Abstract
BackgroundIdiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP). Occupational risk factors have been proposed to be associated with UIP. The aim of this case-control study is to evaluate the relationship between UIP pattern and occupational exposure in Southern Europe.MethodsSixty nine cases with a UIP radiological pattern at CT-scan were selected from a clinical database of the University Hospital of Perugia, Umbria, between January 2010 and December 2013. Controls (n = 277) not reporting doctor diagnosed pulmonary fibrosis, were ascertained casually among general population from the same catching area of cases. Data were collected by a questionnaire used previously in a similar study. Logistic regression models, adjusted for gender, age and smoking, were performed to evaluate the association between UIP and occupational exposure.ResultsFarmers, veterinarians and gardeners (OR = 2.73, 95%CI = 1.47–5.10), metallurgical and steel industry workers (OR = 4.80, 95%CI = 1.50–15.33) were occupations associated with UIP. Metal dust and fumes and organic dust were risk factors for UIP. Increasing the length of occupational exposure in jobs at risk of pulmonary fibrosis, increased the risk of having UIP.ConclusionsThis case control study confirm partially the results from previous similar studies. Some discrepancies could be explained by the different geographical origins of the population under study, reflecting also different occupational exposures.
Highlights
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP)
While several key cellular and molecular events have been identified in the pathogenesis of IPF, such as ageassociated telomerase dysfunction [3], incidence of IPF has increased in the last years with regional differences suggesting the pathogenic role of various environmental and occupational exposures [4]
In similar studies made in America [6], Northern Europe [7] and Japan [8] occupational risk factors, including metal, stone and wood dust have been linked to higher risk of developing pulmonary fibrosis, but to date, the consistency of epidemiological evidence is suggestive but not sufficient to infer a causal relationship between several environmental exposure and IPF
Summary
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia of unknown cause associated with the histopathologic and/or radiologic pattern of usual interstitial pneumonia (UIP). Occupational risk factors have been proposed to be associated with UIP The aim of this case-control study is to evaluate the relationship between UIP pattern and occupational exposure in Southern Europe. Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease of unknown cause with a high risk of rapid progression and mortality, the median survival after diagnosis is approximately 2 years [1]. In similar studies made in America [6], Northern Europe [7] and Japan [8] occupational risk factors, including metal, stone and wood dust have been linked to higher risk of developing pulmonary fibrosis, but to date, the consistency of epidemiological evidence is suggestive but not sufficient to infer a causal relationship between several environmental exposure and IPF.
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