Hypersensitivity pneumonitis in workers exposed to metalworking fluids

Barber, Christopher M.; Burton, Clare; Hendrick, D. J.; Pickering, Christopher; Robertson, Alastair; Robertson, Wendy; Burge, P. S.

doi:10.1002/ajim.22337

Cited by 25 publications

(9 citation statements)

References 27 publications

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“…The prevalence estimates derived from questionnaires were 3–6 times higher than the figures based on a questionnaire combined with the presence of specific IgG antibodies among farmers and pigeon breeders . A case definition based on the predictive value of symptoms and results of diagnostic procedures has been recently developed and may be useful for assessing workers with suspected OHP .…”

Section: Epidemiologymentioning

confidence: 96%

Occupational hypersensitivity pneumonitis: an EAACI position paper

Quirce

Vandenplas

Campo

et al. 2016

Allergy

154

109

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The aim of this document was to provide a critical review of the current knowledge on hypersensitivity pneumonitis caused by the occupational environment and to propose practical guidance for the diagnosis and management of this condition. Occupational hypersensitivity pneumonitis (OHP) is an immunologic lung disease resulting from lymphocytic and frequently granulomatous inflammation of the peripheral airways, alveoli, and surrounding interstitial tissue which develops as the result of a non-IgE-mediated allergic reaction to a variety of organic materials or low molecular weight agents that are present in the workplace. The offending agents can be classified into six broad categories that include bacteria, fungi, animal proteins, plant proteins, low molecular weight chemicals, and metals. The diagnosis of OHP requires a multidisciplinary approach and relies on a combination of diagnostic tests to ascertain the work relatedness of the disease. Both the clinical and the occupational history are keys to the diagnosis and often will lead to the initial suspicion. Diagnostic criteria adapted to OHP are proposed. The cornerstone of treatment is early removal from exposure to the eliciting antigen, although the disease may show an adverse outcome even after avoidance of exposure to the causal agent.

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Section: Epidemiologymentioning

confidence: 96%

Occupational hypersensitivity pneumonitis: an EAACI position paper

Quirce

Vandenplas

Campo

et al. 2016

Allergy

154

109

View full text Add to dashboard Cite

show abstract

“…We synthesized data from 15 relevant publications for HP, the earliest paper dating from 1983 (see Table 7). We excluded case series limited to a single avocation or occupation (e.g., bird fanciers or machinists) (162,163), if there were insufficient data to determine the proportion due to an occupational exposure (164), or if there were overlapping cases (165) that were included in another publication (166). The studies included (166)(167)(168)(169)(170)(171)(172)(173)(174)(175)(176)(177)(178)(179)(180) were all case series (or registries), except for one case-control design (167), but used variable criteria for diagnosing HP and assessing causation.…”

Section: Occupational Burden Of Hp (Extrinsic Allergic Alveolitis) Anmentioning

confidence: 99%

The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement

Blanc¹,

Annesi‐Maesano²,

Balmes³

et al. 2019

Am J Respir Crit Care Med

323

204

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Workplace inhalational hazards remain common worldwide, even though they are ameliorable. Previous American Thoracic Society documents have assessed the contribution of workplace exposures to asthma and chronic obstructive pulmonary disease on a population level, but not to other chronic respiratory diseases. The goal of this document is to report an in-depth literature review and data synthesis of the occupational contribution to the burden of the major nonmalignant respiratory diseases, including airway diseases; interstitial fibrosis; hypersensitivity pneumonitis; other noninfectious granulomatous lung diseases, including sarcoidosis; and selected respiratory infections. Methods: Relevant literature was identified for each respiratory condition. The occupational population attributable fraction (PAF) was estimated for those conditions for which there were sufficient population-based studies to allow pooled estimates. For the other conditions, the occupational burden of disease was estimated on the basis of attribution in case series, incidence rate ratios, or attributable fraction within an exposed group. Results: Workplace exposures contribute substantially to the burden of multiple chronic respiratory diseases, including asthma (PAF, 16%); chronic obstructive pulmonary disease (PAF, 14%); chronic bronchitis (PAF, 13%); idiopathic pulmonary fibrosis (PAF, 26%); hypersensitivity pneumonitis (occupational burden, 19%); other granulomatous diseases, including sarcoidosis (occupational burden, 30%); pulmonary alveolar proteinosis (occupational burden, 29%); tuberculosis (occupational burden, 2.3% in silica-exposed workers and 1% in healthcare workers); and community-acquired pneumonia in working-age adults (PAF, 10%). Conclusions: Workplace exposures contribute to the burden of disease across a range of nonmalignant lung conditions in adults (in addition to the 100% burden for the classic occupational pneumoconioses). This burden has important clinical, research, and policy implications. There is a pressing need to improve clinical recognition and public health awareness of the contribution of occupational factors across a range of nonmalignant respiratory diseases.

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“… 39 Based on the evidence base collected during a large UK outbreak, a case definition was proposed. 40 …”

Section: Exposuresmentioning

confidence: 99%

Chronic hypersensitivity pneumonitis

Pereira¹,

Gimenez²,

Kuranishi³

et al. 2016

JAA

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Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary.

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Hypersensitivity pneumonitis in workers exposed to metalworking fluids

Cited by 25 publications

References 27 publications

Occupational hypersensitivity pneumonitis: an EAACI position paper

Occupational hypersensitivity pneumonitis: an EAACI position paper

The Occupational Burden of Nonmalignant Respiratory Diseases. An Official American Thoracic Society and European Respiratory Society Statement

Chronic hypersensitivity pneumonitis

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