TY - JOUR
T1 - Risk of hypersensitivity pneumonitis and other interstitial lung diseases following organic dust exposure
AU - Iversen, Inge Brosbøl
AU - Vestergaard, Jesper Medom
AU - Basinas, Ioannis
AU - Ohlander, Johan
AU - Peters, Susan
AU - Bendstrup, Elisabeth
AU - Bonde, Jens Peter Ellekilde
AU - Schlünssen, Vivi
AU - Rasmussen, Finn
AU - Stokholm, Zara Ann
AU - Andersen, Michael Brun
AU - Kromhout, Hans
AU - Kolstad, Henrik Albert
N1 - © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2024/8/19
Y1 - 2024/8/19
N2 - BACKGROUND: Organic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and hypersensitivity pneumonitis and other ILDs in a cohort study.METHODS: The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994-2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model.RESULTS: For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensitivity pneumonitis and 1.04 (95% CI 1.02 to 1.06) for other ILDs. We found increasing risk with increasing cumulative endotoxin exposure for hypersensitivity pneumonitis and other ILDs with IRRs per 5000 endotoxin units/m3-years of 1.55 (95% CI 1.38 to 1.73) and 1.09 (95% CI 1.00 to 1.19), respectively. For both exposures, risk also increased with increasing duration of exposure and recent exposure. No increased risks were observed for wood dust exposure.CONCLUSION: Exposure-response relations were observed between organic dust and endotoxin exposure and hypersensitivity pneumonitis and other ILDs, with lower risk estimates for the latter. The findings indicate that organic dust should be considered a possible cause of any ILD.TRIAL REGISTRATION NUMBER: j.no.: 1-16-02-196-17.
AB - BACKGROUND: Organic dust is associated with hypersensitivity pneumonitis, and associations with other types of interstitial lung disease (ILD) have been suggested. We examined the association between occupational organic dust exposure and hypersensitivity pneumonitis and other ILDs in a cohort study.METHODS: The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994-2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model.RESULTS: For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensitivity pneumonitis and 1.04 (95% CI 1.02 to 1.06) for other ILDs. We found increasing risk with increasing cumulative endotoxin exposure for hypersensitivity pneumonitis and other ILDs with IRRs per 5000 endotoxin units/m3-years of 1.55 (95% CI 1.38 to 1.73) and 1.09 (95% CI 1.00 to 1.19), respectively. For both exposures, risk also increased with increasing duration of exposure and recent exposure. No increased risks were observed for wood dust exposure.CONCLUSION: Exposure-response relations were observed between organic dust and endotoxin exposure and hypersensitivity pneumonitis and other ILDs, with lower risk estimates for the latter. The findings indicate that organic dust should be considered a possible cause of any ILD.TRIAL REGISTRATION NUMBER: j.no.: 1-16-02-196-17.
KW - Adult
KW - Alveolitis, Extrinsic Allergic/epidemiology
KW - Denmark/epidemiology
KW - Dust
KW - Endotoxins/adverse effects
KW - Female
KW - Humans
KW - Incidence
KW - Lung Diseases, Interstitial/epidemiology
KW - Male
KW - Middle Aged
KW - Occupational Diseases/epidemiology
KW - Occupational Exposure/adverse effects
KW - Risk Factors
UR - http://www.scopus.com/inward/record.url?scp=85197625015&partnerID=8YFLogxK
U2 - 10.1136/thorax-2023-221275
DO - 10.1136/thorax-2023-221275
M3 - Journal article
C2 - 38777581
SN - 0040-6376
VL - 79
SP - 853
EP - 860
JO - Thorax
JF - Thorax
IS - 9
ER -