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Original Research: Diffuse Lung Disease |

Association Between Occupational Dust Exposure and Prognosis of Idiopathic Pulmonary FibrosisOccupation and Idiopathic Pulmonary Fibrosis: A Korean National Survey

Sang Hoon Lee, MD; Dong Soon Kim, MD, PhD; Young Whan Kim, MD, PhD; Man Pyo Chung, MD, PhD; Soo Taek Uh, MD, PhD; Choon Sik Park, MD, PhD; Sung Hwan Jeong, MD, PhD; Yong Bum Park, MD; Hong Lyeol Lee, MD, PhD; Jeong Sup Song, MD, PhD; Jong Wook Shin, MD, PhD; Nam Soo Yoo, MD, PhD; Eun Joo Lee, MD, PhD; Jin Hwa Lee, MD, PhD; Yangin Jegal, MD; Hyun Kyung Lee, MD; Moo Suk Park, MD, PhD
Author and Funding Information

From the Division of Pulmonary Medicine, Department of Internal Medicine (Dr S. H. Lee), Yonsei University, College of Medicine, Yonsei University Health Service, Seoul; Division of Pulmonary and Critical Care Medicine (Dr D. S. Kim), University of Ulsan College of Medicine, Asan Medical Center, Seoul; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute (Dr Y. W. Kim), Seoul National University College of Medicine, Seoul; Division of Pulmonary and Critical Care Medicine (Dr Chung), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; Division of Allergy and Respiratory Medicine, Department of Internal Medicine (Dr Uh), Soonchunhyang University Seoul Hospital, Seoul; Division of Allergy and Respiratory Medicine, Department of Internal Medicine (Dr C. S. Park), Soonchunhyang University Bucheon Hospital, Bucheon; Division of Pulmonology, Department of Internal Medicine (Dr Jeong), Gachon University Gil Medical Center, Incheon; Division of Pulmonary, Allergy & Critical Care Medicine, Department of Internal Medicine (Dr Y. B. Park), Hallym University Kangdong Sacred Heart Hospital, Seoul; Pulmonary Division, Department of Internal Medicine (Dr H. L. Lee), Inha University Hospital, Incheon; Pulmonary Division, Department of Internal Medicine (Dr Song), St. Mary’s Hospital, Catholic University College of Medicine, Seoul; Division of Pulmonary Medicine, Department of Internal Medicine (Dr Shin), Chung Ang University College of Medicine, Seoul; Division of Pulmonary Medicine (Dr Yoo), National Medical Center, Seoul; Division of Respiratory and Critical Care Medicine, Department of Internal Medicine (Dr E. J. Lee), Korea University Anam Hospital, Korea University College of Medicine, Seoul; Department of Internal Medicine (Dr J. H. Lee), Ewha Womans University School of Medicine, Ewha Medical Research Institute, Seoul; Division of Pulmonary Medicine, Department of Internal Medicine (Dr Jegal), Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan; Division of Critical Care and Pulmonary Medicine, Department of Internal Medicine (Dr H. K. Lee), Inje University Busan Paik Hospital, Busan; and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine (Dr M. S. Park), Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

CORRESPONDENCE TO: Moo Suk Park, MD, PhD, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yonsei University College of Medicine, Yonsei University Health System, 250 Seongsan-ro, Seodaemun-gu, Seoul 120-752, South Korea; e-mail: pms70@yuhs.ac


FUNDING/SUPPORT: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;147(2):465-474. doi:10.1378/chest.14-0994
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BACKGROUND:  Previous studies have investigated the relationship between occupational and environmental agents and idiopathic pulmonary fibrosis (IPF). However, there have been few studies regarding the prognosis of patients with IPF according to patient occupation.

METHODS:  We investigated whether occupational dust exposure was associated with clinically decreased lung function and poor prognosis. The Korean Interstitial Lung Disease Research Group conducted a national survey to evaluate the clinical, physiologic, radiologic, and survival characteristics of patients with IPF. A total of 1,311 patients with IPF were stratified into five groups according to their occupation: (1) unemployed or homemakers (n = 628); (2) farmers, fishers, or ranchers (n = 230); (3) sales or service personnel (n = 131); (4) clerical or professional personnel (n = 151); and (5) specific dust-exposed workers (n = 171).

RESULTS:  The mean age of subjects at diagnosis, was 67.5 ± 9.7 years. Current smokers were 336 patients, 435 were exsmokers, and 456 were never smokers. Dust-exposed workers showed early onset of IPF (61.3 ± 8.6 years; P < .001) and a longer duration of symptoms at diagnosis (17.0 ± 28.2 months; P = .004). Aging (P = .001; hazard ratio [HR], 1.034; 95% CI, 1.014-1.054), FVC % predicted at diagnosis (P = .004; HR, 0.984; 95% CI, 0.974-0.995), and dust-exposure occupation (P = .033; HR, 1.813; 95% CI, 1.049-3.133) were associated with mortality.

CONCLUSIONS:  These findings indicate that occupational dust may be an aggravating factor associated with a poor prognosis in IPF.

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