Free Paper Presentation : F-4 ; Occupational Dust Exposure and Idiopathic Pulmonary Fibrosis Prognosis: A Korean National Survey

Rationale: Previous studies have identified the occupational and environmental agents causing IPF. There have been few studies regarding the prognosis of IPF patients, according to patient occupation. Objective: We investigated whether occupational dust exposure was associated with clinically decreased lung function and poor prognoses. Design: The Korean ILD Research Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of IPF patients. A total of 1,311 IPF patients were stratified into 5 groups, according to their occupation: (1) unemployed or housewives (n=628); (2) farmers, fishers, or ranchers (n=230); (3) sales or service personnel (n=131); (4) clerical or professional personnel (n=151); (5) specific dust-exposed (wood, metal, sand, stone, diesel, chemical) workers (n=171). Results: The mean age of subjects, at diagnosis, was 67.5±9.7 years. With regard to smoking status, 456 patients had never smoked, 435 were ex-smokers, and 336 were current smokers. Dust-exposed workers showed early onset of IPF (61.3±8.6 years, p＜0.001) and a longer duration of symptoms at diagnosis (17.0±28.2 months, p=0.004). Aging (p＜0.001; hazard ratio [HR], 1.055; 95% confidence interval [CI], 1.028-1.082), forced vital capacity (% of predicted) at diagnosis (p=0.011; HR, 0.984; 95% CI, 0.971-0.996), and occupation (p=0.010) were associated with mortality. Conclusion: These findings indicate that occupational dust may be an aggravating factor associated with a poor IPF prognosis.Rationale: Previous studies have identified the occupational and environmental agents causing IPF. There have been few studies regarding the prognosis of IPF patients, according to patient occupation. Objective: We investigated whether occupational dust exposure was associated with clinically decreased lung function and poor prognoses. Design: The Korean ILD Research Group conducted a national survey to evaluate the clinical, physiological, radiological, and survival characteristics of IPF patients. A total of 1,311 IPF patients were stratified into 5 groups, according to their occupation: (1) unemployed or housewives (n=628); (2) farmers, fishers, or ranchers (n=230); (3) sales or service personnel (n=131); (4) clerical or professional personnel (n=151); (5) specific dust-exposed (wood, metal, sand, stone, diesel, chemical) workers (n=171). Results: The mean age of subjects, at diagnosis, was 67.5±9.7 years. With regard to smoking status, 456 patients had never smoked, 435 were ex-smokers, and 336 were current smokers. Dust-exposed workers showed early onset of IPF (61.3±8.6 years, p＜0.001) and a longer duration of symptoms at diagnosis (17.0±28.2 months, p=0.004). Aging (p＜0.001; hazard ratio [HR], 1.055; 95% confidence interval [CI], 1.028-1.082), forced vital capacity (% of predicted) at diagnosis (p=0.011; HR, 0.984; 95% CI, 0.971-0.996), and occupation (p=0.010) were associated with mortality. Conclusion: These findings indicate that occupational dust may be an aggravating factor associated with a poor IPF prognosis.