Ashen Lung

The lungs were never meant to fight what the wasteland puts in the air. Ashen Lung begins where industry meets biology: in the deep ruins where reactors collapsed decades ago, in the burn sites still smoldering with radioactive particulate, in the mines where dust hangs thick enough to taste. Breathe it long enough, and the Infection inside the body decides to help. It tries to neutralize the contaminants through the lungs rather than filtering them naturally. The result is worse than the ash itself. Necrotic buildup layers over the airways, mixing with Infection residue and compacted particulate to form a thick, tar-like compound that the body cannot clear.
  The progression is slow but relentless. A dry cough and scratchy throat give way to gray sputum that smells of burnt metal. The coughing deepens. Ash-colored residue gets expelled from mouth and nose in fits that leave the afflicted doubled over and gasping. The skin around the eyes and mouth takes on a dull gray hue as oxygen levels drop, and the chest pain settles in like a permanent resident. By the time the lungs begin to harden and airflow constricts to a whisper, every word costs effort and every breath is a negotiation between the body and the tar filling it. Final-stage collapse comes when both lungs occlude entirely. Respiratory failure follows.
  Those who receive treatment early enough survive, but the disease leaves its signature behind. A persistent gray discoloration traces the throat and collarbones of former sufferers, a marking that survivors in industrial settlements call "the mark of the ash." Sensitivity to airborne contaminants lingers indefinitely; one bout of Ashen Lung means the next exposure hits harder and faster. Full Dead are the only Lineage naturally immune, their unique biology sparing them from the Infection's misguided defense response. For everyone else, the prescription is simple enough in theory: wear a respirator, avoid the worst air, and stay away from the places where the old world's industry left its longest shadows. In practice, the wasteland rarely makes prevention that convenient.
  Wasteland Lineages carry an additional vulnerability. Unaccustomed to the industrial particulate that more settled survivors encounter regularly, they contract the disease at an advanced stage from the outset. For them, Ashen Lung is not a slow decline but a sudden plunge into a fight their lungs were never prepared for.