METHODS: The study population included all residents of Denmark born in 1956 or later with at least 1 year of gainful employment since 1976. Incident cases of hypersensitivity pneumonitis and other ILDs were identified in the Danish National Patient Register 1994-2015. Job exposure matrices were used to assign individual annual levels of exposure to organic dust, endotoxin and wood dust from 1976 to 2015. We analysed exposure-response relations by different exposure metrics using a discrete-time hazard model.
RESULTS: For organic dust, we observed increasing risk with increasing cumulative exposure with incidence rate ratios (IRR) per 10 unit-years of 1.19 (95% CI 1.12 to 1.27) for hypersensitivity pneumonitis and 1.04 (95% CI 1.02 to 1.06) for other ILDs. We found increasing risk with increasing cumulative endotoxin exposure for hypersensitivity pneumonitis and other ILDs with IRRs per 5000 endotoxin units/m3-years of 1.55 (95% CI 1.38 to 1.73) and 1.09 (95% CI 1.00 to 1.19), respectively. For both exposures, risk also increased with increasing duration of exposure and recent exposure. No increased risks were observed for wood dust exposure.
CONCLUSIONS: Exposure-response relations were observed between organic dust and endotoxin exposure and hypersensitivity pneumonitis and other ILDs, with lower risk estimates for the latter. The findings indicate that organic dust should be considered a possible cause of any ILD.
BACKGROUND: j.no.: 1-16-02-196-17.
方法:研究人群包括1956年出生或更晚出生的丹麦居民,自1976年以来至少有1年的有酬工作。在1994-2015年丹麦国家患者登记册中发现了过敏性肺炎和其他ILD的事件。使用工作暴露矩阵来分配个人的年度有机粉尘暴露水平,从1976年到2015年的内毒素和木材粉尘。我们使用离散时间风险模型通过不同的暴露指标分析了暴露-响应关系。
结果:对于有机粉尘,我们观察到,随着累积暴露量的增加,超敏反应性肺炎的发生率比(IRR)为每10单位年1.19(95%CI1.12~1.27),其他ILD的发生率为1.04(95%CI1.02~1.06).我们发现,随着累积内毒素暴露增加,过敏性肺炎和其他ILD的风险增加,每5000内毒素单位/m3-年的IRR为1.55(95%CI1.38至1.73)和1.09(95%CI1.00至1.19),分别。对于这两种暴露,风险也随着暴露时间和近期暴露时间的增加而增加。没有观察到木尘暴露的风险增加。
结论:观察到有机粉尘和内毒素暴露与过敏性肺炎和其他ILD之间的暴露-反应关系,对后者的风险估计较低。研究结果表明,有机粉尘应被视为任何ILD的可能原因。
背景:j.不。:1-16-02-196-17。