Pulmonary Fibrosis

Pulmonary fibrosis is a chronic disease that causes swelling and scarring of the alveoli (air sacs) and interstitial tissues (tissue between cells) of the lungs. The scar tissue replaces healthy tissue and causes inflammation. This damage causes your lungs to stiffen and makes breathing more and more difficult.

Pulmonary fibrosis can be a mild disease causing few symptoms or it can be a severe and possibly fatal.

This condition is known by many different names, "Interstitial pulmonary fibrosis" is perhaps the most common, but other terms frequently used include: "fibrosing alveolitis", "interstitial pneumonitis" and "Hamman-Rich syndrome".


It appears that the lung is reacting to microscopic damage by developing inflammation and fibrosis (scarring). The nature of the initial damage is not always known and although doctors may say that pulmonary fibrosis is due to a given disease (for example sarcoidosis, ) they often may not know the specific causes of those diseases either.

The most frequent cases of pulmonary fibrosis are related to sarcoidosis, — fibrosis associated with certain occupational diseases — and pulmonary fibrosis where the causes are not known idiopathic.

Occupational diseases and pulmonary fibrosis:

Many jobs, particularly those that involve working with asbestos, ground stone or metal dust, can cause pulmonary fibrosis. The small particles of these materials are inhaled, and they damage the alveoli and cause fibrosis.

Some organic substances, such as mouldy hay can also cause pulmonary fibrosis; this is known as farmers lung.

Asbestosis and pulmonary fibrosis:

Asbestosis is usually caused when small needle-like particles of asbestos are inhaled into the lungs. This can cause lung scarring (pulmonary fibrosis) and in addition can lead to lung cancer.

Cigarette smoking has an interactive relationship with asbestos — the asbestos worker who smokes has a much higher chance of developing lung cancer than does the non-smoker.

Silicosis is another disease producing pulmonary fibrosis in which the cause is known. It is a disease that results from breathing in free crystalline silica dust.

All types of mining in which the ore is extracted from quartz rock can produce silicosis if precautions are not taken. This includes the mining of gold, lead, zinc, copper, iron, anthracite (hard) coal and some bituminous (soft) coal. Workers in foundries, sandstone grinding, tunneling, sandblasting, concrete breaking, granite carving and china manufacturing also encounter silica.

Large silica particles are stopped in the upper airways. But the tiniest specks of silica can be carried down to the alveoli where they lead to pulmonary fibrosis.

Silicosis can be either mild or severe, in direct proportion to the percentage and concentration of silica in the air and the duration of exposure.

Silicosis can be prevented by measures specifically designed for each industry and each job. Dust control is essential. Sometimes this is accomplished by the wetting down of mines, improved ventilation or the wearing of masks.

Some medications that may cause PF :

Certain strong medicines may have the undesirable side effect of causing pulmonary fibrosis. Some of them are:

1) nitrofurantoin (sometimes used for urinary tract infections)
2) amiodarone (sometimes prescribed for an irregular heart rate)
3) bleomycin, cyclophosphamide and methotrexate (sometimes prescribed to fight cancer and Rheumatoid arthritis)

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