To prevent pulmonary fibrosis, attention must be paid to reducing individual risk factors.
Behavioral risk factors
- Drug use
- Cocaine
- Inhalation of noxious agents (tobacco smoke + other noxious agents: see below “Environmental pollution – Intoxications”); but does not occur primarily in smokers; however, former or active smokers have an overall 1.6-fold higher risk
Drugs (including drug-induced interstitial lung disease (DILD)).
- Amiodarone, flecainide (antiarrhythmic drugs).
- Antibiotics – nitrofurantoin, daptomycin.
- Anticonvulsants, unspecified (e.g., phenytoin).
- Calcium channel blockers-bepridil (amine calcium channel blocker; incidence of DILD: 6.3%).
- Checkpoint inhibitors – ipilimumab (incidence of DILD: 5.44%), nivolumab (incidence of DILD: 11.7%).
- Gold
- Granulocyte colony-stimulating factors
- Interferons
- Cancer immunotherapy – imatinib (protein kinase inhibitor), rituximab.
- L-tryptophan
- Monoclonal antibodies – erlotinib, cetuximab, gefitinib, panitumumab.
- MTOR inhibitors – everolimus, temsirolimus and sirolimus.
- Rheumatoid drugs – leflunomide, methotrexate (incidence of DILD: 0.06-15%), TNF inhibitors.
- Oxygen
- Cytostatics
- Bleomycin (incidence of a DILD: 6.8-15%).
- Busulfan
- Gemcitabine (incidence of a DILD: 1.1-3.9%).
- Irinotecan (cytostatic drug from the topoisomerase inhibitor group).
- Methotrexate (MTX) [very rarely.]
- Pemetrexed
Environmental pollution – intoxications (poisonings).
- Herbicides (weed killers) such as paraquat.
- Inhalation of noxious agents such as tobacco smoke, gases, vapors, aerosols, hairspray, wood dusts, metal dusts (workers in metal smelters), stone dusts (siliceous silica/workers in quarries as well as sandblasters; fibrous silicate minerals: asbestos), and plant and animal particles
- Microaspiration of gastric juice
