OCCUPATIONAL AND ENVIRONMENTAL RISK FACTORS OF IDIOPATHIC PULMONARY FIBROSIS IN EGYPT

Abstract

Background: Despite the advances in medical therapy and technology, the prognosis of idiopathic pulmonary fibrosis (IPF) remains poor and the need for disease prevention based on identifying the risk factors becomes mandatory. Occupational and environmental exposures were studied in several countries and found to play an important role in the disease development. However, in Egypt, little attention has been paid to study the effect of these factors in the disease development. Objective: to identify the occupational and environmental risk factors associated with the development of IPF in Egypt.Methods: A multicenter hospital- based case-control study was carried out in chest hospitals in three Egyptian Cities: Cairo, Tanta and Mansoura. Study subjects were 201 IPF confirmed cases and 205 age, sex and residence matched controls. Data on occupational and environmental factors were obtained from a questionnaire. Multiplelogistic regression analysis was used to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of IPF in both sexes for single factors with adjustment for age, residence and smoking status. Results: compared with controls, the risk of IPF in male workers was observed to increase significantly in chemical and petrochemical industries and in carpentry and wood working (OR=2.56, 95%CI: 1.02-7.01) and with occupational exposures to Background: Despite the advances in medical therapy and technology, the prognosis of idiopathic pulmonary fibrosis (IPF) remains poor and the need for disease prevention based on identifying the risk factors becomes mandatory. Occupational and environmental exposures were studied in several countries and found to play an important role in the disease development. However, in Egypt, little attention has been paid to study the effect of these factors in the disease development. Objective: to identify the occupational and environmental risk factors associated withthe development of IPF in Egypt. Methods: A multicenter hospital- based case-control study was carried out in chesthospitals in three Egyptian Cities: Cairo, Tanta and Mansoura. Study subjects were 201 IPF confirmed cases and 205 age, sex and residence matched controls. Data on occupational and environmental factors were obtained from a questionnaire. Multiple logistic regression analysis was used to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of IPF in both sexes for single factors with adjustment for age, residence and smoking status. Results: compared with controls, the risk of IPF in male workers was observed to increase significantly in chemical and petrochemical industries and in carpentry and wood working (OR=2.56, 95%CI: 1.02-7.01) and with occupational exposures to Background: Despite the advances in medical therapy and technology, the prognosis of idiopathic pulmonary fibrosis (IPF) remains poor and the need for disease prevention based on identifying the risk factors becomes mandatory. Occupational and environmental exposures were studied in several countries and found to play an important rol in the disease development. However, in Egypt, little attention has been paid to study the effect of these factors in the disease development. Objective: to identify the occupational and environmental risk factors associated with the development of IPF in Egypt. Methods: A multicenter hospital- based case-control study was carried out in chest hospitals in three Egyptian Cities: Cairo, Tanta and Mansoura. Study subjects were 201 IPF confirmed cases and 205 age, sex and residence matched controls. Data on occupational and environmental factors were obtained from a questionnaire. Multiplelogistic regression analysis was used to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of IPF in both sexes for single factors with adjustment for age, residence and smoking status. Results: compared with controls, the risk of IPF in male workers was observed to increase significantly in chemical and petrochemical industries and in carpentry and wood working (OR=2.56, 95%CI: 1.02-7.01) and with occupational exposures to wood dust and wood preservatives. Among female workers, a significant increase was observed in farming (OR=3.34, 95%CI: 1.17-10.12), raising birds and occupational exposures to animal feeds, products and dusts and to pesticides. Risk of IPF decreased significantly in male workers and insignificantly among female workers in sales and clerical related activities. The environmental exposures to birds and cats were significantly associated with elevated risk of IPF development in both sexes. Conclusion: Results confirm previous studies showing positive association of IPF development and occupational and environmental dust exposures. In Egypt, farming, raising birds and wood working are important risk factors in IPF development.