Occupational and Environmental Lung Diseases: Occupational and Environmental Lung Diseases |

Presentation of IPF and HP in an Avian Exposed Segment of Urban Population: Karachi Pulmonology Clinics Registry Data FREE TO VIEW

Mosavir Ansarie, MBBS; Aneeka Kasmani, MBBS; Asif Naseem, MBBS; Muhammad Azeemuddin, MBBS; Anum Fatima, BS
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Healthcare Hospital, Karachi, Pakistan

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A411. doi:10.1016/j.chest.2016.02.427
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SESSION TITLE: Occupational and Environmental Lung Diseases

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: In continuation of earlier presented data (Ansarie et al, CWC 2014 & ERS 2012) about the incidence of various ILDs in Karachi (estimated population 20 million), we observed a high proportion of IPF (Idiopathic Pulmonary Fibrosis) & HP (Hypersensitivity Pneumonitis) in its avian exposed population. Therefore we decided to investigate the profile of this stratified segment.

METHODS: A total of 361 ILD cases recorded during January 2008 to August 2015 were reevaluated on a case to case basis to confirm their HRCT findings and avian exposure history in IPF, sub-acute & chronic HP patients. SPSS version 20 was used to analyze the data from an ongoing web-based registry (www.ildpak.com) focusing 4 pulmonology clinics of Karachi city.

RESULTS: In a total of 66 avian exposed patients; 38 (57.6%) were IPF and 28 (42.4%) had HP. Out of 28 diagnosed HPs; 14 (50%) were of sub-acute nature and the rest had features of chronicity. The mean age in years of these patients was; IPF: 60.5 ±9.6 SD, Chronic HPs: 56.5 ±13.3 SD, and Sub-acute HPs: 46.8 ±13.6 SD. Out of 43 reporting females, 37 (86%) were housewives living in tall rise apartments infested by hordes of pigeon population with a 4 years median exposure. From these housewives; 22 (59.5%) were IPF & 15 (40.5%) HP. Out of 23 reporting males there was a preponderance of IPF 15 (65%) and 8 (35%) were HP. Interestingly 5 out of these 8 male HPs were bird breeders. Restrictive pulmonary functions: Mean FVC 55-59% predicted with FEV1/FVC ratio 85-90%. It was found that 7/28 (25%) HPs & 14/38 (36%) IPF also suffered from pulmonary hypertension.

CONCLUSIONS: The avian exposed segment of an urban population had significant incidence of HP & IPF mainly because of the domestic infestation by pigeons primarily affecting housewives.

CLINICAL IMPLICATIONS: This data suggests that chronic fibrosis is preventable in this population stratum with early diagnosis and sound advocacy for environmental control.

DISCLOSURE: The following authors have nothing to disclose: Mosavir Ansarie, Aneeka Kasmani, Asif Naseem, Muhammad Azeemuddin, Anum Fatima

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