Epidemiology and Risk Factors

Occupational risk factors and specific occupational lung diseases are reviewed in previous sections. Various medications, chemotherapeutic agents, and radiation therapy can all cause diffuse parenchymal lung disease and may result in end-stage lung disease with pulmonary fibrosis. Other causes include autoimmune connective tissue disorders (SLE, RA), granulomatous diseases (sarcoidosis, pulmonary Langerhans cell histiocytosis, eosinophilic granuloma), and metabolic diseases (Gaucher's, Niemann-Pick), congenital neoplasia (tuberous sclerosis, neurofibromatosis) malignancy (lymphangitic carcinomatosis, bronchoalveo-lar carcinoma, pulmonary lymphoma), and certain drugs (bleomycin, nitrofurantoin, amiodarone). Among the interstitial lung diseases, idiopathic pulmonary fibrosis occurs more often in patients over age 60 and in men more than women. Cigarette smoking, chronic aspiration, various environmental exposures (metal and wood dust), and numerous viruses (Epstein-Barr, influenza, CMV) have been implicated as potential risk factors. The remaining ILDs rarely occur and are designated as separate disease entities based on specific clinicopathologic differences (Lynch et al., 2005).

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