (6, 7).